“Significant safeguards would need to be incorporated in any governmental program promoting… advance care planning in order for [it] to be truly protective of the values and intent of patients, and to ensure they are not pressured into rejecting treatment against their wishes…all in the name of cost-savings.”
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It’s a policy change supported by Republican presidential candidate Jeb Bush.
The American Medical Association, which has strongly backed expanding end-of-life discussions, applauded the proposal. “No one can determine, until faced with the specific health care scenario, the risks and benefits of any treatment, especially the proportionate benefit of antibiotics and hydration and nutrition, years, or even weeks before that dilemma is encountered”.
Without advance care planning, patients end up living a version of the scenario that the death panel rhetoric made so fearsome: giving over decisions about their last moments of life to another party.
A provision of the mammouth health care reform bill that did not make it into the final law signed by President Obama in 2010 is being resurrected as a proposed rule by the Centers for Medicare and Medicaid Services.
Health officials said they chose hip and knee replacements because they are the most commonly performed Medicare inpatient surgeries and are expected to continue to grow as the population ages.
Stuart Butler, a senior fellow in economic studies at the Brookings Institution, a think tank based in Washington, wrote that plenty of doctors do not treat enough elderly patients to feel the financial burden associated with freeing up time for these discussions.
This new policy, announced Wednesday, comes at a time when patients, families and health providers are placing greater emphasis on allowing people to choose the way they die – whether that means trying every possible medical option to stay alive or discontinuing life support for those who do not want to be sustained by ventilators and feeding tubes.
The Obama administration’s new rules will reimburse doctors for having an end-of-life care consultation with Medicare patients – a conversation in which a doctor would tell a patient about his or her options.
Also in the proposal, the Medicare and Medicaid administrator outlined plans to publish data on physician performance through a Physician’s Compare tool, similar to the agency’s Hospital Compare database on hospital ratings.
Palin is bringing back her death panels claim, however, writing that the “ultimate fix” for Obamacare is rationed care.
Six years after the proposal asking Medicare to offer end-of-life counselling reimbursements caused massive uproar among lawmakers, the federal program has finally accepted the proposal. In 2013, there were more than 400,000 inpatient procedures, costing Medicare more than $7 billion for the hospitalizations alone. Those hospitals and doctors, home health agencies and nursing facilities involved in caring for patients undergoing the surgeries would receive a “bundled payment” for their treatment as opposed to being paid for individual services. “Beginning Medicare is one of those times, since it can be a point of awareness and reflection”.
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Supporters of this step by Medicare are saying that counseling would provide patients with more control and also free their families from the process of making tortuous decisions.
