The Right Prescription

Recent Media Coverage of the End of Life Counseling Provisions

A response from the chairman and founder of the Committee to Reduce Infection Deaths.

By 8.17.09

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Instead of trying to discredit me, the focus should be on the facts about the proposed health legislation. The House bill (H.R.3200) is dangerous to the elderly, as many are beginning to realize. Here is what you need to know:

Partisans for the legislation claim that it simply aims to provide Medicare coverage for once-every-five-year conversations with doctors over end of life care. Wrong. The new "benefit" is inserted in legislation with the express purpose of controlling health care costs (page 1). The bill lists what must be covered in the consultation (pages 425-30). Worse still, the legislation states that the Medicare system will rate your doctor's "quality" and (and adjust reimbursement) based on the percentage of your doctor's patients who create living wills and adhere to them.

The "adhere to" part is especially dangerous. Some people say "they'd never want to be on a ventilator," but when the time comes, they choose it over death. Sick patients sometimes become depressed and ready to give up on life, but a day later regain their will to live. Doctors will incur penalties when families don't adhere to end of life plans -- a horrible conflict of interest. As a patient advocate, I see these difficult situations and know that government should not be involved.

The President and his supporters claim that the provision is "voluntary." The bill does not have to use the word mandatory to make the counseling mandatory. In fact, the word mandatory is seldom used in any legislation. But if there is a penalty for noncompliance, it is mandatory. In this case the penalty is on your doctor.

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About the Author
Betsy McCaugheyis a senior fellow at the London Center for Policy Analysis and author of Beating Obamacare 2014.