The New York Times reports that the administration has brought back the end-of-life planning provision that triggered last year's "death panel" debate. The measure allowed doctors to be paid for providing voluntary counseling to patients about deciding what kind of life-sustaining treatment they'd want if they were no longer in a condition to make decisions about their own care. As I wrote at that time, this is the reality of what happens when government is involved in medical care -- suddenly the state gains an interest in individual decisions. And given that government at all levels is spending $1.1 trillion a year on health care, roughly half of which is federal Medicare spending, decisions about what they decide to pay and not pay for is going to have a major impact on medical care.
The Democrats' dropped this provision in the Senate Finance Committee last summer because the "death panel" talk was generating too much negative attention to the then fledgling bill. But now, it's back -- and not surprisingly, it was revived by none other that Donald Berwick, the Medicare administrator who if you recall, was recess-appointed, because his self-professed love of Britain's health care system and fondness for rationing made him unconfirmable. So though it isn't a surprise, this news is it's another example of how the Obama administration plans to achieve through regulation what it could not pass through legislation.
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