ObamaCare Death Panels?

I was reading in the New York Times today an article entitled “Obama to Enact End-of-Life Plan that Caused Stir.”  Do you remember when ObamaCare (rather, the Patient Protection and Affordable Care Act) was being debated, and there was this big kerfuffle about “death panels”?  The reason that this particular provision was being shouted down was that it was the largest example of government having control over a person’s healthcare.  The provision was stripped from the final bill.

It seems now that the Obama administration is now implementing that provision (at the urging of Representative Earl Blumenauer of Oregon (how cool is that name?  By the way… he’s also known for his bow ties) by regulation.  End-of-life planning will be covered as a Medicare wellness benefit beginning on January 1.  Doctors will be paid by Medicare to provide the benefit at wellness visits each year.

After learning about the decision by the administration, Rep. Blumenauer’s office sent an email to staff urging them not to talk about it:

Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.

Here’s a discussion of the new regulation on Fox News, including a clip from President Obama in August 2009:

Here’s a video on the new regulation on “Parker/Spitzer” on CNN:

Is this regulation a big deal?  Or are we just trying to help our seniors plan for the end of their life?

  • Broc

    Sarah Palin’s stupidity has struck again, if Republicans know who to do one thing well, it is scare people into backing them. I mean the power of something called “Death Panels.” If the common name was “Life Transition Session” or “Transitional Education Counseling” I don’t think some people would be in such an uproar because there would not be the same level of misinformation being put out. But with a name like DEATH PANELS, and people just straight making stuff up, rumors catch like wild fire.

    I’ll pull some quotes from the story to below.
    http://www.factcheck.org/2009/08/palin-vs-obama-death-panels/

    “Like many disagreements in the digital age, it all started with a post on Facebook. Last Friday, former Alaska Gov. Sarah Palin posted a note to her Facebook page and introduced a new term to the health care debate:”
    Palin, Aug. 7: The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care.”
    Keep in mind nothing about the statement above is true of the regulation in question.

    Factcheck.org:
    “The fact remains that the bill wouldn’t require patients to receive counseling sessions, nor would it require a doctor to offer one. Rather, it modifies Section 1861(s)2 of the Social Security Act, defining what services Medicare will pay for. So if a patient receives a counseling session from a doctor or health care practitioner, he or she doesn’t have to pay for it – Medicare will.”

    Now if the question is SHOULD Medicare cover (pay doctors for) these sessions, that debate would be fine to have as long as the conversation is seated in fact. The Budget is all out of wack and maybe now isn’t the best time to expand spending in this area. I am a big on balancing the budget and lowering the deficit, but to play my own devil advocate the number of seniors (baby boomers) is growing year by year and establishing a responsible end of life plan is really important to families and loved ones who may need to make those decisions, if these topics are not talked about. Hopefully just the media coverage this story provides will get the message out for people to talk about this issue.

    P.S. Glad to see the Parker/Spitzer clip, have you started to watch the show?

    • Bob

      I do enjoy Parker/Spitzer, but I can’t watch the entire show, because I don’t have cable… I only see the best-of clips that are posted on the web.

      I wouldn’t call this controversy stupidity… there’s a legitimate debate to be had here. People that come from the philosophy that government should not interfere with people’s freedom and liberty to choose their own healthcare (or in innumerable other areas) believe that the government shouldn’t be involved in deciding when a person gets care and when a person doesn’t get care.

      This particular regulation doesn’t REQUIRE that they plan when they’ll end their life, but the government is paying doctors to have this conversation with people. There’s a fine line between that and paying doctors more to encourage them to decide one thing over another.

      Also, since when is it a good thing that the executive branch implements something that the legislative branch specifically removed from a piece of legislation? I think that’s a larger issue than the issue of the actual language of the regulation. The President is circumventing the power of the legislature.

  • Broc

    …Legitimate Debate… If you are one of those people that think government should not be evolved with people’s healthcare choice in anyway, I would be glad to have that debate about OBAMACARE. However, this specific topic (“Death Panels”) has nothing to do with “the philosophy that government should not interfere with people’s freedom and liberty to choose their own healthcare” The policy in question has no connection to that broad debate about Obamacare has a whole.

    “The bill wouldn’t require patients to receive counseling sessions, nor would it require a doctor to offer one. Rather, it modifies Section 1861(s)2 of the Social Security Act, defining what services Medicare will pay for. So if a patient receives a counseling session from a doctor or health care practitioner, he or she doesn’t have to pay for it – Medicare will.”

    “…the government is paying doctors to have this conversation with people….” Medicare is not dictating decisions or laying out mandates with this regulation, it would pay for an OPTIONAL “Advance Care Planning Consultation” instead of the patient paying for it. So if a patient chooses to have the consultation the cost incurred would be covered by Medicare. To say the government is paying doctors to have this conversation with people is a bit misleading, sounds more persuasive, but a bit misleading.

    “…executive branch implements something that the legislative branch specifically removed…” I completely agree for a few reasons. One, it is totally hypocritical to rail on how DADT should be repealed through legislation. NOT courts or executive order, but through congress and then go and do the exact OPPOSITE on this issue. Secondly, it looks lazy to me. If Obama stands by this issue then go out, campaign it, have a public debate, get some support and do it. In my opinion, that’s the RIGHT way. Debunk the myths and rhetoric; get your message out there. To do it this way was a poor decision.

    • Bob

      I agree with you on each thing that you outline.

      Having “death panels” is a legitimate debate, too. But I think that you and I would agree that this particular regulation that’s being implemented does not constitute “death panels.” A “death panel” is a government board that decides whether or not a certain procedure is too expensive to be covered by government healthcare. That, I think you would agree, is a level of government intrusion that’s not good.

      This “Advance Care Planning Consultation” (the end-of-life consultation) is not a “death panel.” I agree with you on that. However, there is reason for concern and caution here. The government is paying for doctors to have this planning consultation with elderly people. What’s to say that they won’t, in the future, be paid for certain outcomes of that conversation (or be given other incentives for certain outcomes)? For instance, if the result of the consultation is that the elderly person issues a DNR for certain circumstances, will the doctor be paid more because they’re saving the system money? The decision is still technically the person’s own decision, but the doctor is being paid more for a certain outcome.

  • Broc

    Regarding “Death Panels”….There are death panels right now all over America and the world. All insurance companies have these “death panels”, although I am sure that insurance companies do not call them “death panels”…lol…that would be bad for business. But insurance companies have cost/benefit analysis all the time and I don’t hear the public outcry against those. Whether it is because it’s too expensive or not a high enough chance of success, insurance companies refuse payment for medical procedures all the time. Death Panels do exist, just not in the government sector. However that is off topic so I apologize for the rant.

    A slippery slope argument huh, ok… I agree that the outcome of a consultation should never lead to compensation, EVER. First of all, because I believe that payments like that would be completely unethical. Secondly, if doctors are paid for certain outcomes, even completely legit decisions by patients become suspect because of the payment. However let’s be clear, this regulation DOES NOT do that. This regulation DOES NOT pay doctors for outcomes or decisions, this regulation pays for cost of the “Advance Care Planning Consultation”

    • Bob

      Yes, insurance companies now offer different coverage, and in that sense they are “death panels.” However, people are free to choose the coverage (or their employer chooses their coverage). But this does not discourage innovation in medicine; people are free to go out and get greater coverage if they want to; it’s available. If one insurance company doesn’t cover a certain procedure, it’s likely that another one does. If they don’t like the insurance that their employer provides, they can go out and buy other insurance. That’s the problem with a single-payer or government-sponsored healthcare system: if there’s only one entity deciding what procedures are covered, there’s no choice for Americans, and people’s freedom and liberty is abridged. And when the one entity is deciding which procedures are covered and which ones are not, it stifles innovation (because if your procedure isn’t covered by the government healthcare, then it’s available to no one).

  • Broc

    “…That’s the problem with a single-payer or government-sponsored healthcare system: if there’s only one entity deciding what procedures are covered, there’s no choice for Americans….”

    Well it’s a good thing then that Obamacare is NOT a single payer system.

    Also, while in theory everyone has choice for whatever health coverage and procedure options they want, free market and all that. Reality is the cost of health insurance and some on those “Gold” PPO plans stops many people from having them. However I feel we getting further away from the issue at hand here.

    So while true Universal Healthcare (100% government sponsored healthcare for all) is not the answer, our system is not the greatest either. Remember the reason why there was a big Healthcare reform push was because so many people viewed the system as not working the way it should. I.E. Booting people off there coverage when they got sick (too expensive), barring people with pre-existing conditions, healthcare cost limits. Again this is a more general Obamacare debate issue not related to the regulation in question here.

  • Broc

    So, can we agree that this regulation is an option to try and help our seniors plan for end of life; and while it was achieved through the wrong means (not through legislation), and it implementation may be untimely or debatable (due to budget/deficit issues), it is in NO WAY a “death panel.” Also with that being said, there are still more broad overarching issues with Obamacare that should be discussed and debated.

    • Bob

      I can get on board with you on that statement (very well-put, by the way).

  • Broc

    Now if we can come to a resolution like this… in a day… via blog… what is wrong with Washington DC? LOL!

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