It took more than five years, but the outbreak of “death panel” hysteria — a national embarrassment fueled by former Alaska Gov. Sarah Palin — finally appears to be ending.
This week, the Obama administration again proposed expanding a compassionate, common-sense policy: having Medicare pay medical providers to advise patients on advance care planning. Medicare is the federal government’s health insurance program serving Americans age 65 and up.
It is eminently reasonable to have elderly people think through end-of-life planning with trusted medical providers before a medical crisis occurs and family members must make rushed, anguished decisions about what their loved ones would have wanted. Anyone who has watched an older parent or other relative decline intuitively understands this.
Paying a doctor or another provider for their time with patients ensures that informed planning takes place. It also gives providers an incentive to bring up a delicate topic and not feel as though they have to rush through it. Like it or not, health care is big business, and what’s billable or not from Medicare influences how medical professionals spend their time.
Medicare already allowed payment for this planning during a one-time “Welcome to Medicare” exam. What the proposed policy does is expand the opportunities to have this conversation.
As federal officials prepared to launch a similar policy in 2010 as part of the Affordable Care Act (ACA) rollout, some of the health care law’s opponents deliberately equated end-of-life care planning with end-of-life advocacy. Ill-informed critics cited the proposal as evidence of ACA “death panels” — that the federal government would weed out the old and infirm to save money. Palin was among the chief architects of the death panels lie.
Regrettably, the Obama administration abandoned the expanded payment policy in 2011 in a display of political cowardice — a decision this Editorial Board took issue with at the time.
The fact that officials have proposed it again suggests that the discussion about the health law has moved to a calmer place. That’s a welcome development. End-of-life care planning does not cede control of a patient’s last days to some far-off bureaucrat. Rather, it ensures that individual choices are known and honored.
It’s important to note that advance-care decisions are made by the patient, not the provider. Nor are the plans binding. Decisions can be revoked or altered by patients at any time.
Any political haymaking over this new policy, which is expected to begin in 2016 if adopted, is self-serving fearmongering. Patient choice and comfort should come first. This policy would ensure that happens.