There is reason to hope that a degree of sanity may be returning to the touchy issue of advance planning for medical care at the end of life. Just five years ago, Republican politicians, Sarah Palin prominent among them, were falsely charging that President Obama's health care reforms would create "death panels" that could cut off care for the critically ill to save money on health care costs.

Since then, that claim has been thoroughly debunked and Republicans have moved on to other attacks on the reform law. Now, with little fanfare, some private and public insurers have begun paying doctors to have end-of-life discussions with their patients.

That can only be helpful to consumers. Advance planning ensures that patients make decisions for themselves when they are of sound mind and that all family members are aware of a patient's wishes. It also gives doctors and nurses critical information about the kind of care desired.

As the New York Times reported last week, private insurers have begun covering "advance care planning" conversations as the number of aging Americans rises and many people want more input into how and where they will spend their final days (at home or in an institution) and what treatment they will receive, ranging from all-out efforts to sustain life to simple pain relief.

Private policies vary in how much they will pay for a planning session. Excellus Blue Cross Blue Shield of New York, for instance, reimburses doctors $150 for an hourlong conversation to help patients complete the state's advance directive form. Some states, including Colorado and Oregon, have begun covering end-of-life planning for poor people insured by Medicaid. Still to be heard from is Medicare, which covers some 50 million Americans. Clearly, the Centers for Medicare and Medicaid Services, which runs Medicare, should encourage doctors to make end-of-life planning sessions a routine service. By setting a reasonable reimbursement rate, Medicare can provide a good example for private insurers to follow.