Advance planning for end-of-life care is far too sensitive and complex an endeavor for a “one-and-done” policy approach. That’s why a bipartisan bill that would expand Medicare enrollees’ ability to make care preferences known and fine tune their choices at a crucial time should be moving at a brisk clip through Congress instead of languishing.
The bill, known as the Care Planning Act of 2015, has been introduced by Sen. Mark Warner, D-Va. Democratic Sens. Amy Klobuchar of Minnesota and Tammy Baldwin of Wisconsin are among the bill’s influential five early cosponsors, along with Republican Sens. Johnny Isakson of Georgia, Susan Collins of Maine and Shelley Moore Capito of West Virginia.
Warner introduced the bill last summer, shortly before Medicare announced a compassionate new end-of-life planning policy change, a reform supported by the Star Tribune Editorial Board. Medicare is the federal government’s popular health insurance program for those 65 and older. Beginning in 2016, it will reimburse doctors who advise Medicare enrollees who wish to decide how they will be cared for in their dying days. Previously, this voluntary service had only been billable during a new enrollee’s exam.
Warner’s bill goes a step further to better serve Medicare enrollees. The legislation laudably reflects that end-of-life planning is a dynamic process, especially when a diagnosis of a serious illness changes the theoretical to a reality. As patients adjust, it’s understandable that many will want to update end-of-life plans. Those without a plan may wish to put a plan in place.
The Care Planning Act is a thoughtful measure to meet this need. “It creates a Medicare benefit for patient-centered care planning for people with serious illness. It will reimburse a team of health care professionals for providing a voluntary, structured discussion about the patient’s goals, illness and treatment options,’’ according to information from Warner’s office.
It’s important to emphasize — after years of false “death panel” attacks on end-of-life planning — that the service is voluntary. Warner’s bill also merits praise for its team approach. Having a variety of medical care professionals involved will give patients the most complete information about their options. Having the entire care team aware of those preferences will help ensure that these choices are respected in a fragmented care system.
The bill includes admirable steps to measure outcomes — health care jargon for determining whether the program is meeting its intended goal of reflecting a patient’s choices in the treatment that is delivered. In addition, the bill would provide grants to increase public awareness of new end-of-life care planning options and the value of making decisions in advance.
The bill’s bipartisan backing is a welcome advance, as well. For more than five years, toxic politics inspired by the death panel drivel regrettably made policymakers leery of reforms to add dignity and choice to final days. Medicare took over five years to make its recent end-of-life planning policy change. Congress should move much more quickly to make the compassionate Care Planning Act a reality.