Wednesday, October 1, 2014

Congressmen want to revive end-of-life support

Thirty-four Democratic members of Congress,  including North Carolina's David Price,  recently wrote to the nation's top Medicare administrator urging her to adopt a plan that would reimburse doctors for time spent counseling patients about end-of-life care.

The letter to Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, notes that working with a doctor to create an advance directive ensures that the elderly will receive the type of care they want and reduces stress and depression among loved ones.

"We find it troubling that Medicare reimburses almost every medical procedure, yet places no value on the time doctors take to provide thoughtful counsel to prepare patients and families for the delicate,  complex and emotionally demanding decisions surrounding the end of life,"  says the letter,  composed by Rep. Earl Blumenauer of Oregon.

2009 Obamacare protest (Talking Points Memo)
Such reimbursements were part of an early version of the Affordable Care Act,  leading Sarah Palin to launch the stubbornly persistent idea that the president wants to create  "death panels" that would rule on whether the elderly are granted medical care.  I've always found that one of the more baffling twists to Obamacare politics; I don't know anyone who doesn't want some control over their final days.

The reimbursements were cut from the act that won approval,  but Blumenauer,  Price and others keep pushing to revive them.   The  "Personalize Your Care Act"  introduced by Blumenauer to provide Medicare and Medicaid reimbursement for voluntary end-of-life planning got 59 co-sponsors.  Among them are eight Republicans  (none from the Carolinas).  Price,  whose District 4 includes Raleigh, Durham, Chapel Hill and Fayetteville,  is among the sponsors,  as was Congressman Mel Watt of Charlotte,  a Democrat who later resigned to become director of the Federal Housing Finance Agency.  That bill was referred to the Ways and Means Subcommittee on Health,  joining the list of issues Congress hasn't acted on.

Last week's letter didn't include any Republican signers,  and Tavenner's office has not yet responded to a query about whether the letter will prompt any action.

Price said he thinks it's important to keep pushing.

“The American Medical Association, the Institute of Medicine, and a bipartisan group of lawmakers support Medicare coverage of voluntary end-of-life counseling, which is already covered by many private insurers and Medicare Advantage plans," he said Tuesday.  "I strongly agree with Congressman Blumenauer that Medicare should empower seniors to develop and adopt advance directives to protect their dignity in the final stages of life."