The truth about end-of-life counseling
Jeffrey A. Singer
Reason Magazine
1/5/2011
Over the Christmas holiday weekend, The New York Times revealed that the Obama administration’s Medicare regulators have enacted new regulatory guidelines, in complete defiance of Congress, that will result in health care providers receiving payment to give annual “end-of-life counseling” to their patients.
As a physician, I can tell you that we doctors do routinely have end-of-life discussions with our patients. This is a necessary part of our job. But we do it when it is appropriate and indicated by the clinical situation. And we have never expected payment for this. It is part and parcel of the practice of medicine.
Medicare, however, will now incentivize health care providers to have this discussion annually, as part of an annual physical exam. Providers will get paid extra if they have this conversation. But consider the implications: When discussing such matters with an otherwise healthy and possibly youngish senior, the “directives” that health care providers will elicit may be significantly different from what they would have been if the patient was actually confronting a life and death situation. One’s directives are often quite different when talking about a theoretical future versus a real situation occurring in the present. After all, the future might offer technological advances that are not available at the time of the theoretical discussion, thus making a patient reach a very different decision when that future reality arrives.
The article continues at Reason.com
Update: At Althouse, The Obama administration gets cold feet on death panels.
Is it wrong to use the inflammatory rhetorical term “death panels”? It sure gets results!
