Robert Pear
The New York Times
12/25/2010
WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.
Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.
Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.
The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.
Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress. [Emphasis CAJ]
The article continues at The New York Times.
Update: Also at The New York Times, Obama Is Set to Shuffle His Staff.
President Obama is planning the first major reorganization of his administration, preparing to shuffle several positions in the West Wing as he tries to fortify his political team for the realities of divided government and his own re-election.
The president is studying how to maximize the power of the executive branch, advisers said, seeking insight from veterans of previous administrations and fresh advice from business leaders to guide the second half of his term. [Emphasis CAJ]…
…The White House is hiring more lawyers to handle oversight investigations from the new Congress, even as the president sets up a re-election headquarters in Chicago and considers ways to streamline operations inside the West Wing…
…Despite all his time studying the Clinton administration, Mr. Obama told his aides that he had no intention of following the precise path of Mr. Clinton, who after the Democratic midterm election defeats of 1994 ordered a clearing of the decks inside the White House, installed competing teams of advisers and employed a centrist policy of triangulation. In fact, several advisers confirmed, the word “triangulation” has been banned by Mr. Obama because he does not believe it accurately describes his approach. [Emphasis CAJ]
On Wednesday afternoon, even as lawmakers were approving a burst of Mr. Obama’s legislative priorities in the waning hours of the Congressional session, the president and a small circle of advisers convened to sketch out the next two months. Mr. Obama intends not only to extend a hand to Republicans but also to begin detaching himself more from Congress and spending more time making his case directly to the American people.
“In a world of divided government, getting things done requires a mix of compromise and confrontation,” said Dan Pfeiffer, the White House communications director. “What are the things you can do without Congress? In some cases, that involves executive orders, but it also involves using the bully pulpit of the presidency to make a political argument about the direction of the country.” [Emphasis CAJ]
H/T Instapundit
Update 2: Professor Jacobson at Legal Insurrection has some thoughts about this executive order. And Wordboss found this explanation of executive orders, just in case there are readers who aren’t sure what this is all about.
