Death panels sneak in under the radar as a Medicare regulation

tea party activist

A Medicare rule paying doctors to give advice on end-of-life care has conservatives shouting about death panels once again. Image: CC Andrew Aliferis/Flickr

“Death panels” was the cry right wing protesters used in an attempt to shout down health care reform. The phrase “death panels” refers to a proposal for funding end-of-life counseling. Advice for end-of-life care was dropped from the health care bill, but the Obama administration included it in new Medicare regulations  announced Monday.

Advice for end-of-life care covered by Medicare

Republicans and Tea Party activists played the death panels card when legislation was proposed allowing Medicare to pay for “advance care planning.” Opponents of health care reform spread the lie that Democrats wanted the government to decide who would qualify for medical care as they neared the end of their lives. Advance care planning didn’t make it into the Affordable Care Act, but it will be part of new Medicare rules in effect Jan. 1. The new policy will pay doctors to advise patients about their options for end-of-life care during an “annual wellness visit” that is part of the health care law. Those options include how to prepare a written “advance directive” about how patients want to be treated if they can’t decide for themselves.

Death panel myths versus reality

Conservatives are saying that the new Medicare rule will force patients to relinquish their ability to control end-of-life care. According to them, advice on end-of-life care is an effort to cut health care costs that will inevitably lead to death panels. The idea of a written advance directive resulting from a conference with a physician reimbursed by Medicare promotes a government agenda for health care rationing. The new Medicare provision does the exact opposite. It gives patients more control. Plus, physicians have always been opposed to government rules limiting health care.

What’s all the fuss about?

Amid all the death panels shouting, the Obama administration says the new Medicare rule for advance care planning is nothing new. An administration spokesman said the regulation continues policies enacted under George W. Bush. In 2003 Medicare started paying for a consultation visit to seniors starting out on Medicare. In 2008, a law was enacted allowing end-of-life planning as part of that consultation. The new Medicare rule simply states that advance care planning is allowed in the government funded annual wellness visit specified in the health care overhaul.



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