After the preceding two posts on misinformation being spread by the right with regards to health care reform we have a real whopper from Sarah Palin:
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.
The creation of a “death panel” is totally untrue. Steve Benen notes the irony in Sarah Palin making up a claim such as this after all her demands that journalists “quit making things up” about her. He also quotes Karen Tumulty:
Yes, such a system would indeed be downright evil. Which is why no one is proposing anything like it. Let’s repeat: No one is proposing anything like it.
There is a lot of similar disinformation being spread by the right by distorting items which are in the proposed bills. This includes scare tactics about end-of-life counseling sessions. PolitiFact sets them straight:
According to the bill, “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.”
Medicare will cover one session every five years, the legislation states. If a patient becomes very ill in the interim, Medicare will cover additional sessions.
Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, said the bill doesn’t encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration.
“These are very serious conversations,” he said. “It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families.”
In no way would these sessions be designed to encourage patients to end their lives, said Jim Dau, national spokeman for AARP, a group that represents people over 50 that has lobbied in support of the advanced planning provision.
McCaughey’s comments are “not just wrong, they are cruel,” said Dau. “We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that’s their call. Others will decide it’s not worth going through this trauma just for themselves and their families, and that’s their decision, too.”
Both Keyserling and Dau were particularly troubled that McCaughey insisted — three times, to be exact — that the sessions would be mandatory, which they are not.
For his part, Keyserling said he and outside counsel read the language carefully to make sure that was not the case.
“Neither of us can come to the conclusion that it’s mandatory.” he said. “This new consultation is just like all in Medicare: it’s voluntary.”
“The only thing mandatory is that Medicare will have to pay for the counseling,” said Dau.
Factcheck.org has also debunked conservative claims that the proposed bill will include forced euthanasia. Here is a small portion:
The accepted definition of end-of-life planning means thinking ahead about the care you would like to receive at the end of your life – which may include the choice to reject extraordinary measures of life support, or the choice to embrace them. For instance, the National Library of Medicine describes end-of-life services as “services [that] are available to help patients and their families deal with issues surrounding death.” This can include making decisions about treatment, designating a health care proxy, choosing a hospice program and putting together a living will, all of which the bill mentions explicitly as being part of an advance care planning consultation. In a 2003 study, the Agency for Healthcare Research and Quality found that “[p]atients who talked with their families or physicians about their preferences for end-of-life care had less fear and anxiety, felt they had more ability to influence and direct their medical care, believed that their physicians had a better understanding of their wishes, and indicated a greater understanding and comfort level than they had before the discussion.”
Furthermore, the bill would not make these sessions mandatory. It modifies section 1861(s)(2) of the Social Security Act, defining what services Medicare will pay for – if these definitions made treatments mandatory, seniors would all be required to get artificial legs and midwife services, too. In other words, this section of H.R. 3200 would require Medicare to pay doctors when they counsel their patients about such things as living wills, but no more frequently than once every five years, unless there’s a significant change in health status. “Both myself and our outside counsel have reviewed section 1233 of the House bill, and neither one of us can reach the conclusion that it is a mandatory consultation for Medicare and Medicaid beneficiaries,” Jon Keyserling, vice president of public policy at the National Hospice and Palliative Care Organization, told us. “The opportunity for the consultation is not only voluntary but patient-initiated.”
“As I understand it, the intent of the provision is to have patients be provided an opportunity to discuss with their own health care professional, probably the one they have been seeing for the past many years, what their treatment wishes might be as they approach the end of life,” said Keyserling, who stressed that consultations like this are treatment-neutral. Comparing this to forced euthanasia is like saying that a bill making retirement planning easier would force Americans to quit their jobs.
I can attest to the value to patients of open discussion of end of life issues. This comes both from experience with my patients and now to an even greater degree after seeing how my father handled this situation, having decided to discontinue life support eight days ago.
