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Saturday, August 15, 2009

Republicans Support End-of-Life Counseling Legislation for Decades...

...until they decide they need a political ploy.

Hey, you know those end-of-life consultations that H.R. 3200 (Sec. 1233) would require Medicare to pay for? Did you know President George H.W. Bush signed a law in 1990 requiring health care facilities to offer such information?

To set the record straight, we checked in with Washington and Lee law professor Timothy Jost, an expert on consumer-driven health care. Jost told us that the bill allows Medicare to pay for voluntary consultations between doctors, nurse practitioners, and physician assistants about advance planning for the end of life. Medicare will pay for the service every five years, or more often if warranted by changes in a patient’s health. Consultations can cover such issues as hospice and palliative care, setting up a durable power of attorney, and advance directives which instruct medical providers about your wishes for end-of-life care. In my other writings, I have urged consumers to set these up, but according to Howard Brody, who directs the Institute for the Medical Humanities at the University of Texas, Galveston, only about one-quarter of Americans have done so.

“There is nothing new here,” Jost explained. The proposed legislation builds on the Patient Self-Determination Act of 1990, signed into law by George H.W. Bush. That law requires hospitals, nursing homes, hospices, and home health agencies to provide the same kind of information contemplated in the House bill. “Anyone who has been though the death of a parent knows the value of this service,” Jost said. “It is impossible to believe that this innocently got twisted into this ‘death panel’ legislation” [emphasis mine; Trudy Lieberman, "Straight Talk, Part I: The end-of-life myth and the real long-term care stories to be told," Columbia Journalism Review: Campaign Desk, 2009.08.13]

Did you know that Senator John C. Danforth, Republican sponsor of the Patient Self-Determination Act, said the law provided citizens "with information so that they can decide their own fate. . . . Let's let people have the dignity of deciding what they want and what they don't want"?

Did you know that Senator Sonny Isakson, Republican from Georgia, has been a long-time supporter of legislation promoting voluntary end-of-life consultation, just like H.R. 3200 Sec. 1233? Said the Senator Monday, "For the peace of mind of your children and your spouse as well as the comfort of knowing the government won't make these decisions, it's a very popular thing."

Did you know that just last year, "Congress overwhelmingly approved legislation requiring doctors to discuss issues like living wills and advance directives with new Medicare enrollees"?

Did you know end-of-life consultations were "basically a non-partisan issue" with support "across the political spectrum" until last week, when the Republican fear machine decided it couldn't muster enough rational arguments against the actual health coverage reform proposals before Congress and needed to make more stuff up?

One more quote:

[AARP policy VP John Rother] and Jon Keyserling, a vice president at the National Hospice and Palliative Care Organization, say there is little difference between the current proposal and past legislation that Republicans have supported. The current bill specifies that the counseling would be covered only every five years to prevent people from overusing it, and describes what the consultations must include [emphasis mine; Ben Evans, "GOP Backs Away from End-of-Life Counseling," AP via Yahoo News, 2009.08.14].

The outrage over "pulling the plug on Grandma" is a sham, hypocritical partisanship manufactured by Republicans to distract voters from practical solutions that Republicans themselves supported just weeks ago.

Update 14:25 CDT: Read more on how Sarah Palin and Newt Gingrich have both endorsed end-of-life consultations.


  1. What's troubling is how gullible and ignorant many are who have attended these town hall meetings, but much worse how willing politicians (in this case Republicans) have shown themselves to exploit falsehoods, half truths, and their knowledge these people would react, all for their own political purposes rather than what would benefit many lower-income people that have created most of the noise. Even if they disagree, decent, well-informed Republicans won't stoop this low.

  2. Case in point by anonymous poster "Fastidious".

    How many times must Obama repeat there are no "End of Life Panels" that would dictate how you end your life. It's a paid for, recommended consultation with your physician so you can decide what life-saving measures you wish to take, which yes, can also save many days of hospitalization and money, but most importantly keep you in step with your value system.

    I've been there with a family member with no living will, and we (mostly me actually) allowed him to suffer to the point I can't think of reliving because his wishes were not in writing.

  3. Huh?

    By our nature the executive branch enforces laws passed by the legislature. This is a house bill.

    Here are no "end of life panels" regardless of how many times you repeat it.

    You remind me of what Palin says about the media: "Quit making things up!", although it seems to suit you.

    How about putting your name to it. Or is that asking too much of an "educator" to do?

  4. [Thanks for the comments, John! My apologies for deleting the Anon to whom you were replying.]


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