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Author Topic: End of Life Counseling Read on, This was posted on defendyourhealthcare  (Read 1450 times)
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« on: August 01, 2009, 09:47:41 PM »

End of Life Counseling
There have been flawed criticisms of my reading of a section of H.R. 3200. The critics have hastily read page 425 of the HR 3200, rather than reading the full relevant text (425?443) or considering the reality of being a frail elderly patient. Here are the four facts she omitted:
The counseling includes not only living wills and durable powers of attorney, but specific methods to end life. On page 430, the bill prescribes counseling on whether or not to forego nutrition, hydration, and antibiotics, in states where such counseling is permitted.
There is an inherent conflict of interest in this counseling. Medicare funding is going to be cut 10% over the next decade ($500 billion in cuts) to pay for the health reform legislation, at the same tine that Medicare enrollment is projected to increase 30%. More people to care for and fewer dollars will necessitate rationing. It is understandable that the government wants to curtail spending on end of life care. But the use of specific “patient decision aids” (p.443) discussed in the legislation such as scripts, videos, and brochures is problematic. If United Healthcare provided end of life counseling with a script prepared by the insurance company, there would be up uproar over the obvious conflict of interest.
The author of “Pants on Fire” should read on to pages 443 to see that patients will participate in “shared decision making.” Shared with whom? The government certified counselors. No where is it stated that the patient unilaterally has the final say. The bill merely says the patient’s views will be “incorporated” into the decision making.
The author ignores how unlikely it is that elderly patients will instruct a doctor or other authority figure who offers end of life counseling to stop the presentation
In summary, the Truth?O?Meter should turn its attention to the man with his pants on fire, the President, who makes the false statement daily that if you like your health insurance you can keep it. Pages 15?17 of H.R. 3200 make it clear that is untrue.
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