I continue to scratch my head over the response of Obamacare supporters to the concern about Medicare “end of life” counseling sessions. Liberal Boston Globe columnist Ellen Goodman, for example, scorns the worry as a mere scare tactic mounted by ”wing nuts.” From her column:
This modest idea was willfully distorted by people such as Betsy McCaughey, the former lieutenant governor of New York, who said that the bill would “absolutely require’’ end-of-life counseling that “will tell them how to end their life sooner.’’ Republican leader John Boehner offered the same flawed product, saying, “This provision may start us down a treacherous path toward government-encouraged euthanasia.’’
The bill doesn’t really mandate anything. It simply assures that a talk about advance care planning will be covered for the patients and families who want it. As Obama told a woman at an AARP forum, “It strikes me that that’s a sensible thing to do.’’ But who would trust someone who offed his grandma?
Their views were also sold by right-wing franchise operators. Laura Ingraham warned that government bureaucrats would “come to an old person’s house’’ - yeah, house calls! - for scary death chats. Randall Terry, the Zelig of the pro-life movement, said this was an attempt to “kill Granny.’’ Panic is their most important product.
Only people like Goodman take anything “Elmer Gantry” Terry says seriously, perhaps because it permits them to demonize those with whom they disagree. But to the point: The fears about the counseling provision are reasonable.
- I have shown here at SHS how the default setting on the advance directive pushed by one notable bioethics think tank is to refuse care.
- I pointed out that the purpose of the sessions is to reduce costs, which means the hope at least, is that “grandma” will refuse treatment (which is fine with me so long as she isn’t pushed into that choice).
- And I pointed out how easy it would be to put this worry to bed by making it clear in the bill that the counseling is wholly voluntary for provider and patient, with no cuts in benefits or compensation for those who opt out.
But it is a funny thing: The bill was revised and that simple clarification wasn’t made. Nor does Goodman recommend this easy answer to the controversy. Like I said, I am scratching my head.
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