Obamacare:Mandatory End-of-Life Counseling Provision or Simple Requirement to Pay the Counselor?

For nearly two weeks, the Obama health care plan has been mired in a controversy over supposed mandatory counseling requirements for seniors about end-of-life care.  Is it true?  Hard to tell when on page 424, the section in question begins:

(a) MEDICARE.—17 (1) IN GENERAL.—Section 61 of the Social18 Security Act (42 U.S.C. 1395x) is amended—(A) in subsection (s)(2)—(i) by striking ‘‘and’’ at the end of subparagraph (DD);  (ii) by adding ‘‘and’’ at the end of  subparagraph (EE); and  (iii) by adding at the end the following new subparagraph:  ‘‘(FF) advance care planning consultation (as2 defined in subsection (hhh)(1));’’; and (B) by adding at the end the following new subsection:  ‘‘Advance Care Planning Consultation

That’s gobbedlygook any way you look at it.

Today, the president finally said something coherent about the controversy, asserting that the section in question didn’t mandate counseling, but merely mandated that the providers of the counseling be paid by Medicare.  Perhaps, but you can’t tell that from the face of the legislation.

The one sure way to ensure that this brouhaha goes away is to amend the bill by adding the following provisions: State explicitly that the counseling is entirely voluntary–both for the patient and the medical provider. Another welcomed assurance would be an amendment stating that the patient will not lose benefits if he/she refuses counseling or does not sign an advance directive. Finally, to ensure that the “counseling” isn’t directed at persuading seniors to refuse care, add  a provision along the same lines of the Kennedy/Brownback bill passed last year to prevent genetic counselors of pregnant women carrying a Down baby from pushing the abortion option.

More analysis about this and other aspects of the Obamacare controversy over at Secondhand Smoke .