According to a new Medicare policy, the government is preparing to pay doctors who advise patients on their end-of-life care options, including the possibility of forgoing aggressive life-sustaining treatment. The new policy is providing politicians and religious groups with a renewed opening into the old political debate about so-called “death panels.” Democrats had dropped the idea from the health-care-reform bill, but the Obama administration—citing, in part, the work of a University of Colorado doctor—will use a Medicare regulation to begin covering “voluntary advance care planning” as of January 1, according to The New York Times (free registration required). Patients can give an advance directive on how aggressively they wish to be treated if they are so ill they cannot decide about their care for themselves.
The administration references research by Dr. Stacy M. Fischer, an assistant professor at CU’s School of Medicine, who concludes that “end-of-life discussions between doctor and patient help ensure that one gets the care one wants,” while protecting “patient autonomy.” Rick Ungar at Forbes writes that end-of-life care can be expensive and may produce little benefit, possibly leaving patients to receive care they may not have wanted, as their families struggle with what to do. But Ungar argues the common-sense idea will again become political, just as it did when conservatives, such as Sarah Palin, first opposed the idea.
The Denver Post notes that the nonprofit Colorado Trust will enter the fray, providing information about health insurance, including “death panels.” The trust has launched a three-year effort aiming to educate residents about the health care system and eliminate confusion over reform efforts. Scott Downes, the trust’s senior project director, says, “Some groups will work specifically to dispel some of the misinformation that has been spread in some of the more partisan forums. But this is a broader effort than just talking about the federal reform.”