Monday, December 27, 2010


The cover-up sent out in the email referenced below is scary..."The longer this goes unnoticed, the better our chances of keeping it.

I'm NOT surprised at the regulation-writing, as I've stated previously this is a serious problem that allows the large bureaucracies to implement things without any congressional approval.  What is stunning to me is that The New York Times published this.  But on the other hand, I'm sure they have been sitting on it and decided to publish this on Christmas day when they thought no one would be paying attention. Even though the headline greatly under describes the "stir" that occurred over this issue, the first sentence is a little more accurate in stating it as a "political storm," and the sixth paragraph is getting even closer describing that the Democrats "fear provoking another furor like the one in 2009."

Although this is not the same as the "death panels" as referred to in the original bill, it now encourages doctors to have an end-of-life conversation with all Medicare recipients on every routine yearly check-up. Oh wow, don't you look forward to that bit of stimulative conversation once a year!

Published: December 25, 2010 by THE NEW YORK TIMES

Obama Returns to End-of-Life Plan That Caused Stir
WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.

Several Democratic members of Congress, led by Representative Earl Blumenauer of Oregon and Senator John D. Rockefeller IV of West Virginia, had urged the administration to cover end-of-life planning as a service offered under the Medicare wellness benefit. A national organization of hopice providers made the same recommendation.

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans successfully argued that "end-of-life counseling" in the Democrats’ bill  would allow the government to cut off care for the critically ill. Section 1233 of the bill passed by the House in November 2009 — but was not included in the final legislation — allowed Medicare to pay for consultations about advance care planning every five years.

Rep. Blumenauer (D - OR), the author of the original end-of-life proposal, praised the rule as “a step in the right direction.”

“It will give people more control over the care they receive,” Mr. Blumenauer said in an interview. “It means that doctors and patients can have these conversations in the normal course of business, as part of our health care routine, not as something put off until we are forced to do it.”

After learning of the administration’s decision, Mr. Blumenauer’s office celebrated “a quiet victory,” but urged supporters not to crow about it.

“While we are very happy with the result, we won’t be shouting it from the rooftops,” Mr. Blumenauer’s office said in an e-mail in early November to people working with him on the issue. Moreover, the e-mail said: “We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded.”
Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.

The administration said research had shown the value of end-of-life planning.
“Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives,” the administration said in the preamble to the Medicare regulation, quoting research published this year in the British Medical Journal.

Opponents say the Obama administration is bringing back a procedure that could be used to justify the premature withdrawal of life-sustaining treatment from people with severe illnesses and disabilities.

Elizabeth D. Wickham, executive director of LifeTree, which describes itself as “a pro-life Christian educational ministry,” said she was concerned that end-of-life counseling would encourage patients to forgo or curtail care, thus hastening death.

“The infamous Section 1233 is still alive and kicking,” Ms. Wickham said. “Patients will lose the ability to control treatments at the end of life.”

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