What is wrong with end-of-life counseling in healthcare reform?

I was on a radio interview yesterday, where the interviewer asked, “So, what’s wrong with end-of-life counseling? I mean, isn’t it considered quality medicine for doctors to discuss these issues with their patients?

More Information:Absolutely it’s good medicine, I told the show host. And, it is a form of counseling that is already reimbursed by every major insurance company, including Medicare.

As a physician, I can counsel my patients on medical issues and decision making, and charge an office visit. If the counseling makes up more than 50% of our face-to-face time, I can charge for the time.

But, my friend, Carrie Gordon Earll, who is Focus on the Family Action’s senior director of issue analysis and a senior policy analyst for bioethics, shares why we each should be concerned about this provision in this particular bill (HR3200):

The end-of-life counseling provisions in the House version of the proposed health-care reform bill reportedly have been dropped by a Senate committee. What’s the significance of that?

“Sen. Charles Grassley of Iowa, who is the ranking Republican on the Senate Finance Committee, issued a news release Thursday saying the committee’s version of health-care reform would not include this controversial component.

“The announcement comes after Senator Grassley spent Wednesday listening to constituents at four town-hall meetings in central Iowa, all of which reportedly had to be moved to larger quarters to accommodate the crowds. His constituents raised concerns about this and other provisions.

“The next day, the senator announced the provisions would be off the table.  Is this a coincidence?  I don’t think so.  I think in this case, public outcry to the right elected official paid off.”

What’s the problem with end-of-life counseling?

“The idea of discussing your end-of-life wishes with your doctor and family when faced with a terminal diagnosis is a good one. However, the end-of-life counseling section raises several red flags.

  • “First, a primary goal of this health-care reform bill is to cut costs and reduce health-care spending. Studies indicate that patients who discuss end-of-life options with their doctors tend to receive fewer medical interventions. While that may be an appropriate decision in some cases, when a bill promotes reduced costs at the same time it pays doctors to potentially encourage less care, that’s a problem and puts human life at risk.
  • This government-funded, end-of-life counseling will also allow physician-assisted suicide to be on the list of options in states where assisted suicide is legal (Oregon, Washington and Montana), paid for with your tax dollars.
  • Finally, a leading pro-assisted suicide organization called Compassion and Choices is actively pushing this provision and brags that it had a hand in putting the language in the bill. That, in and of itself, is serious cause for concern.”

What do you think about the way pro-life people have been speaking into the debate so far?

“The public outcry against this bill may be remembered as one of most pivotal moments in recent political history. Folks from all walks of life are calling, writing and visiting their members of Congress about a proposal that generates any number of reasons to oppose it.

“To date, pro-lifers have had a significant voice in this debate, raising opposition to the inclusion of abortion and exclusion of freedom of conscience protections for health-care professionals.

“The pro-life community is part of a larger community speaking out against a public policy that they think will take our nation down the wrong road.”

Where is their attention best directed right now? Where should they be calling? What should they be saying?

“Congress – both the House and Senate – is in recess until after Labor Day, so there is still time to make your voice heard.

“What we’ve found is that some members, like Senator Grassley, are holding public forums to meet with constituents; others are not.

“Call the district or state office of your U.S. House member and your two U.S. senators and ask about public meetings. If none are scheduled, politely share your thoughts on the health-care reform measure with the staff person who answers the phone.  You can also visit our Web page on this topic.”

I’ve heard many people saying that there seems to be a new energy among pro-lifers and conservatives in general.

“The good news about controversial policy proposals like this is that they generate grassroots energy and heat. The bad news is that these policies can become law and impact our families for years to come.

“So, yes we see renewed energy, and we hope it will be constructively channeled to stop bad policy from becoming law.”

So, what can you do? TAKE ACTION. Ask your U.S. representative to exclude abortion funding from any health-care reform proposal. You may contact your lawmaker through FOTF’s Action Center.

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