When Sarah Palin (wrongly) said that insurance payments for advance planning under Obamacare were “death panels”–there are other such potentialities in the law, but not that–she killed the provision.
Ever since, politicians of both parties have been struggling to bring it back.
The latest bipartisan attempt–S 1549–has been filed by Senator Johnny Isakson (R-GA) and Senator Mark Warner (D-VA).
Here is an article about in eHospice.com.
I can’t get deep into the weeds in this blog format, but I would like to offer a few observations:
1. The bill is primarily aimed at Americans with serious medical conditions, such as advanced cancer, dementia, and debilitation requiring living assistance. It also provides general education grants to groups that educate healthy adults about advanced planning.
2. The good senators of failed to offer the one crucial reform that would open the door to greater participation in advanced planning and hospice: ENDING THE CRUEL CHOICE of making terminally ill patients choose to either receive hospice services OR curative/life-extending treatments.
This bill would be the perfect vehicle for eliminating that awful requirement under Medicare. I just don’t understand why there is no energy toward making this reform. Studies show that participation in such programs rise without the cruel choice and costs go down. (Hit this link for an article I co-authored with Arthur Caplan about the issue.)
3. This bill would–no doubt in my mind–enable Compassion and Choices to meet its ambition of becoming the Planned Parenthood of death by receiving government/insurance funding. From the bill:
C) The requirements established by the Secretary under subparagraph (A)(ii) shall include a requirement that interdisciplinary team members (except for the chosen chaplain, minister, or personal religious or spiritual advisor) have training and experience in delivering person-directed planning services and in team-based delivery of services for individuals with dementing illness and individuals with a serious or life threatening illness.
C & C primarily pushes assisted suicide, but also pretends to be about such counseling. It has worked with federal legislators before on worming itself into federal funding. If passed, I believe his bill would give the organization access to Medicare funds.
4. Religious organizations also qualify for payments under the bill. That’s good. But this provision will surely be challenged on constitutional grounds by organizations that seek to drive all religious service providers out of the public square.
5. I also have no doubt that organizations seeking to qualify for funding would have to follow federally-required hiring and domestic relations policies under enabling regulations. That would drive orthodox religious organizations out of the marketplace.
5. The bill ensures that the law prohibiting federal money going to assisted suicide remains intact and unchanged. That’s good.
6. The bill moves advance planning from the legal sphere toward the social services sphere. That means the use of forms as opposed to individual drafting by a lawyer.
The more technocratic our healthcare delivery systems, the more complicated it all becomes.