Charles Grassley responds to the idea that his 2003 vote for the Medicare Modernization Act (MMA)–which, again, included funding for end-of-life counseling–in any way makes his stringent opposition to end-of-life counseling in current health reform legislation somewhat questionable:
The MMA offers terminally ill patients a pain and care management evaluation and counseling about hospice care and other options. And it offers optional advice from a specialized hospice physician on advanced care planning. One could be assured that the provision of advice on advanced care planning in this context can be done in a correct manner and by an appropriate provider. I can’t say the same thing about what would happen under the provisions in the Pelosi bill.
Under the Pelosi bill, all physicians risk losing quality bonus payments unless they report on whether they provide advanced care planning and adherence to that plan…. [T]he concerns about the advanced planning provisions in the Pelosi bill are made because they are proposed in the context of a bill that is ostensibly working to save money by spending less on health care in health care reform, and in a bill that creates a government-run plan that will surely lead to rationing of health care just like has happened in other countries that have government-run systems. It’s plain to see why Iowans and others are legitimately concerned about the unintended consequences of the House bill.