Re: “Pulling the Plug on Grandma”

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A quick recent history lesson seems in order, following Michael C.’s post below.

The “death panels” lie – and yes, it was a lie – came about after Democrats tried to include in health reform legislation compensation for doctors who talk to their patients about their end of life care plans. Talk to any doctor who cares for elderly patients – and I talk to a lot of these folks – and it quickly becomes clear that paying for these kinds of conversations would benefit doctors and patients alike.

The Weekly Standard post that Michael links to includes this line:

McDowell did hedge at the end of his comments and say these decisions should be made by individuals, but end of life decisions currently are up to individuals in consultation with their families and health care providers.

The truth is, these decisions – in far too many cases – aren’t made in any deliberate way, or aren’t made with any involvement from patients. Many elderly Americans enter their final days or months with no end of life care plan in place. In these cases, families – who often can’t bear to refuse any treatment for their loved ones, no matter how remote the possibility it could help – and doctors – who also are often focused on preserving life at all costs – are the ones steering the ship.

Compensating doctors for having end of life care conversations with patients – which means asking patients what they want for themselves – would undoubtedly cause more patients to have end of life care plans. This government involvement – basically inventing a Medicare payment code for these consultations – would result in more people getting the care they want, as opposed to the care their families and doctors guess they want, and would relieve families of the guilt and stress that stem from trying to decide what to authorize as a loved one is dying.

Yes, if this provision had been in the final Affordable Care Act it would have also saved money because, for many people, dying under inexpensive hospice care surrounded by family is preferable to dying in a more expensive hospital setting only after every attempt to preserve life is exhausted.

This clause in the House health reform bill was the root of the “death panels” lie.

All of this said, I expect any politician – especially a Democrat – who tries to talk about this easily caricatured subject will face an accusation that he or she wants to “pull the plug on grandma.”