The end-of-life planning provision is back. It was deleted from the health care nationalization bill over concerns that the elderly would be pressured into consenting to end their lives, but now it’s back, as part of the regulations being written by the Obama administration.
The new provision is more aggressive than the earlier attempt, in that it pays for the planning sessions every year, rather than every five years:
Section 1233 of the bill passed by the House in November 2009 — but not included in the final legislation — allowed Medicare to pay for consultations about advance care planning every five years. In contrast, the new rule allows annual discussions as part of the wellness visit.
Supporters of the provision did their best to keep it quiet:
After learning of the administration’s decision, Mr. Blumenauer’s [D-OR, the provision’s original author] 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 because we aren’t out of the woods yet,” 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.”
The e-mail continued: “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.”