GOP Lifeclocks All On Lastday

Greg Sargent reminds us that the Medicare end-of-life debate has been around for a while, and that it started again this year at least not in the House, but in the Senate. The GOP has been unfairly attacking the House Democrats for including that provision in their health care bill, railing against it as a "measure to euthanize seniors".

But it turns out over in the Senate that a similar bi-partisan measure to include the same type of counseling in Medicare was introduced earlier this year by Senators Jay Rockefeller (a Democrat) and Susan Collins (a Republican).

This sharply undercuts the GOP and conservative claim — unless, of course, you believe Collins backed an initiative she thinks could lead to mass government extermination of the elderly. Though this talking point has been debunked multiple times, conservatives and GOP leaders like John Boehner continue to employ it with abandon.

On May 22nd, Senators Collins and Jay Rockefeller introduced the “Advance Planning and Compassionate Care Act,” according to a press release sent over by a source. The measure provides Medicare funding “for advance care planning so that patients can routinely talk to their physicians about their wishes for end-of-life care,” the release says.

Collins praised the measure, which may be included in the Senate health care bill, in the release. “Our legislation will improve the way our health care system care for patients at the end of their lives,” she said, “and it will also facilitate appropriate discussions and individual autonomy in making decisions about end-of-life care.”

Which is almost exactly what the House measure provides for. Funny how that works. The bill was referred to Max Baucus's committee with little fanfare.

Forbes has a very good article on both the APCCA in the Senate and the House health care bill:

The end-of-life language originates from a different bill, called the Advance Planning and Compassionate Care Act, introduced earlier this year by Sens. Jay Rockefeller, D-W.Va., and Susan Collins, R-Maine. In addition to the consultation, which Medicare will pay for every five years, the bill also says that patients will be informed about the benefits of hospice and palliative care. Hospices are facility or home-based services for terminally ill patients to receive pain medicine and other comforts before they die.

The proposed legislation says that patients should be instructed on how to write an advanced health care directive. It defines standard categories of care that can be included in such a document as nutrition, hydration, antibiotics and resuscitation in the event of a lack of pulse. It also would create a tracking system to see if doctors are promoting advanced care directives and following them. Sen. Rockefeller's office released a statement Friday saying the measure has bipartisan support as well as the backing of groups like the AARP.

Why the focus on end-of-life care? Sen. Rockefeller announced at the time of the original bill's introduction that he wants to encourage the use of hospices and help families make the right decisions as death approaches.

Yet end-of-life care is also a key issue when it comes to slowing the growth of health care costs. About a quarter of all spending by Medicare, more than $100 billion, takes place during a patient's final year of life. President Obama has made reference multiple times to the fact that his grandmother received an expensive hip replacement while she was terminally ill with cancer, holding it up as an example of spending that sometimes takes place near the end of life. He's wondered whether the country can afford those kinds of bills, even though he said he would have paid for grandmother's hip out of pocket.

Which is true. End-of-life care is a massive issue, and I'm glad to see that at least some Republicans (well, one anyway) are willing to deal with it. But the rest of the rhetoric has been just absurd.

The idea that ObamaCare is promoting physician-assisted suicide for old people, or encouraging them to forgo medical care late in life, has made its way into partisan rhetoric among the bill's opponents. "[The bill] would require every senior to have a mandatory counseling session with a government bureaucrat every five years on ways to 'die with dignity;' starvation, dehydration, stuff like that," Republican strategist Lawrence Lindsey wrote in a memo.

In a post entitled "The Democratic Culture of Death is Absolutely Terrifying." one blogger wrote "First they came for our light bulbs, then they came for our SUVs. Now, they are coming for our senior citizens," Other commentators have made a connection between the bill and the Terry Schiavo episode, in which a woman on life support in Florida starved to death after a feeding tube was removed when her husband prevailed in a prolonged legal battle.

In fact, the bill says nothing about death with dignity or any other code words for euthanasia. It also does not make these counseling sessions in any way mandatory--it just says that Medicare will start reimbursing for them.

Which apparently is a massive crime, at least if you're a Republican. How this became Logan's Run, well, you'll have to ask our moderately delusional GOP House friends and their media enablers about that. The GOP decided to turn it into a talking point, strategists like Lawrence Lindsey communicated it with the usual suspects, and the Wingers and the Village Steno Pool crapped the lie back out while making fools of themselves, it's what they do best after all.

It's a cruel and degrading lie. But we are talking about the Republican Party, after all.