Thursday, July 9, 2015

Last Call For Zombie Death Panels

Medicare end-of-life care is back in the news, and that's a good thing.

Six years after end-of-life planning nearly derailed development of the Affordable Care Act amid charges of "death panels," the Obama administration has revived a proposal to reimburse physicians for talking with their Medicare patients about how patients want to be cared for as they near death.

The proposal, contained in a large set of Medicare regulations unveiled Wednesday, comes amid growing public discussion about the need for medical care that better reflects patients’ wishes as they get older.

Expect Republicans to start screaming that Obama wants to murder your grandmother again. Well...maybe not all Republicans...

Two months ago, former Florida Gov. Jeb Bush, one of the front-runners for the Republican presidential nomination in 2016, suggested that Medicare patients should sign so-called advance directives that spell out the care they want if they become incapacitated.

So Jeb Bush is pro-"death panels" huh.  This should be fun.

In all seriousness, as James Joyner points out, palliative care is a legitimate Medicare issue and should be discussed by doctors and their senior patients.

Aside from the cleverness of “death panels” as a mobilizing tool, capitalizing on longstanding American fears about government control of healthcare, I’ve never understood the argument against the practice. Of course physicians ought to discuss with their patients what their end-of-life options are once they become terminally ill or sufficiently advanced in age. And, so long as we maintain a fee-for-service model, of course they ought get paid for it. 
To the extent that government is a prime payer of healthcare expenses—and for those over 65, there’s little controversy over the fact that it is—there is something of a conflict of interest at work, in that care for terminal patients eats up an inordinate percentage of lifetime costs. But it strikes me as absurd that doctors are going to talk their patients into ending their lives prematurely mostly on the basis of cost savings.

Oh, an absurd idea that Republicans aren't going to run with at full throttle?  That would be a first. Because that's exactly the fear Republicans stoked in voters in 2009 and 2010 and they won huge.

Sarah Palin, the former governor of Alaska, urged her supporters to oppose Democratic plans for health care reform on her Facebook page. 
"As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!" wrote Palin in a note posted Aug. 7, 2009. 
She said that the Democrats plan to reduce health care costs by simply refusing to pay for care. 
"And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

It was PolitiFact's Lie of the Year, remember?

Republicans still won 60+ House seats.

I fully expect this Medicare rule change to be quietly pulled once again.  Republicans will keep winning that PR battle until the end of time.

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