SMRs and AMRs

Monday, November 16, 2009

My Near Death Panel Experience

By EARL BLUMENAUER
NYT
Blumenauer is a Democratic representative from Oregon.
Washington

I DIDN’T mean to kill Grandma. I didn’t even mean to create death panels.

But now that I and my fellow lawmakers in the House have passed a health care bill, I’m finally free to explain what I learned as the author of the now-famous end-of-life provisions. My experiences during the bizarre controversies of the summer should provide a note of caution about what potential troubles and political distortions might lie ahead as health care legislation moves forward in the Senate, through the reconciliation process and toward a final bill.

This proposal was not even my top health-care priority. During my 13 years in the House, I have written and co-sponsored numerous provisions to change the way the government pays for health care. I am much more interested in extending coverage to the uninsured and moving away from “fee for service” Medicare, which rewards volume over value.

In this context, I found it perverse that Medicare would pay for almost any medical procedure, yet not reimburse doctors for having a thoughtful conversation to prepare patients and families for the delicate, complex and emotionally demanding decisions surrounding the end of life. So when I was working on the health care bill, I included language directing Medicare to cover a voluntary discussion with a doctor once every five years about living wills, power of attorney and end-of-life treatment preferences.

(More here.)

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