End of Life Counseling in HR 3200

There has been much discussion about the end of life counseling in HR 3200. Under TITLE II—MEDICARE BENEFICIARY IMPROVEMENTS; Subtitle C—Miscellaneous Improvements there is a section called ADVANCE CARE PLANNING CONSULTATION. This section contains consultations, including advance directives and living wills (page 425 of HR 3200), and the practitioner would provide “a list of national and State-specific resources to assist consumers and their families with advance care planning” (page 425 of HR 3200).  The government will ask doctors to hand out material about living wills and advance directives. What kind of materials will the government hand out? You can see the materials former President Clinton handed out at this link: http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf.

 

I have read this booklet and it definitely seems to encourage people to write decisions about their care. However, some of the examples and questions they say people should ask themselves seem to devalue human life. Former President Bush stopped this book from being handed out and now President Obama is bringing it back with changes. As we put government in control of our health care, we are politicizing end of life care and the type of materials available could change every four years.

 

As we read further in this section, we find the bill asks for changes to the “Medicare and You Handbook.”

 

              (A) IN GENERAL.—Not later than 1 year after the date of the             
               enactment of this Act, the Secretary of Health and Human
               Services shall update the online version of the Medicare & You          
               Handbook to include the following:

                        (i) An explanation of advance care planning and advance
                        directives, including--

                                       (I) living wills;

                                       (II) durable power of attorney;

                                      (III) orders of life-sustaining treatment; and

                                      (IV) health care proxies.

                     (ii) A description of Federal and State resources available to
                     assist individuals  and their families with advance care
                     planning and advance directives, including--

                                      (I) available State legal service organizations to
                                       assist individuals with advance care planning,
                                       including those organizations that receive
                                       funding pursuant to the Older Americans Act of 
                                      1965 (42 U.S.C. 93001 et seq.);

                                     (II) website links or addresses for State-specific
                                    advance directive forms; and

                                   (III) any additional information, as determined by
                                   the Secretary.

 

(pages 432-434 of HR 3200)

 

The “Medicare and You Handbook” can be viewed at the following link:

http://www.q1medicare.com/pics/ContentPics/MedicareAndYou2009_10050.pdf

 

It already contains information about advance directives and living wills. What changes are going to be made by the government?

 

As you write your living will, make sure you know the beliefs of the people supplying the information. There is a program that helps people have pro-life living wills. If you are interested, go to one of these sites http://www.nrlc.org/News_and_Views/April09/nv040709part2.html or http://www.alliancedefensefund.org/willtolive/Default.aspx.