By Daniel Rothberg
4:22 PM EDT, July 22, 2013
Probably nothing causes members of Congress more unease than having to talk about death. It’s only been four years since healthcare reform became more about whether President Obama wanted to throw mama from a train via “death panels” than, well, how best to reform a broken healthcare system.
Still, there are several representatives from both parties who want to discuss it.
Since 2009, Rep. Earl Blumenauer (D-Ore.) has been pushing a bill that would require Medicare coverage for an optional end-of-life consultation between a patient and a doctor every five years (more often if the patient's health declines).
Even though this might be the same policy Sarah Palin termed the “death panel,” it’s not a conversation Congress should shy away from.
There’s been some support for Blumenauer’s bill from across the aisle. One of the cosponsors, Rep. Phil Roe (R-Tenn.), has strong conservative credentials when it comes to healthcare, having often voted to repeal Obamacare.
According to Politico, they make the common-sense argument that the bill doesn’t force a patient to pursue a particular end-of-life treatment:
Both lawmakers noted that an advanced directive doesn’t mean a do-not-resuscitate order. People can and do opt for very aggressive do-everything care.
In many ways, the bill is a very moderate approach. After all, it doesn’t even mandate that all Medicare subscribers have an advanced directive, something the Washington Post’s Ezra Klein argues for:
The problem with Blumenauer’s legislation isn’t that it goes too far. It’s that it doesn’t go nearly far enough. Blumenauer’s bill would reimburse doctors in the event that their patients want to schedule a visit to discuss end-of-life-care. But everyone on Medicare should have their end-of-life preferences clearly spelled out.
Instead, the bill simply requires that Medicare cover the consultation in the same way other (more expensive) medical procedures are covered. Here’s his argument:
Blumenauer notes that Medicare will pay doctors, hospitals and rehab centers tens of thousands of dollars for a terminally ill 90-year-old to get a hip replacement. But it won’t pay a couple hundred bucks for a conversation about other dimensions of that terminal illness.
For legislators still worried about political fallout, they should look at public opinion on the subject. According to a National Journal survey in 2011, “78 percent said that palliative care and end-of-life treatment should be part of the public discourse, and 93 percent said they believe such decisions should be a top priority for the U.S. health care system.”
Though the results also show that 23% inaccurately conflate healthcare reform with death panels, it should be a fairly easy obstacle to surmount because, at its core, Blumenauer’s legislation is about giving patients more choice rather than stripping them of it. And at a time when trust in government is low, that’s a highly popular idea.
Follow Daniel Rothberg on Twitter: @danielrothberg
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