Ask Your Representative to Co-Sponsor H.R. 3251 against Biased “Advance Care Planning” Under Medicare
Background:
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| English: image edited to hide card's owner name. author: Arturo Portilla (Photo credit: Wikipedia) |
During
the debate over the enactment of Obamacare, there was considerable
controversy over paying Medicare health care providers to conduct
“advance care planning,” which
counsels patients on deciding whether to choose or reject
life-preserving medical treatment (and even food and fluids) and
advising on legal documents implementing that decision. That provision was taken out of the ultimately enacted law because of an outcry by those who feared it would
be used to limit health care spending by persuading people to agree to forego life-saving treatments. Now, the Obama Administration is proposing to use executive power to revive it as a regulation to take effect January 1, 2016.Rep. Steve King (R-IA) has introduced a bill, H.R.
3251, to prevent the Administration from implementing new Medicare
payments for “advance care planning” sessions, which substantial
evidence shows are in most cases likely to “nudge” seniors to accept
denial of life-preserving care and medically assisted provision of food
and fluids.
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| English: US Rep. Steve King (Photo credit: Wikipedia) |
Talking Points
- If advance
care planning provided truly informed consent for decisions about
medical treatment it would be laudable. It is good to help people to
prepare advance directives, like NRLC’s Will to Live, that set forth treatment decisions based on what are genuinely their own values and preferences.
- In practice,
however, advance care planning is typically less about discovering and
applying patients’ own wishes than about pushing them to accept
premature death.
- Many
“decision aids” in widespread use are suffused with vivid, emotional,
and distorted presentations designed to persuade individuals to forego
life-preserving medical treatment.
- Both
private insurers and the government seek to constrain health care
spending, which motivates them to tilt these conversations in a way
likely to reduce their liability for expensive treatment.
- Firms
hired by private insurers to aggressively conduct advance care planning
with their insurees publicize that they save thousands of dollars per
beneficiary annually.
- Significant
factual inaccuracies have been documented in materials dealing with
cardiopulmonary resuscitation and medically assisted nutrition and
hydration. Many decision aids paint unquestionably slanted and negative
pictures of the quality of life one would have if one’s life is
preserved in what one packet called
“Conditions Worse Than Death.”
- There
is strong reason to believe that these biased already-existing
materials will be used far more commonly if tax dollars pay health
providers specifically for advance care planning
- If
the government simply writes checks to health care providers for
advance care planning sessions with
patients, given patient confidentiality requirements there will be no
way to monitor these tax funded conversations for bias, factual
inaccuracies, or “nudging.” No safeguards will be possible to prevent
the highly likely use of our tax dollars to push seniors to premature
death.
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