Sunday, 26 Dec 2010 06:41 PM
During the stormy debate over his healthcare plan,
President Barack Obama promised his program would not
"pull the plug on grandma," and Congress dropped plans
for death panels and "end of life" counseling that would
encourage aged patients from partaking in costly medical
procedures.
Opponents of Obama's plan, including former
vice-presidential candidate Sarah Palin, dubbed such
efforts as "death panels" that would encourage
euthanasia.
But on Dec. 3, the Obama administration seemingly
flouted the will of Congress by issuing a new Medicare
regulation detailing "voluntary advance care planning"
that is to be included during patients' annual checkups.
The regulation aimed at the aged "may include advance
directives to forgo aggressive life-sustaining
treatment,"
The New York Times reported.
The
new provision, which goes into effect Jan. 1, allows
Medicare to pay for voluntary counseling to help
beneficiaries deal with the complex decisions families
face when a loved one is approaching death. Critics say
it is another attempt to limit healthcare options for
the elderly as they face serious illness.
Incoming House Speaker John Boehner said during the
healthcare debate: “This provision may start us down a
treacherous path toward government-encouraged
euthanasia.”
Specifically, the measure was known as Section 1233 of
the bill the House passed in November 2009. It was not
included in the final legislation, however. It allowed
Medicare to pay for consultations about advance care
planning every five years. In contrast, the new rule
allows annual discussions as part of wellness visits.
Elizabeth D. Wickham, executive director of LifeTree, a
pro-life Christian educational ministry, told the Times
that she is concerned that end-of-life counseling would
encourage patients to forgo or curtail care, thus
hastening death.
“The infamous Section 1233 is still alive and kicking,”
Wickham said. “Patients will lose the ability to control
treatments at the end of life.”
The rule was issued by Dr. Donald Berwick, administrator
of the Centers for Medicare and Medicaid Services,
according to the Times. He is a longtime advocate for
rationing medical procedures for the elderly.
Before Obama tapped Berwick for the Medicare post,
Berwick had long applauded Britain's National Health
Service, which uses an algorithm to determine whether
the aged are worthy of additional expenditures for
medical care and advanced treatments.
Berwick has argued that rationing will have to be
implemented eventually, stating, “The decision is not
whether or not we will ration care. The decision is
whether we will ration with our eyes open.”
Seniors appear to be a major target for precious
resources under the Obama healthcare plan. According to
the Congressional Budget Office, the Obama plan cuts
nearly $500 billion in Medicare benefits to seniors as
the federal government adds 30 million uninsured
Americans to private and public healthcare systems.
The cost of caring for the elderly has not been lost on
Berwick.
“The chronically ill and those towards the end of their
lives are accounting for potentially 80 percent of the
total health care bill out here . . . there is going to
have to be a very difficult democratic conversation that
takes place,” he said.
During the heated healthcare debate, supporters of the
Obama plan vigorously denied that rationing for seniors
would take place and scoffed at "death panel" critics
such as Palin.
Last month, however, economist and New York Times
columnist
Paul Krugman told ABC News that rising Medicare
costs could be dealt with
only by "death panels and sales taxes."
He added: "Medicare is going to have to decide what it's
going to pay for. And at least for starters, it's going
to have to decide which medical procedures are not
effective at all and should not be paid for at all. In
other words, it should have endorsed the [death] panel
that was part of the healthcare reform.’"