The Truth About Page 425 of the Health Care Reform Bill; NO Such Thing as Death Panels

No doubt most of you have heard by now several wild rumors about the various health care reform bills now being considered by the Congress. One of the wildest is the one that death boards will encourage euthanasia of older people in order to save the health care system money spent on keeping them alive.

The rumor or rumors maintain that a House bill would require Medicare beneficiaries to have a class or review every five years "to decide how to end their lives sooner."

These spurious emails always add that "They're going to push suicide to cut Medicare spending!" All these emails seem to point to page 425 as the source of their claims.

What is actually on page 425?

There is a page 425. That is about all that the emails have gotten correct.

It says that Medicare is required to pay doctors for consultations regarding advance care planning, which may include things like making a living will, appointing a health proxy (a medical power-of-attorney), or indicating a preference for hospice care if necessary.

Medicare would pay for these sessions a maximum of once every five years.

And why would any bill even mention such consultations?

Because as it is now, no one is paid for their time to talk to you about things that need to be said and done. You may get a few minutes with a nurse or a hospital patient-representative. You may get a few forms pushed at you. But there is no incentive for anyone to actually sit down with you and go through all the options you have and what they really mean if one day you cannot indicate what you want done.

Often people think that they have taken care of the matter by signing a medical power of attorney form. But who is given a copy of that form? Their primary physician? The hospital they usually go to? An eldest child?

Patients need to have their preferences on record with their primary provider and made part of their medical records, so that if they wind up in a hospital with a stroke, the health care professionals will know who to contact and where your main records are.

Gxx forbid that you should have such a medical event while out of town, on vacation, in transit (alone) to visit an adult child and then you don't show up at the appointed time.

Please believe me, I wish more people had their plans and preferences incorporated into their medical record, and their providers and family all kept in the loop about what their wishes are.