No two issues have received more attention and generated more controversy in the current healthcare reform debate than the public health insurance option and end of life care (also referred to as advanced directives).
Advance directives are part of the America’s Affordable Health Choices Act (HR 3200, commonly referred to as the Tri-Conference Bill) that is under discussion in the House, and that I previously discussed. The bill says, verbatim, that a health plan will give “the option to establish advance directives and physician’s orders for life-sustaining treatment according to the laws of the state in which the resident resides.” It goes on that it “shall not promote suicide, assisted suicide or the active hastening of death.” Moreover, the advance directive process is not obligatory, meaning it is up to the senior to decide whether to participate in such a process. A senior will have the option to discuss end-of-life care with his/her doctor, and the doctor will get paid for it.
There is really no mention of euthanasia or death panels. But don’t take my word on it. Two very influential groups have also reviewed the same bill and came up with the same conclusions. The AARP, the main lobbying group for older Americans, has said that any allegations about “government-encouraged euthanasia” are “flat-out lies.” Another group, the Association of Bioethics Program Directors, which represents the leadership of 60 academic bioethics programs across North America also weighed on this issue. They called the suggestion that “healthcare reform will deny older Americans medical treatments at the end of life,” the “most pernicious myth of all.” They explained that the provision “supports the rights of individuals and their families to make decisions at the end of life by institutionalizing a process for patients and families to express their desires to their physicians…”
So while keeping my promise in keeping this blog strictly non-political, end-of-life care as part of the new healthcare reform bills seems to me like a potential good thing for older Americans. The Big Bad Wolf, after all, is just a little lamb!
This article was included in Health Wonk Review.