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End-of-Life Care Provision Back from the Dead

The Obama administration has inserted through regulation a politically explosive provision – removed from the health care reform bill to help it pass – that would pay doctors to provide counseling to patients on planning their deaths.

The provision encourages doctors – by giving them money to do it – to discuss treatment options for patients should they become incapacitated and unable to make their own decisions.

Advocates say this helps patients inform doctors of what type of treatment they want before it’s too late. But opponents are concerned that the government will encourage doctors to steer patients toward less expensive options – a version of the “death panels” opponents of health reform fear.

What President Obama couldn’t do by legislation, he’s now done by fiat, the New York Times reports.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process.

Proponents of the provision, who were stymied during the legislative  process, are now trying to keep their circumvention of Congress quiet.

The following email was dispatched to supporters by the office of Earl Blumenaur, D-Ore, who wrote the provision’s failed legislative language.

While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet.  This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth.

We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded.

Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.

With the House in the hand of Republicans, the regulation writing process will increasingly be used by the president to get his way. It’s inherently undemocratic and violates the principle that Congress writes the laws, but so what when you know what’s best, right?

Other presidents have done this and other similar strategies.

George W.Bush issued his infamous signing statements, which essentially said, “I have a right to ignore these sections of your law, you jackasses down the street.” But, given Obama’s commitment to expanding the federal role, I would expect a new level of lawmaking out of the executive branch.

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7 Responses to End-of-Life Care Provision Back from the Dead

  1. While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet. This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth.

    Perpetuate–how about Illustrate? Aw Zekie babes, we knew you were just lying low.

  2. Oh heck, we’ll be leaving this planet soon so what’s the hurry?
    As for the “death panel”, that’s a stretch; most of us have a “living will” directive signed and delivered anyway.

    • Another reg pays docs to have a “weight management” talk with us. I assume this, too, will be “voluntary.” Yeah, sure. Well, I am going Tues and am practicing saying, “I’ll pass.”

      • That death panel talk (am I too blabby on here today?) is also to be sort of scripted by the govt–with helpful brochures and videos for the short-timers. This put me in mind of a thing my new Medicare health plan sent me–called FIVE WISHES. This was a long and laughably stupid checklist of things I wanted to specify. My favorite part was would I want to be cleaned up if I had an accident. Why, no–who would want that? Would I want music played while I breathed my last? HOTEL CALIFORNIA. Would it be OK with me if some kind soul held a pillow over my face? (Aw, kidding…) But who WRITES this crap? Probably someone like me and I didn’t get the job, darn it all.