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Sunday, January 9, 2011

Retreat on End of Life Counseling

It is a great pity that the Administration has rescinded the regulation allowing doctors to be compensated by Medicare for end-of-life discussions with their patients.

As you stated on December 26th:
"The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning," to discuss end-of-life treatment, as part of the annual visit.

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."

This retreat says much about the political incompetence of the administration (yes, I voted enthusiastically for Obama). Throughout 2009 and 2010 the Republicans vociferously denounced the proposal as the creation of "death panels" which would reduce a person's right to a long life. It appears that this outcry was insufficient to alert the Administration that there might be objections to its new regulation.

It is clear that the Administration did not prepare the public and the Congress for the introduction of the rule so that it, in turn, was unprepared to resist the objections to the policy that has occurred since it was announced.

It is incomprehensible to me that the Administration did not do the political and educational work required to explain this policy which in the past, as you note, has garnered bipartisan support.

This is not a good omen for the future political initiatives by the Obama Administration.

Sent to Boston Globe

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