Obama Administration Backs Down On End-Of-Life Planning In Medicare

After the inevitable hyperbolic reaction to last weeks report that new Medicare regulations would include provisions to fund end-of-life counseling, the Obama Administration has apparently decided to back down yet again:

WASHINGTON — The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.

Many doctors and providers of hospice care had praised the regulation, which listed “advance care planning” as one of the services that could be offered in the “annual wellness visit” for Medicare beneficiaries.

While administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor. The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House.

Although the health care bill signed into law in March did not mention end-of-life planning, the topic was included in a huge Medicare regulation setting payment rates for thousands of physician services. The final regulation was published in the Federal Register in late November. The proposed rule, published for public comment in July, did not include advance care planning.

An administration official, authorized by the White House to explain the mix-up, said Tuesday, “We realize that this should have been included in the proposed rule, so more people could have commented on it specifically.”

“We will amend the regulation to take out voluntary advance care planning,” the official said. “This should not affect beneficiaries’ ability to have these voluntary conversations with their doctors.”

The November regulation was issued by Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services and a longtime advocate for better end-of-life care. White House officials who work on health care apparently did not focus on the part of the rule that dealt with advance care planning.

Quite honestly, I can’t help but think that this is largely related to the Administration’s fear of being caught up in another ridiculous “death panel” argument with the right.  It’s unfortunate, though, because, whatever the reason, there’s really no reason why these types of conservations between doctors, patients, and families should not be encouraged to take place before they become a necessity.

FILED UNDER: Barack Obama, Health Care, Politicians, Quick Takes, US Politics
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Franklin says:

    Nope, Doug, you’re all wrong. We should really just keep people alive as long as possible, even in vegetative states, and pray that they never die. Never EVER plan anything out!

  2. Jack says:

    Perhaps if the GOP was serious about good governance and really cared about those on Medicare (which they claim to do) instead of scoring cheap political points through the careful application of fear (hmmm, another form of terrorism, perhaps???), then we wouldn’t have this problem.

  3. PJ says:

    “We should really just keep people alive as long as possible, even in vegetative states, and pray that they never die.”

    Actually, they should be kept alive as long as they or someone close to them can pay. If no one can pay, then it’s obviously time to pull the plug since there are more worthy people (aka paying people) who deserves their bed.

  4. tom p says:

    As one who recently dealt with these “end of life” decisions, my parents both had DNR orders, living wills, etc etc. But we, as a family, were still faced with several difficult decisions. For a doctor to get paid thru Medicare for spending a half hour fleshing out a few of these issues, is hardly unreasonable.

    And Folks, most docs can’t give even that much (my mothers doc was useless)

  5. anjin-san says:

    > there’s really no reason why these types of conservations between doctors, patients, and families should not be encouraged to take place before they become a necessity.

    Sure there is a reason. The GOP is more interested in scoring political points than in doing something that absolutely makes sense. To make matters worse, a frigging moron like Palin is the one who is calling the shots on this.

    I left the GOP years ago because it was too embarrassing to be a member any longer. This is what your party is Doug. How much embarrassment can you take?

  6. Patrick T. McGuire says:

    “The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.”

    Obama either has no guts for a fight or no principles worth fighting for. I wonder sometimes if there is anything he would really fight to protect.

  7. PJ says:

    Death Panel alert:

    “2nd person denied Arizona transplant coverage dies.”

    Was there any End-Of-Life Planning?

  8. Terrye says:

    The crazy thing is doctors already talk to patients, they have to…after all, it is doctors who prescribe the care..not lawyers.

    Of course both sides demagogue the issue for political purposes, when in fact this is something we will have to deal with as a society.

    This care is not free, it costs money and someone has to pay for it.

  9. Terrye says:

    anjinsan:

    If Democrats had not pushed through that idiotic Obamacare against the will of the people, maybe Americans would not be so distrustful of regulations like this.

  10. An Interested Party says:

    Rather, if Republicans had not demagogued and lied about “death panels”, maybe Americans would not be so distrustful of regulations like this…

  11. Jim says:

    Hey, Sara Palin was right… Way to go. Obummer and his followers, denied there were “death panels”
    Jim

  12. anjin-san says:

    > If Democrats had not pushed through that idiotic Obamacare against the will of the people,

    Why is it idiotic? Do you have any actual thoughts on the issue or are you just repeating right wing talking points?

    How do you define “the will of the people”? I assure you that many millions favor HCR.

    If the GOP had not been fighting against ANY reform so hard, we could have had a much better program of incremental reform.

  13. anjin-san says:

    > The crazy thing is doctors already talk to patients, they have to

    Have you ever had a loved one in a vegetative state? People in that condition don’t do a lot of talking.