Hey, whatever happened to the Obamacare death panels? How many people got paneled to death by them--hundreds, right, and maybe thousands? As Republicans prepare to pass their new improved American Healthcare Act, the least we can do is to tote up Obamacare’s body count; which stands, as of right now, officially at…zero?
Wait: that can’t be right. Let’s think this through. Obamacare death panels were enabled by a provision in the original ACA (Affordable Care Act), a provision that was removed because of public uproar (led by Princess Dumbass of the North Woods) and then sneakily re-inserted in 2015:
At the heart of the controversy is whether Medicare will pay for doctors to discuss end-of-life options with patients. The idea was first introduced in 2009 as the Affordable Care Act was being crafted, but was dropped amid the furor. In 2015, however, Centers for Medicare & Medicaid Services officials quietly issued a new rule allowing Medicare reimbursement as a way to improve patients' ability to make decisions about their care.
Okay, so the panels were gone but then they came back. How’s that been working?
Providers and patients are taking advantage of the program. Medicare paid doctors nearly $16 million for such consultations in the first six months of 2016. In total, nearly 14,000 providers billed almost $35 million for advance care planning conversations for about 223,000 patients, according to data released last week by the Centers for Medicare & Medicaid Services. Full year figures won't be available until July, but use appears to be higher than anticipated. Providers in California, New York and Florida led use of the policy, which pays about $86 a session for the first 30-minute office-based visit and about $75 per visit for any additional sessions.
Excuse me, but I don’t care about reimbursement rates; what I want to know is, how many patients were heartlessly murdered? How many citizens were told to quietly give up the ghost and stop costing the government money?
The CMS rule requires no specific diagnosis and sets no guidelines for the end-of-life discussions. Conversations center on medical directives and treatment preferences, including hospice enrollment and the desire for care if patients lose the ability to make their own decisions. The conversations may occur during annual wellness exams, in separate office visits or in hospitals. Nurse practitioners and physicians' assistants may also seek payment for end-of-life talks.
“Medical directives,” “end-of life discussions,” “hospice enrollment,” and “treatment preferences”: that's nothing but fake news! 1 Why all the misdirection? Why won’t they tell us about all the deaths?
End-of-life conversations have occurred in the past, but not as often as they should, said Paul Malley, president of Aging with Dignity, a Florida nonprofit. Many doctors aren't trained to have such discussions and find them difficult to initiate. "For a lot of health providers, we hear the concern that this is not why patients come to us," he said. "They come to us looking to be cured, for hope. And it's sensitive to talk about what happens if we can't cure you."
Okay, death panels are very “sensitive” and all that, but please just give us the facts about how many Americans have been paneled to death:
Proponents of advance care planning cheered evidence of the program's early use as a sign of growing interest in late-stage life planning. Being able to bill makes a difference, Malley said.
The new reimbursement led Dr. Peter Sutherland, a family medicine physician in Morristown, Tenn., to schedule more end-of-life conversations with patients last year.
"They were very few and far between before," he said. "They were usually hospice-specific."
Now, he said, he has time to have thorough discussions with patients, including a 60-year-old woman whose recent complaints of back and shoulder pain turned out to be cancer that had metastasized to her lungs. In early January, he talked with an 84-year-old woman with Stage IV breast cancer.
"She didn't understand what a living will was," Sutherland said. "We went through all that. I had her daughter with her and we went through it all."
You would think that Republicans who made such a big deal about the Obamacare killing machinery would be brandishing statistics, or at least anecdotes, proving their point; apparently, Obama loyalists in the Deep State have managed somehow to hide all the evidence. Thank goodness there’s at least one member of Congress who is willing, sans evidence, to stand athwart these death panels and holler Stop:
Controversy, however, is threatening to reemerge in Congress over the funding. Representative Steve King, introduced the Protecting Life Until Natural Death Act last month that would revoke Medicare reimbursement for the sessions, which he called "yet another life-devaluing policy."
There’s nothing more “life-devaluing” than having medical providers talk with patients about the patients’ preferences for care under various circumstances. Given that, I suggest that Rep. King’s doctors refrain from ever asking him about his preferences; instead, they should contact me on his behalf and I’ll be happy to advise them.
1 Of course it’s fake news—it’s CNN!