Jul 14, 2015

Medicare proposes covering voluntary end-of-life counseling

On July 8 Medicare proposed that beginning in 2016, it will pay doctors to discuss end-of-life care options with patients who request such counseling. Although many private insurance plans already provide coverage for this purpose, the proposal is a game-changer because the vast majority of people who seek counseling are older patients covered by Medicare.

A 2014 report from the Institute of Medicine, Dying in America, documents what is commonly known: Many people spend their last days unnecessarily uncomfortable, undergoing painful and invasive treatments that fail to extend life. Medicare's proposal, contend supporters such as the American Medical Association and the AARP, would educate patients and families about the full spectrum of  options, from palliative care to more rigorous life-extending options.  

The proposal has its critics, too. The National Right to Life organization, for example, has indicated that unmonitored counseling sessions could push people into foregoing life-saving treatments. This echoes the controversy that erupted over a similar proposal that was included in the first iteration of the Affordable Care Act. At that time, Sarah Palin and others characterized Medicare-funded patient-doctor discussions about end-of-life care as a precursor to "death panels." Ultimately, coverage for end-of-life counseling was scrubbed from the legislation.

As someone who makes his living helping people plan for the future and maintain their independence, I think everyone has the right to make informed choices about how they live their lives and manage their health care. Voluntary discussions between doctors and patients can only lead to more informed choices.

Comment period for the proposal closes on Sept. 8, 2015. Coverage would begin in 2016. You can read the proposal here.

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