Profile: American Academy of Hospice and Palliative Medicine

Representative Earl Blumenauer (D-OR), who co-authored the provision in the House health care reform legislation mandating that Medicare would pay for periodic “end-of-life” counseling sessions between patients and doctors, releases a fact sheet called “Myth vs. Fact: Advance Planning Consultations in HR 3200” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, and July 31, 2009 - August 12, 2009). Blumenauer writes: “Few areas are more vital for honest discussion and careful consideration than end-of-life care for America’s seniors. Unfortunately, families often do not know their loved ones’ preferences for end-of-life care and are not confronted with these difficult decisions until an emergency arises. This leaves spouses, sons, daughters, and grandchildren unprepared; as a result families struggle to make decisions in the midst of turmoil. The House health care legislation includes a provision (Sec. 1233) that provides seniors with better care as they grapple with these hard questions. This provision extends Medicare coverage to cover the cost of patients voluntarily speaking with their doctors about their values and preferences regarding end-of-life care. These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time.” He then corrects three “myths” surrounding the provision:
Myth: Patients will be forced to have this consultation once every five years. In reality, he writes, such advance planning consultations are entirely voluntary; the provision mandates that Medicare will pay for one such consultation every five years if the patient chooses. Under certain circumstances, Medicare will pay for more frequent consultations.
Myth: Patients will be forced to sign an advance care directive (or living will). Blumenauer writes that no such mandate exists in the legislation, or is being contemplated. Like the advance planning consultations, living wills are entirely voluntary.
Myth: Patients will have to see a health care professional chosen by the government. The government will not choose any health care professionals for anyone. If a patient chooses to have an advance planning consultation, it will be with a doctor of his or her choosing.
Blumenauer notes that the following organizations have endorsed his provision: the American Association of Retired Persons (AARP), the American Academy of Hospice and Palliative Medicine, the American College of Physicians, the American Hospice Foundation, the Center to Advance Palliative Care, Consumers Union, Gundersen Lutheran Health System, the Hospice and Palliative Nursing Association, Medicare Rights Center, the National Hospice and Palliative Care Organization, the National Palliative Care Research Center, Providence Health and Services, and the Supportive Care Coalition. [US House of Representatives, 7/2009 ; Politico, 7/28/2009]