Letters to the Editor

Viewpoint: Let’s not reverse decades of progress on end-of-life care

On Dec. 31, The Tribune printed a commentary by Charles Krauthammer, “Government by regulation — shhhhhh,” that included his observation that Medicare quietly, and “by administrative fiat,” issued a regulation effective Jan. 1 that would provide payment to physicians for end-of-life care counseling for Medicare recipients during annual wellness visits.

Krauthammer’s concern was that Medicare was making an end run around Congress by instituting a regulation similar to Section 1233, which had been removed from the health care bill prior to its passage last year. Back during the debates on the bill, some politicians and individuals referred to Section 1233 as the first step in the creation of death panels.

On Jan. 3, The Tribune printed an editorial by the San Jose Mercury News that sensibly discussed this same new Medicare regulation in a favorable and supportive stance (“Everyone’s favorite topic: death panels”). The editorial went on to dispel “the outrageous claim” that the regulation takes control out of patients’ hands and hands it over to the government. In essence, death panels.

Coincidentally, in the same edition was a Viewpoint by Grace-Marie Turner opposing portions of the new health care law and criticizing this new Medicare regulation, calling for Congress to repeal it, alluding to fears of death panels (“Dismantle legislation in individual pieces”).

Guess what? It didn’t take long for politics to change things again. On Jan. 5, four days after the regulation went into effect, Medicare reversed the decision to include advance care planning consultations as part of Medicare beneficiaries’ annual wellness exam.

We at Hospice Partners of the Central Coast feel stunned and disappointed that politicians and individuals are choosing to block such a beneficial opportunity for discussions between patients and physicians under the mistaken belie that it will lead to the introduction of death panels.

This is not the forerunner of death panels. It is information that everyone deserves to have.

Patients can’t be expected to make informed decisions and choose the treatment or services they wish if they don’t know the options available to them. Adding a payment through Medicare to physicians who take vital time to explain advance care planning and end-of-life care benefits can only raise awareness that will allow these individuals to live the last phase of their lives with dignity and control.

There are other benefits: Research has shown that patients who discuss their care options when facing a serious or life-limiting illness report fewer hospitalizations and fewer visits to the emergency department.

Family caregivers have also been shown to benefit from discussions held between physicians and patients. Far too often, patients and their families are forced to make decisions in times of crisis; these voluntary advance care planning consultations will facilitate informed conversations prior to the onset of an illness or medical crisis.

We emphatically believe that these discussions between physicians and their patients are a good thing. They help ensure that patient wishes are known and then honored — regardless of whether patients choose every medical intervention available, discontinue nonproductive treatments or something in between.

Lest we forget, back in the early 1980s, it was Medicare that transform-ed the volunteer hospice movement to a more comprehensive Medicare certified hospice program simply by providing a hospice benefit to Medicare recipients who receive end-of-life care from qualified hospices.

Last year, 5,000 qualified hospices provided end-of-life care to more than 1.56 million terminally ill patients and their families.

Let’s not reverse 30 years of progress in end-of-life care. Call or e-mail your congressional representatives and tell them to allow this Medicare regulation to be re-instated.

And if you would like information on advance care planning or end-of-life care services provided right here in our community, visit the Hospice Partners of the Central Coast website www.hospicepartnerscc.org or call our office at 782-8608. We will not allow politics to keep information from you.

Ron McEvoy has been employed with Hospice Partners since 2002 as their media liaison.