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Health insurance reform and end of life planning

Kathleen Blanchard's picture
Health insurance and planning

Planning for end of life care is not an effort by the Obama administration to “kill old people”. Misinformation about health care reform makes it difficult to sort through the validity of components of health insurance reform efforts.

End of life planning is already offered by major health insurance companies to Medicare recipients. Expanded Medicare plans include end of life planning as a benefit to members. Social workers and nurse case managers actively engaged in helping Medicare health insurance recipients obtain access to living wills and advanced directives. Anyone admitted to a hospital knows that counseling about living wills and advanced directive are also offered during hospital registration.

Consumer focused healthcare is nothing new, especially from Medicare advantage plans. Few know how to approach decisions that need to be made about care at end of life. Health insurance reform does not include killing old people.

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Recently a woman asked President Barack Obama about the end of life provision that is a part of health insurance reform during an AARP-sponsored town-hall meeting. "I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die. This bothers me greatly, and I'd like for you to promise me that this is not in this bill."

New York State Lieutenant Governor Betsy McCaughey created fear when she suggested that a part of health insurance reform means, “every five years people in Medicare have a required counseling session that will tell them how to end their life sooner." She later claimed to have been misunderstood, saying "I worry cutbacks on health spending will jeopardize the health of elderly Americans, leaving some with no choice but to consider ending their lives. This end-of-life counseling specifically includes whether or not to forgo nutrition, hydration, and antibiotics, which many families would regard as inappropriate for their loved ones."

In truth, many elders and others with incurable diseases choose to forego artificial means of life support in an effort to die with dignity. We all know death is inevitable. Planning for care at end of life is an important consideration as we age. There is no question - health insurance reform does not include euthanizing elders.

Health insurance reform does not include a euthanasia clause for elders. Obama, in responding at the AARP sponsored meeting said, "The intent here is to simply make sure that you've got more information, and that Medicare will pay for it." Some Medicare Advantage programs already incorporate end of life planning as part of their service to Medicare recipients. Health insurance reform includes a focus on end of life planning, but it is in no way about “killing old people”.

Health insurance reform, with respect to end of life planning, aims to ensure access to information about death with dignity. Ask any healthcare professional - when counseling and caring for our patients, end of life care is addressed. Health care reform that includes counseling for end of life planning is in no way a sinister plot from the Obama administration. It is a part of health insurance reform that is an appropriate consideration that needs to be addressed.