I was a little puzzled to see the claim that health care reform was the fast track to euthanasia surface in recent days; Carrie Budoff Brown has the background, which is an obscure provision requiring coverage for end-of-life consultations.
The provision would require Medicare to cover advanced care consultations for the first time, but it does not mandate individuals to take advantage of the benefit, proponents say. The consultations would take place between the patient and a doctor or nurse practitioner, not a government bureaucrat. And there would be no requirement for the individual to sign a directive or living will at the end of the discussion.
“This measure would not only help people make the best decisions for themselves but also better ensure that their wishes are followed,” AARP Executive Vice President John Rother said in a statement. “To suggest otherwise is a gross, and even cruel, distortion — especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives.”
Jon Keyserling, vice president for public policy and counsel at the National Hospice and Palliative Care Organization, said: “I was surprised that any responsible legislative analyst would indicate this is a mandatory provision. That is just a misreading of the language and, certainly, of the intent.”
This sort of line of attack — an intense focus on, and in this case distortion of — a narrow provision is a key part of how health care changes were defeated in 1993. The new media environment is much less hospitable, I think, to this sort of thing. In fact, for all the talk of dumbing down media, you can find a very nuanced, rich policy debate based on original documents all over the place, and while myths spread fast, the practice of nipping them in the bud is a well-developed one.