End-of-life care is a touchy subject
Today the Senate Finance Committee decided end-of-life care is so politically touchy that it can't even be talked about, let alone be included in the final bill. Joel Rose reports.
Caskets at a funeral. (Sergio Dionisio/Getty Images)
TEXT OF STORY
Kai Ryssdal: You know all those town hall meetings. Where people are protesting death panels, and other things they've heard are going to be included in the health-care overhaul? Turns out all the yelling is having a real effect on the debate and on the policy, too. Today the Senate Finance Committee decided end of life care is so politically touchy that it can't even be talked about, let alone be included in the final bill. Joel Rose reports.
JOEL ROSE: A lot of the heat at the town hall meetings focused on a provision in the house's health-care bill. It would encourage doctors to talk with their patients about the care they want at the end of their lives.
For example, do they want to be put on life support, the kind of thing living wills spell out. But that got blown up into supposed "death panels" -- first in an Op-Ed in the New York Post, later in comments in comments by Sarah Palin and Newt Gingrich.
ROBERT Berenson: The way it's been distorted into death panels, government bureaucrats deciding who should live or die, is a complete fabrication.
Robert Berenson is a fellow at the Urban Institute. More than a quarter of all Medicare spending happens in the last year of patients' lives, much of it as they're dying. And Berenson says the government could save billions of dollars by reducing care that patients may not even want.
Berenson: The savings would have nothing to do with anybody making a decision to deny some care that patients and their families want, but rather would be associated with honoring patients' own wishes.
Conversations about end-of-life care are often difficult for doctors to have, says Peter Pronovost at Johns Hopkins School of Medicine. He says the goal should be more dialogue between doctors and patients, not less.
PETER Pronovost: We would like patients and their families to make the wisest decisions. There's information that has to inform that decision. And far too often, physicians don't provide it.
After a week where the political discourse was dominated by "death panels," Pronovost says that goal seems more remote than ever.
I'm Joel Rose for Marketplace.
Comments
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From Reno, NV, 08/14/2009
It's good to see this subject being addressed and it's a shame our legislators are too sensitive to the subject to honestly confront it. The facts, the statistics of health care don’t lie. I would estimate that more than 25% of national health care is spent in the last year of life. And what does that cost return as a benefit to society? Do these people add value to our society? Do these people want to be kept alive? At the core of the "end-of-life" health care issue is our society’s value of the human body as opposed to the value of the human being. In our materialistic age (from the late 1800's to now) we have drifted from the value of the “being” and focused on the value of a body. We, as a society, are confusing the body with the “being”. And there lies the biggest problem; we begin to enter the realm of religion, which under our law is supposed to be separate from the State, the government. It’s difficult to confront the fact that some people want to die, but the fact is some people do. They know they are more trouble to a society than they can provide value to it. They know it’s best to exit this life, they know it’s better to remove themselves as a burden. But, under the effect of heavy drugs, or in a comatose state they either can’t communicate their desire or their minds are in a state where they cannot use reason to arrive at the correct decision. Less “advanced” societies don’t have the problem we do because they don’t have the technology to “mechanically” extend life. When a person is ready to die, they die. Since we have the technology to extend the body’s life without the “being’s” consent we place ourselves in the position of a god. I think it’s time to let the “being” be more at cause over its life. In other words, we need to return to a more spiritual basis for our decisions. Here’s an example: A 20 year old guy jumps off a building in an attempt to commit suicide. He doesn’t die, but ends up in a physical state where he must be cared for by the State for 50 years. What’s the correct decision?
From MA, 08/14/2009
Surprise, folks! Someday, we're all gonna die. And there are few things more sad and disgusting than someone dying an undignified life in a hospital, being poked, prodded and needlessly tested, because the patient didn't specify when to stop heroic measures to save their life.
The sad reality is that hospitals see dollar signs when they have a terminally ill patient. Do you want to be the child of a parent who didn't express their end-of-life wishes, sitting by your parent's bedside as doctors put your parent through unnecessary test after after test? If you don't specify your wishes for care at the end of your life, THEY are the "death panel".
From Naperville, IL, 08/14/2009
Harold, your issues are very real concerns, but most of the protesters were there because they were told lies and misinformed. As fas as being authorizied under the constitution, both sides always find a way to bend the rules.
08/14/2009
Sheri, let's be fair. I strongly applaud the administration’s attempt to control Medicare cost, but at least some of the fear is from the experience of an administration rushing to pass a stimulus bill without time to read and study, ostensibly because of urgent economic necessity. Six months later less than 10% of the allocation has been spent. The rush was political expediency. Protesters have heard Specter say “we had to hurry” (interject the shout-down). These protesters have every right to have this bill fully read, studied, and debated. They fear another political jam job. On another note, can anyone tell me hypothetically how, without state opt out provisions, that this bill could be authorized under the US Constitution?
From naperville, IL, 08/14/2009
what world do you people live in? DNR's are already manadatory in every hospital here and there IS NOTHING WRONG WITH THAT. Spend 1 week in a nursing home and you'll wish you had talked about end-of life issues. AND THERE IS NOTHING WRONG WITH THAT. Small minded people afraid of your own shadows that let fear feed your decisions, just like they want. A bunch of sheeple
08/13/2009
Richard Cole.
Now look there at Palin's proclamation.
Nowhere does she say she will not pull the plug on a grandma. So therefore, using your logic, she must be secretly wanting to allow the Alaskan Government to pull the plug on grandma, take her TV and sell it on eBay to fund needle exchange for drug addicts. Then leading, again using your logic, further to busing out expensive care elderly patients to Russia thus scoring monetary points for Alaska.
It's all right there.
Don't tell me this isn't true or else you are a brownshirt.
08/13/2009
It is so touchy that Sarah Palin declared that every April 16 is Healthcare Decision Day (Alaska Death Panel Day).
"NOW, THEREFORE, I, Sarah Palin, Governor of the state of Alaska, do hereby proclaim April 16, 2008, as:
Healthcare Decisions Day in Alaska, and I call this observance to the attention of all our citizens.
Dated: April 16, 2008 "
http://gov.state.ak.us/archive.php?id=1094&type=6
From Ann Arbor, MI, 08/13/2009
Dismissive, oblique, misinformed, ilinformed, misleading, even disingenuous describe the responses people get from their representatives, and others, when they ask about some of HR 3200's provisions. No wonder people become frustrated.
Now, Mr. Ponovost is correct that the bill does not mention death panels. But "Telephone" can explain the morph as easily as blaming it on a conspiracy.
A bill like this leaves much to future modification by bureaucrats. There is nothing in the bill to prevent some future Commissioner from making the end-of-life counseling mandatory, then encouraging "no heroic measures" orders, then encouraging DNRs. It could pay doctors more the higher level the patient "chooses".
The Service Employees International Union members are the Brownshirts -- purple shirts -- beating up voters trying to find out the truth.
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