From IOpinion
We’ll be hearing a lot from politicians
this summer and fall about the urgency of dealing with Medicare
spending, which will begin to rise sharply in the coming years as
increasing numbers of the country’s 75 million baby boomers turn 65.
If we’re fortunate, some courageous candidates will call for renewed debate on a provision of the health care reform bill that had once enjoyed bipartisan support. The one that spineless Democrats decided had to be yanked when a certain former vice presidential nominee claimed, falsely, that it would create government-run “death panels.”
Medicare expenditures now total more than half a trillion dollars annually, representing 15 percent of federal spending. The only programs to which the government devotes more dollars are Social Security and national defense, both of which consume 20 percent of yearly federal outlays.
The Congressional Budget Office projects that the average annual growth in Medicare spending will be 5.8 percent between 2012 and 2020. It would have been one percentage point higher than that, according to the CBO, if not for the cost-constraining provisions of the Affordable Care Act, most notably the one that will gradually eliminate the bonuses the government pays private insurers to participate in the Medicare Advantage program.
The Affordable Care Act might have been able to curtail spending further if it hadn’t been for Sarah Palin’s reckless rhetoric. It was Palin who charged that a provision of the law allowing Medicare to pay doctors for having end-of-life discussions with their patients would lead to government-run “death panels.”
That provision was important because, according to the Congressional Research Service, about one-fourth of total Medicare spending is for the last year of life, and a lot of that spending could be avoided if more folks received counseling from their doctors on what they should do to ensure that their wishes are carried out when the grim reaper comes calling.
No one understands this better than Dan Morhaim, an adjunct professor in the Johns Hopkins Bloomberg School of Public Health and deputy majority leader of the Maryland House of Delegates. Morhaim, who also has been an emergency room physician and internist, has seen many cases in which people were hooked up to machines in vain attempts to restore their health — so many, in fact, that he wrote a book that should be required reading on Capitol Hill.
After reading Morhaim’s book, “The Better End—Surviving (and Dying) on Your Own Terms in Today’s Modern Medical World,” you’ll want to be sure you have a living will or advance directive in place—for your own good, for your family’s good and for your country’s as well.
Advance directives, which allow you to specify the kind of care you want as you approach the end of life, “offer something rare and important in our modern medical system,” Morhaim wrote. “They provide an opportunity to exert influence.”
And that’s never been more important, Morhaim contends. “As the baby boom generation reaches its senior years, as new lifesaving medical treatments are announced almost weekly and as our health care system confronts a crisis of affordability, the need is urgent for ordinary people to demand participation in end-of-life decisions.”
Another physician lawmaker who once shared Morhaim’s passion on this issue is Rep. Charles Boustany of Louisiana. Boustany, a heart surgeon, was one of three Republicans who cosponsored a bill in 2009 that formed the basis of the provision Palin maligned and mischaracterized.
When other Republicans began adopting Palin’s talking point, Boustany was forced to defend his support of the original bill. He was quoted as saying that he knew of many situations in which a critically ill patient hadn’t made his wishes known, leaving family members with the burden of making end-of-life treatment decisions. “This happens every day, multiple times, in hospitals across the country,” he said. “It’s a very important issue.”
The principal sponsor of the legislation, Rep. Earl Blumenauer, D-Ore., said he was stunned when the controversy erupted. “It’s just beyond bizarre,” he told reporters at the time, noting that his bill had broad bipartisan support before Palin posted the death-panel charge on her Facebook page.
What was a good idea then is a good idea now, but Palin so poisoned the well that not a single Republican, not even Boustany, will go near it, certainly not in an election year. Blumenauer has reintroduced the measure as a stand-alone bill, and it has several cosponsors. But as you might imagine, all of them are Democrats.
And because Republicans now control the House, Blumenauer hasn’t even been able to get a hearing on the measure.
There is still some hope that the bill might someday become law. Boustany indicated in a 2009 interview that he and other proponents might be willing to back it again “at some point when the temperature has cooled down.”
Many families—and the Medicare program—will be better off if that moment comes sooner rather than later.
I've said it before and I'll say it again. Everything Sarah touches turns to shit. Now more people are going to die because of her comments. Sarah really does love death panels.
If we’re fortunate, some courageous candidates will call for renewed debate on a provision of the health care reform bill that had once enjoyed bipartisan support. The one that spineless Democrats decided had to be yanked when a certain former vice presidential nominee claimed, falsely, that it would create government-run “death panels.”
Medicare expenditures now total more than half a trillion dollars annually, representing 15 percent of federal spending. The only programs to which the government devotes more dollars are Social Security and national defense, both of which consume 20 percent of yearly federal outlays.
The Congressional Budget Office projects that the average annual growth in Medicare spending will be 5.8 percent between 2012 and 2020. It would have been one percentage point higher than that, according to the CBO, if not for the cost-constraining provisions of the Affordable Care Act, most notably the one that will gradually eliminate the bonuses the government pays private insurers to participate in the Medicare Advantage program.
The Affordable Care Act might have been able to curtail spending further if it hadn’t been for Sarah Palin’s reckless rhetoric. It was Palin who charged that a provision of the law allowing Medicare to pay doctors for having end-of-life discussions with their patients would lead to government-run “death panels.”
That provision was important because, according to the Congressional Research Service, about one-fourth of total Medicare spending is for the last year of life, and a lot of that spending could be avoided if more folks received counseling from their doctors on what they should do to ensure that their wishes are carried out when the grim reaper comes calling.
No one understands this better than Dan Morhaim, an adjunct professor in the Johns Hopkins Bloomberg School of Public Health and deputy majority leader of the Maryland House of Delegates. Morhaim, who also has been an emergency room physician and internist, has seen many cases in which people were hooked up to machines in vain attempts to restore their health — so many, in fact, that he wrote a book that should be required reading on Capitol Hill.
After reading Morhaim’s book, “The Better End—Surviving (and Dying) on Your Own Terms in Today’s Modern Medical World,” you’ll want to be sure you have a living will or advance directive in place—for your own good, for your family’s good and for your country’s as well.
Advance directives, which allow you to specify the kind of care you want as you approach the end of life, “offer something rare and important in our modern medical system,” Morhaim wrote. “They provide an opportunity to exert influence.”
And that’s never been more important, Morhaim contends. “As the baby boom generation reaches its senior years, as new lifesaving medical treatments are announced almost weekly and as our health care system confronts a crisis of affordability, the need is urgent for ordinary people to demand participation in end-of-life decisions.”
Another physician lawmaker who once shared Morhaim’s passion on this issue is Rep. Charles Boustany of Louisiana. Boustany, a heart surgeon, was one of three Republicans who cosponsored a bill in 2009 that formed the basis of the provision Palin maligned and mischaracterized.
When other Republicans began adopting Palin’s talking point, Boustany was forced to defend his support of the original bill. He was quoted as saying that he knew of many situations in which a critically ill patient hadn’t made his wishes known, leaving family members with the burden of making end-of-life treatment decisions. “This happens every day, multiple times, in hospitals across the country,” he said. “It’s a very important issue.”
The principal sponsor of the legislation, Rep. Earl Blumenauer, D-Ore., said he was stunned when the controversy erupted. “It’s just beyond bizarre,” he told reporters at the time, noting that his bill had broad bipartisan support before Palin posted the death-panel charge on her Facebook page.
What was a good idea then is a good idea now, but Palin so poisoned the well that not a single Republican, not even Boustany, will go near it, certainly not in an election year. Blumenauer has reintroduced the measure as a stand-alone bill, and it has several cosponsors. But as you might imagine, all of them are Democrats.
And because Republicans now control the House, Blumenauer hasn’t even been able to get a hearing on the measure.
There is still some hope that the bill might someday become law. Boustany indicated in a 2009 interview that he and other proponents might be willing to back it again “at some point when the temperature has cooled down.”
Many families—and the Medicare program—will be better off if that moment comes sooner rather than later.
I've said it before and I'll say it again. Everything Sarah touches turns to shit. Now more people are going to die because of her comments. Sarah really does love death panels.

Umm - more people aren't going to die due to the lack of end of life counseling. But their deaths will be prolonged, more painful, and more expensive.
ReplyDeleteI agree. Her comments won't increase the number of deaths; they will prolong the deaths.
ReplyDeletePeople will suffer a great deal more~ unnecessarily.
DeleteIt will also cost billions of dollars that could save them all the suffering & heart ache when end of life Counseling really does matter.
It is unbelievable that not only did Palin espouse this ridiculous lie, but the Republicans bought it without a thought. Not one scintilla of reason or reality was evident. There is something endemically wrong when an idiot has any voice that affects the lives of so many people. How cruel and heartless and unforgivable. The Republicans have done nothing to help this nation move forward. Their only mission is to stop President Obama at all costs.
ReplyDeletePetition to boycott Bristol's reality show.
ReplyDeletehttp://www.change.org/petitions/boycott-bristol-palin-reality-show
It isn't even so much about the advance directive planning for end of life. If you read the statistics you cited, 1/4 of Medicare spending is for the last year of life, but what kind of spending is that money going towards? Much of it continues to be spent on "curative" treatment vs. palliative end of life comfort care aka hospice care. Every single Medicare beneficiary has 100% coverage for hospice care, which is also part of the end of life planning process, and an issue that would have been or could have been addressed by many physicians had Sarah Palin's "death panel" rhetoric been stopped cold.
ReplyDeleteHaving worked in hospice, I can't tell you how many people don't enter hospice care until their last few days of life....after much money has been spent on curative care that probably should have ended long before, given honest and proper counseling by the physicians involved. Cancer treatments and cardiology care are BIG BUSINESS - docs make a lot more money treating these conditions even when it becomes clear to them that continued curative treatment is futile. With that said, whether or not a physician gets reimbursed for end of life counseling or not, I really think they have a duty to provide it irregardless - in the name of patient care, appropriate care, and being good stewards of resources for all.
In the end,the medical establishment is almost as culpable as Sarah Palin's death panels rhetoric - I've seen it many, many times.