Now to my mind THIS is upsetting.
Posted: 03 Jan 2011 12:57 PM PST
Dan Pattarozzi BS,RRT
While many policies our government have enacted over the last thirty years or so can easily be deemed Orwellian, one that has everyone jumping and shouting currently is actually about personal choice. The new Medicare guidelines and regulations that became effective on January 1, 2011 allow people covered by Medicare to have a yearly physical exam that will also include reimbursement to the doctor for counseling them on the likelihood of surviving whatever condition they have– or whatever unforeseen event may take place– and how far they would like their treatment to go given their prognosis. While this practice within medicine is not new, or even rare, this new regulation will ensure the doctor gets paid for doing it. Paying the doc ensures people talk about it, and that ensures some education will be thrown around and bounce into people’s heads. This education, no matter what anyone says to the contrary, will always benefit the patient. Without it how can someone be expected to make a truly informed decision about their own life?
All the brouhaha over “death panels” has become a distraction to the people of America ( particularly the voting elderly), and those who protest a move towards informed choices seem to me to be those that would like to usurp personal freedom. Humorous that the party which has “promoted” being for the people’s will with this issue is hell-bent on telling elderly or disabled Americans that more choice is somehow less freedom. Somehow because death is mentioned as a part of this counseling it must be evil and irresponsible. As a healthcare professional myself, I can only see good things coming from people discussing their goals for care, which in essence is fighting their death. As so many of today’s medical practices and technologies have only been in use for 50 to 60 years, and the mean age of death has advanced some 20 years over that time as a result, utilizing these advancements is fighting “natural” death. With this new rule more people will be exposed to conversations about their death and will be free, free mind you, to choose the way in which they die.
July of 2009 is really when this party started over “death panels” or “end-of-life-care.” At that time the United States House of Representatives had passed through all its’ committees a bill entitled “America’s Affordable Health Choices Act of 2009,” which had language that, as a healthcare provider, I found to be standard operating procedure for anyone in a hospital who was facing an end-of-life situation. For no obvious reason other than to create a distracting non-issue to gain political hit-points, Betsy McCaughey a former New York lieutenant governor said in a radio interview that Medicare would require recipients every five years to have their doctors tell them how to end their lives sooner. Please read HR 3200, Sec 1233 and see if this true. Sarah Palin then started a campaign of misinformation saying that the provisions called for an involuntary “death panel” to be convened and decide how and when the elderly would die. It’s kind of like saying Jews have horns and eat Christian children for dinner, a little Goebbelsesque frankly.
So due to the public “outrage” Palin et al cooked up, Rep. Charles Grassley (R-IA) came out on August 13, 2009 and reported that all the
language regarding end-of-life-care had been cut from the provision in its entirety. Thus the bill that went to the Senate and then to the President deleted language that would incentivize doctors to discuss what their patients’ goals for care would be should their conditions/diseases progress quickly, or if something unforeseen happens (apparently discussing this is taboo, and not doing so can be cruel in my experience). Good work for fear-mongers, and a bad day for those of us who know and care what really happens to people who don’t make these decisions.
So dying dignified at home or in a hospital/hospice with one’s family and friends at their side, enjoying their last moments ever together is apparently bad for old people. Being hooked to a machine that breathes for them and having “nutrition” slowly oozed into their gut via tubes while they languish without the strength to speak because they neglected to specify their care is good for them. More people being free to know these outcomes, and choose accordingly is now being lauded by the Right as undemocratic and an invasion on freedom. But nowhere is it mentioned that poor choices leading to more expensive care will be limited despite the pain and suffering and lack of quality of life that ensues because of those choices. The current right-wing talking points have alluded to doctors surreptitiously discussing these issues with their patients against their will in order to profit. To oppose this counseling, and other responsible Medicare reforms, is to oppose Medicare as a whole. With one the most consistent and active voting blocks being the elderly, one would think politicians would be on their side, not exploiting their natural fear of death. No rationing is being called for, no dying is being called for, only informed choices are being offered.
Dan Pattarozzi is a licensed Respiratory Therapist with over sixteen years experience in hospital, pharmacy, oncology, and home care, as both a service provider and educator.