ricketyclick

Well, OK, that’s a bit of exaggeration. Section 1233 of House Bill 3200 (a.k.a. the Obamacare bill, a.k.k. Socialized Medicine) is actually titled “Advance Care Planning Consultation.”

This is the section which Republicans claim is going to require doctors to tell the terminally ill and elderly to just die, already; and which Democrats say is just a funding provision to allow patients to talk with their doctors about “end of life” care.

(”End of life”? Isn’t that what was formerly known as “Death” or “dying”?)

I tried to read it, and I suggest you do to: it starts on page 425 of the bill, which you can download here, and runs on to page 434, almost ten pages.

Two of those pages, about fifty lines, specify the exact content of the consultation as provided by a doctor to his elderly, sick, and very likely confused and deeply frightened patients:

                                               425
11  ... Such
12 consultation shall include the following:
13                    ‘‘(A) An explanation by the practitioner of ad-
14              vance care planning, including key questions and
15              considerations, important steps, and suggested peo-
16              ple to talk to.
17                     ‘‘(B) An explanation by the practitioner of ad-
18              vance directives, including living wills and durable
19              powers of attorney, and their uses.
20                     ‘‘(C) An explanation by the practitioner of the
21              role and responsibilities of a health care proxy.
22                     ‘‘(D) The provision by the practitioner of a list
23              of national and State-specific resources to assist con-
24              sumers and their families with advance care plan-
25              ning, including the national toll-free hotline, the ad-
                                               426
  1            vance care planning clearinghouses, and State legal
  2            service organizations (including those funded
  3            through the Older Americans Act of 1965).
  4                   ‘‘(E) An explanation by the practitioner of the
  5            continuum of end-of-life services and supports avail-
  6            able, including palliative care and hospice, and bene-
  7            fits for such services and supports that are available
  8            under this title.
  9                   ‘‘(F)(i) Subject to clause (ii), an explanation of
 10              orders regarding life sustaining treatment or similar
 11              orders, which shall include—
 12                            ‘‘(I) the reasons why the development of
 13                     such an order is beneficial to the individual and
 14                     the individual’s family and the reasons why
 15                     such an order should be updated periodically as
 16                     the health of the individual changes;
 17                            ‘‘(II) the information needed for an indi-
 18                     vidual or legal surrogate to make informed deci-
 19                     sions regarding the completion of such an
 20                     order; and
 21                            ‘‘(III) the identification of resources that
 22                     an individual may use to determine the require-
 23                     ments of the State in which such individual re-
 24                     sides so that the treatment wishes of that indi-
 25                     vidual will be carried out if the individual is un-
                                               427
   1                     able to communicate those wishes, including re-
   2                     quirements regarding the designation of a sur-
   3                     rogate decisionmaker (also known as a health
   4                     care proxy).

The bill then runs on for another couple of pages trying to specify exactly when such consultations are eligible for reimbursement by the Feds.

(And again, folks, the whole plan is like this, at least the pieces I’ve seen. The best parts are the ones amending some already established law, which is referenced but not printed. Thus, you don’t really know what’s going on until you look up the act in question. This kind of hyperdetailed crap, written by lawyers not doctors, will utterly control the most sensitive and personal areas of your life if it is passed. Ahem.)

Now comes Sarah Palin to explain the confusion arising from this section:

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones…. If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]

As Lane also points out:

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive — money — to do so. Indeed, that’s an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic. [7]

Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]

Emphasis mine. Read the whole thing for [references].

So, no, the bill does not order physicians to make their patients agree to die. It simply offers to pay them to bury their patients in bullshit, including a disguised offer to allow themselves to be neglected to death, because remember: from here on out, your health care will administered with all the compassion of the IRS or the DMV. And eventually, there will be no alternative.
Via The Other McCain, who makes must-read comments.