In a nod to sanity, the Obama administration will pay doctors for end-of-life planning advice provided to Medicare patients, a provision dropped from the Affordable Care Act after the "Death Panel" lies were allowed to rule the day.
Under the rule, doctors can provide information to patients on how to prepare an "advance directive," stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.
In this case, the administration said research had shown the value of end-of-life planning.
"Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives," the administration said in the preamble to the Medicare regulation, quoting research published this year in the British Medical Journal.
The administration also cited research by Dr. Stacy M. Fischer, an assistant professor at the University of Colorado School of Medicine, who found that "end-of-life discussions between doctor and patient help ensure that one gets the care one wants." In this sense, Dr. Fischer said, such consultations "protect patient autonomy."
The administration and the members of Congress most involved in the issue, Rep. Earl Blumenauer and Sen. Jay Rockefeller, have been staying fairly mum on moving forward with this regulation, in anticipation of the FOX News death panel screeching. But for Medicare patients, their families, and their doctors, this common-sense measure will provide a degree of certainty and relief in a difficult time.
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