Obama Regulations Put Death Panels Back in Health Care

Bioethics   |   Steven Ertelt   |   Dec 27, 2010   |   12:12PM   |   Washington, DC

New regulations the Obama administration will put in place starting January 1 essentially put the controversial death panels back in the much-maligned ObamaCare law.

Although Democrats dropped the idea during consideration of the health care law in Congress after significant public pressure, a new Medicare regulation taking effect at the beginning of the year will have the federal government paying doctors to advise patients on possible end-of-life care treatment options. The advice may include advanced directives to authorize withdrawal of lifesaving medical treatment or, in three states, assisted suicide.

Under the ObamaCare law, Medicare coverage of yearly physical examinations, or wellness visits, is authorized and a New York Times report indicates the new rule covers “voluntary advance care planning” as part of the annual visit. The rule allows physicians to discuss with patients the potential of an advanced directive — which can be used to request medical care and lifesaving treatment, or deny it.

The section of the ObamaCare bill that had pro-life advocates concerned about death panels would have allowed for taxpayer funding of end-of-life treatment discussions via Medicare once every five years. The new rule pays for such discussions annually.

Elizabeth D. Wickham, executive director of LifeTree, which warned LifeNews.com earlier this month about the problematic regulations, told the Times this weekend that the new regulation could encourage patients to agree, whether they understand or not, to rationing of their medical care and treatment.

“Patients will lose the ability to control treatments at the end of life,’’ Wickham said.

The new rule has received the praise of Representative Earl Blumenauer of Oregon, a euthanasia and assisted suicide backer who tried to get the death panels section in the final version of the ObamaCare bill on behalf of a pro-euthanasia group. He praised the rule as “a step in the right direction.’’

The rule was issued by Donald Berwick, the prominent rationing advocate pro-life groups strongly opposed and who was given a recess appointment when Republicans in the Senate blocked his confirmation to head Medicare and Medicaid and lead implementation of ObamaCare.

The Obama administration is pushing back on the New York Times story of the new regulation, which gained traction on the Internet over the weekend, saying the regulation is nothing new.

“The Times story is wrong. This benefit was signed into law under President Bush. The only thing new here is a regulation allowing the discussions –authorized in 2003 by the prescription drug benefit — to happen in the context of the new annual wellness visit created by the Affordable Care Act,” said White House spokesman Reid Cherlin, according to Fox News.

But the discussions, the point of contention for pro-life groups and conservatives who oppose the government giving financial incentives for doctors to push a potential rationing or revocation of treatment, is the crux of the issue.

Writing at the conservative publication Human Events, John Hayward says people need to understand the difference between allocation and rationing and says regulations like this one will ultimately hurt patients by hurting doctors.

“A recent report from The Physician’s Foundation showed 74% of doctors polled were considering restrictions on their practice over the next three years due to ObamaCare, while 40% were making plans to drop out of private practice altogether.  Those grim numbers only describe the effect of rationing on the existing supply of medicine.  The tidal effect of fewer medical students will be devastating in years to come,” he writes.

The death panels initially came under fire when former vice-presidential candidate Sarah Palin used the phrase to describe the advance care planning consultations found in Section 1233 of the bill before the final version received Congressional approval. The infamous Section 1233 of HR 3200 would have federalized “voluntary” end-of-life “consultations,” and, in three states, had patients advised they could seek a legal assisted suicide.

Earlier this month, LifeTree said The Federal Register (page 73406) published a new funding rule for “voluntary” advance care planning consultations that changes Department of Health and Human Services regulation pertaining to Medicare and Medicaid patients

Voluntary advance planning is defined as:

“Verbal or written information regarding the following areas: (1) An individual’s ability to prepare an advance directive in the case where an injury or illness causes the individual to be unable to make health care decisions[; and] (2) Whether or not the physician is willing to follow the individual’s wishes as expressed in an advance directive.”

“The new regulation states that advanced care planning consultations will now be offered (and funded) as part of the initial wellness visit for medicare patients and during all subsequent annual visits,” LifeTree says.

The group complained at the time that media outlets did not mention anything about the changes after they were published.

“Has there been any media attention to this important change in health care coverage for all those receiving medicare and medicaid services? You will recall the uproar about death panels, but this week funding for these consultation sessions became part of general government regulations without fanfare,” the group added.