The Bullies Won… Again

In a hugely disappointing move, the Obama administration has abruptly backed away from supporting a frank and open discussion about end-of-life planning between doctors and their elderly patients.

Only three days after implementing a new regulation that provided Medicare coverage for doctors to talk to their patients about what kind of care they wanted at the end of their lives, the White House announced on Wednesday that they were reversing it.

Why the short order flip-flop? Why disappoint the thousands of hospice workers, geriatricians, doctors, caregivers and seniors who had been working towards and supporting this kind of coverage, some of them for years?

Simple: Obama buckled to the bullies. As soon as the loud and vociferous opponents of end-of-life choice began their usual scare mongering and name-calling, he stood down. Instead of sticking to his principles, he chose the politically expedient response and caved…. again.

Yep, because these are the exact same folks who hijacked the healthcare reform debate in 2009 by telling us that Obamacare would result in “death panels” and that Big Government would decide whether or not your granny got to live or die. The same rabid conservatives and “Got you in our crosshairs” Palin supporters who managed to wrest our president’s lunch money away from him two years ago — only this time they just had to yell a little and he handed it right over.

The news is a devastating blow to anyone whose work involves helping people make decisions about end-of-life care. And it will mean millions of the sick and elderly will enter the final chapter of their lives woefully unprepared.

Only 20 or 30 percent of patients at the most have an advance directive in place in this country. The new regulation would have increased that number substantially. It would also have empowered dying patients to think about and choose the kind of death they wanted in advance. Instead, most of us will find ourselves at the mercy of a healthcare system that knows how to keep throwing drugs and procedures at us — insisting on unnecessary “heroic measures” right up to our final painful breath — but isn’t very good at helping us find comfort and peace at the end.

The implications of this cowardly backing down for our healthcare system and our aging population are devastating. It also reveals a most disappointing truth: our political system is being taken over by bullies and the leaders we elected with such high hopes to stand up to them are letting them do it.

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8 Responses to “The Bullies Won… Again”

  1. Susan English

    This is so disappointing and absurd! Thanks for puttting it out there -

  2. Ros Wyatt

    What depressing news. Totally spineless of Obama. Thanks for keeping me in touch with this.

  3. Betsy Rose

    Very well said, Zoe. Thanks for putting thought and language to important issues like this.

  4. Marti

    This is a sad day for senior citizens…….why do people have a problem with discussing the enivitable? I hate to tell you, no one gets out alive!! Why not discuss, debate, participate in these life threatening decisions? I happen to believe we chose to come here and we can choose to leave….now is the time to discuss this openly and honestly!

  5. B. Lynn Goodwin

    I had not heard this sad news. Of course debate in Washington has shifted again since you posted this….

    Thanks for keeping us up to date.

    Author of You Want Me to Do WHAT? Journaling for Caregivers

  6. Olivia

    I interpret this as meaning that the “end of life discussion” between patient & MD, as a diagnosis code won’t be paid by medicare, BUT a patient/family can still chose someone to research “end of life issues/concerns” on reliable internet sites, to assist family discussions, then bring some of the conclusions to a brief discussion w/ their MDs during an office/hospital visit. Other knowledgeable healthcare providers (e.g., hospice/palliative care RNs, NPs, LCSWs, MSWs, etc. can be sought for consultation on these matters. There are end-of-life blogs, email lists, support groups… Much information exists in various forms of print, including typical disease processes, their effects on life quality, & long-term prognosis, w/or w/o treatment. Okay so, Medicare won’t openly support reimbursement, for this discussion between MD & Pt., but it doesn’t have to be a diagnosis code cited on the medical billing record, either. No one needs be “victimized” by the Medicare penny-pincers. Information is available for all, in these amazing days of IT.

  7. admin

    Very good points, Olivia. Thank you for your comment. And to everyone else who wrote, thank you for your interest and concern on this topic! I have a feeling we’re going to be hearing a lot more about these end-of-life issues in the year to come.

  8. Catherine

    My mother, a retired nurse was always angry at the system being too worried that a terminally ill patient would be come an addict over the patient’s right to die pain-free. My mother would shake her head and say, “Who cares if they are addicted? They are going to die – why not let them die as comfortably, and pain-free as possible?” She has her Right To Die forms completed and has given my brother and I strict instructions on what to do when it is time to let her go.


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