Last summer, some opponents of President Obama’s health reform bill set off a firestorm with claims that the proposed overhaul would include government-run death panels that would “pull the plug on Granny” if she ever came to require costly, end-of-life care.
Collateral damage from the scurrilous attacks included the jettisoning of proposed legislation that would have covered physician consultations for Medicare beneficiaries about end-of-life issues like hospice benefits, living wills and so forth.
Remarkably, some of the misperceptions created during that fiasco remain entrenched in the minds of American people. For example, 36% of seniors who responded to a July survey by the Kaiser Family Foundation said they believe the new health reform law does indeed create death panels. An additional 17% said they weren’t sure whether the law called for them or not.
The irony of course, is that the new law will improve options for terminally ill people, especially when it comes to hospice care. According to the Washington Post, current Medicare rules allow beneficiaries that have been deemed by a physician to have 6 months or less to live can opt to receive hospice care – “but only if they forgo any further life-prolonging treatment.”
In an attempt to partially shield people and their providers from this inhumane dilemma, the new law creates a “concurrent care” demonstration program in which Medicare will cover both kinds of treatment at the same time. The experiment will take place at 15 sites across the nation, and last for 3 years. The program will also be open to children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).
In hospice care, a team of providers manages pain and other symptoms in dying patients, but makes no effort to treat the underlying disease. Team members teach family members how to care for their loved ones and provide bereavement counseling after death.
Although experts agree that hospice programs can be exceptionally beneficial to dying patients and their families, less than 40% of people are receiving hospice care at the time of death, according to the National Hospice and Palliative Care Organization.
Experts in hospice care believe that patients and their family are optimally served if they access hospice services for approximately 2 months, yet the average length of time spent in hospice care is more like 20 days. Fully one-third of people receive such services for a week or less.
“We think it’s far too short a period for patients and their families to adjust to the realities of impending death,” Jon Keyserling, the NHPCO’s VP for public policy told the Post.
Of note, several private insurers including UnitedHealthcare and Aetna have covered both hospice care and life-prolonging treatment for enrollees in certain plans for several years.
Glenn Laffel, MD, PhD
Sr VP Clinical Affairs
Practice Fusion EMR