Healthcare reform bad for seniors?
House bill includes advance care planningStarting to see and hear more about aging and end of life provisions in proposed health reform measures.
A guest column in the New York Post by the former lieutenant governor of New York, Betsy McCaughey, states in part:
One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and "the use of artificially administered nutrition and hydration."
This mandate invites abuse, and seniors could easily be pushed to refuse care. Do we really want government involved in such deeply personal issues?
When you read the language in the bill, it sounds a lot like rather basic advance care planning. The link to the entire bill … 1,018 pages … is:
http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf
You can scroll down rather easily to pages 425 to 430.
What do you think?
Labels: aging and end of life, healthcare reform
posted by Practical Bioethics at
9:28 AM
5 Comments:
Comment received via email:
I see nothing wrong with health care and advance care planning per se. I expect that to be a feature in any single-payer health care program.
I do have some concerns, however.
Every now and then I hear (and sometimes see things in print) that "the Seniors are living too long." Back in the 1960's and early 1970's I occasionally heard and read references to the practice among some Inuit (Eskimo) tribes where the elderly, when they required too much care, would say their goodbyes, and start walking out on the sea ice, never to return.
That form of suicide was held up as something "enlightened." (I disagree: suicide in any form is always an absolute "wrong.")
As a bishop of a small Church which accepts the teachings of the Roman Catholic Church, suicide and euthanasia (whether active or passive) are always wrong.
So I see it as the responsibility of Churches which share this opinion to teach this to their people, and lead them to sign advance care directives which forbid both active and indirect / passive euthanasia.
That way, when counseled in that direction, the people will reject the counselor's advice.
Blessings,
+ Irl Gladfelter, D.D.S., M.Div., S.T.M., D.D.
Metropolitan Archbishop of the Anglo-Lutheran Catholic Church
(816) 468-96t91
There is nothing wrong with advance care planning. Many of our end of life disputes are because of lack of thinking or planning for terminal illness. Precisely because these are sensitive issues and they need to be discussed before there is a crisis. It may be sensitive but it is critical enough that it needs to be done. In fact, because it is sensitive and often not addressed, some form of mandatory system will help.
The fear of "abuse" should not be reason to prevent the implementation of a useful and much needed change. There can be abuse of any law or rule. The benefits of clear discussion on EOL outweight the occasional abuse.
This is a good bill and I endorse it.
Unfortunately, advanced care planning will result in euthenasia of the elderly.
However, it would be no more prevalent under any single-payer health care program than it is in our current system where senions on Medicare and Tricare provide great product for the industry.
It is my belief that physicians throughout the USA have been using "Do Not Ressusitate" DNR's to euthenize elderly patients as a matter of expediency and fiscal policy with and without the elderly patients permissions.
If we talk about money, I guess I will not expende money saving someone old because old people and sorry for this, it's useless and just obstruct another people's life.
As long as the advanced directive and the DNR are voluntary and require the consent of the patient under a single-payer health care program, there's a chance that we won't send the elderly off earlier to die to save money and PROFITS -- that is, if federal and state laws mandate the written informed consent of the patient or the legal surrogate.
DNRs are being used in our health care system today to cut the costs of treating the elderly at the end of life BUT many times these DNRs are without the informed consent of the patient or the patient's legal surrogate.
We need new law to clarify that DNRs are voluntary and that they require the written consent of the patient or the legal surrogate before the DNR can be put in hospital or nursing home charts.
This rampant age discrimination that is hidden takes place in the for-profit health care system who want no change to the current system and who divert attention as to what is going on behind the scenes by claiming that universal or uniform DNRs that would require informed and educated consent would increase the euthanasia of the elderly.
Healthcare reform would save a lot of seniors if the truth were known!
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