Health Care Law: New Words, Same Meaning (2010)

by Rita L. Marker On March 23, 2010, President Obama signed HR 3590, the "Patient Protection and Affordable Care Act" (P.L. 111-148, 124 Stat. 119) which was drafted by the Senate. The following week, on March 30, 2010, he signed HR 4872, the "Health Care and Education Reconciliation Act of 2010" (P.L. 111-152, 124 Stat. 1029) as part of the budget reconciliation process, amending and modifying HR 3590. Together, they make up the new health care law that is often referred to as ObamaCare. During the months leading up to passage of the health-care overhaul legislation, there was a lot of discussion—sometimes very heated discussion—about death panels, end-of-life consultations, and advance care planning. But are those words in the new law? The answer is "no." In fact, the phrase, "death panel," was never in any version of the law. It was used by many to describe what they believed would happen if the law passed. The reasons for that concern were provisions about end-of-life consultations and advance care planning that would be paid for under several early versions of health care reform. Heightening that concern was the fact that the assisted-suicide advocacy group Compassion & Choices (C&C)—previously known as the Hemlock Society—had openly acknowledged that it had played a major role in formulating and supporting the end-of-life and advance care planning portions of the early bills. However, one can search the more than two thousand pages of the new law and not find the words "end-of-life options" or "advance care planning." So, it would be tempting to breathe a sigh of relief and assume that the problems envisioned by...

How Will Hospice Care Change?

[Note: Read the comment at end. I think that comment is more likely than the answer from the NYT. Left out of all the discussion is how assisted suicide will “work” in hospice. The Obamacare bills I read used the same disclaimer terminology about not condoning assisted suicide that Oregon’s assisted suicide law uses. While the end comment is “only” a comment, it is a comment worth repeating, if simply to stimulate reflection.] Q. I am a medical social worker in the hospice arena. Would this bill include cuts to the hospice Medicare program? What would this bill mean to hospice programs in general? — Mary Z A. Hospice benefits won’t change under the new law, said Vicki Gottlich, a senior policy lawyer at the Center for Medicare Advocacy. The House provision that would have required plans to offer voluntary end-of-life counseling — which led to the infamous “death panel” claims that government bureaucrats would be empowered to give the thumbs up or thumbs down to care for the critically ill — was dropped. Nothing similar was included in the Senate bill, which ultimately became law, Ms. Gottlich said. Comment: Douglaston, NY May 12th, 2010 The buildings will still be there, the admission standards for hospice care will still be there, but there are lots of changes this law will make to hospices, and they’re not good. Hospice care is often provided by non-profits, and church or religious affiliated agencies. Should they not undertake the paperwork required by the secretary, the states, the countless bureaucracies this law creates, hospices will see their reimbursement cut 2% for each report they...