There Will Be "Death Panels" but They Have Nothing to Do with Advance Care Planning
In yesterday's New York Times, distinguished health economist Uwe Reinhardt accurately distinguishes the movement toward greater cost control and the proposed Medicare reimbursement for advance care planning.
Re H.R. 3200 sec. 1233: "The thrust of . . . the Senate bill and of Section 1233 of the House bill, was to enhance the probability that the end-of-life care actually received by a person should conform to his or her own preferences, rather than either the physician’s or the government’s preferences."
Re Rationing: "As health spending grows, year after year, roughly twice as fast as the payroll that supports private health spending in this country, Americans sooner or later will have to confront the hard questions about access to expensive treatments . . . ."
There are already death panels--private insurance, Medicare, Medicaid, and the Veterans Administration all face daily the issue that within the arena of health care there are unlimited demands for services and treatments, but only finite resources to meet them.
The messy and honest-as-I-can-be-truth: There is not a good way to deal with this issue.