A little talked about proposal greatly concerns U.S. seniors; the end-of-life treatment provisions in the Patient Self-Determination Act.
When the Patient Self-Determination Act was passed, keeping down the costs at the end of a person’s life was a Medicare and government issue. This is directly due to the fact that the largest part of a person’s medical expenses tends to come at the end of life. This act mandates that health care providers, nursing homes and hospitals tell patients about health care powers of attorney and make them aware of living wills.
One of the latest proposals, in keeping with the drive to change the health care system, is a proposal that doctors must talk to patients about end-of-life issues and to outline handling advanced health care directives and hospice care offered under the auspices of Medicare. This is startling because it means physicians will be cast in the roll of pseudo-lawyers discussing legal issues that affect their patients.
The interesting part of this proposed change is that if it’s passed as currently written, those same pseudo-lawyers, dressed as doctors, would make money from the government providing Medicare patients with end-of-life consulting every five years. This has the potential to happen more often if a person is diagnosed with a terminal condition. Also, this end-of-life consultation wouldn’t be offered to those covered under “other” health plans. As yet, no one has explained why that would be the case.
This proposal is rife with unanswered questions, not the least of which is who would train the doctors and how would seniors with dementia or other forms of cognitive impairment be informed about these “directives”? Obviously there are other dangling questions that concern America’s seniors when it comes to their health insurance coverage. Concerns that for the most part seem to be going by the wayside as the country struggles with the massive debt load it is carrying, and tries to handle an out-of-control health system before it falls flat on its face from overuse and abuse.
What do all the changes in 2010 in Medicare and Medicare supplements really mean? This is a question that seems to have no direct answer at the moment. Only time will tell how the coming changes to Medicare will affect American seniors.