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bureaucrats-have-revived-end-life-counselingAmerican Spectator:

Remember the controversial provision of Obamacare that would have paid physicians extra money to provide “end-of-life counseling” to seniors whose conditions required expensive medical care? That feature of “reform” caused such a public outcry that the Democrats had to drop it from the final legislation. But the government apparatchiks didn’t give up. On Christmas Day, 2010, it came to light that the Centers for Medicare and Medicaid Services (CMS) planned to implement the program anyway. Within a week, however, vehement objections by clinicians and citizens alike forced the CMS bureaucrats to back off once more. Well, they’re at it again.


The New York Times reports, “Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association.” If CMS accedes to this “request,” many doctors will find it difficult to resist the resultant financial pressure to counsel gravely ill seniors concerning their “options.” Why? At present, Medicare doesn’t pay enough to cover the cost of an office visit to a family physician. But an additional payment for end-of-life counseling will render such visits marginally profitable, which will encourage doctors to inform Granny about the “pros and cons” of some treatment plan that might land her in Forest Lawn.


There are, of course, few “pros” associated with relocation to the local necropolis. So, what makes the Obama administration believe end-of-life counseling will be more acceptable now than it was four years ago? This time, it will use the vestigial prestige of the American Medical Association (AMA) for cover. The public believes the AMA is, as the Times puts it, “the country’s largest association of physicians and medical students.” In reality, it represents less than 20 percent of practicing physicians. The vast majority of the AMA’s income emanates from its government-granted monopoly on the Current Procedural Terminology (CPT) coding system.Scissors-32x32.png

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