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http://www.cnsnews.com/news/article/52529

“House Health Care Legislation May Lead to ‘Unintended Consequences,’ Republican Senator Says”
Friday, August 14, 2009
By Susan Jones, Senior Editor

(CNSNews.com) –

SNIPPET: “Grassley announced on Thursday that the Senate Finance Committee has dropped end-of-life provisions from its health care legislation — “entirely because of the way they could be misinterpreted and implemented incorrectly.”

That’s apparently what many town hall attendees fear.

While Democrats insist that concerned American citizens are “spreading lies” about health care reform legislation, Grassley speaks for those who worry that end-of-life provisions in the House bill will be interpreted in a way that encourages the elderly and infirm to forego life-sustaining treatment.

Section 1233 of the House bill 3200 has been a target of particular wrath at town hall meetings across the country.

What the bill says

Section 1233 deals with “advance care planning consultations” between Medicare patients and a doctor, nurse practitioner or physician’s assistant – someone who is legally authorized to sign orders for life-sustaining treatments.

Section 1233 says Medicare will cover such consultations once every five years, or more frequently – “if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility, or a hospice program.”

“A consultation under this subsection may include the formulation of an order regarding life sustaining treatment,” the bill says.

The bill specifically says that advance care consultations shall include the following:

(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.

(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.

(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations…

(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.

House bill 3200 further says that explanations of life-sustaining treatment shall include:

— reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;

— information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and

— resources that an individual may use to ensure that his or her treatment wishes will be carried out if the individual is unable to communicate those wishes. (i.e., health care proxy).”