RE “WHAT the end-of-life conversation can bring’’ (Page A1, Sept. 2) and the Sept. 7 letter “Shame on fear-mongers’’: I am labeled a fear-monger for my concerns regarding health legislation HR 3200. The article and letter suggest that under the bill, Medicare would simply cover end-of-life counseling if you choose to seek your doctor’s advice on these issues. Wrong. Simply providing coverage would have taken one or two lines in the bill, not six pages.
The bill lists what “shall’’ be covered in the consultations, a decision that should be left to the patient and doctor, not prescribed by government. The bill’s partisans say the consultation sessions are voluntary. But if there is a penalty for noncompliance, then it is not voluntary, regardless of whether the word “mandatory’’ is used. The penalty is on Page 432. Doctors’ quality ratings would be determined in part by the percentage of the doctor’s patients who create a living will and the percentage who adhere to it - and quality ratings affect a doctor’s Medicare reimbursement.
The “adhere to’’ part is especially dangerous. Some people say they’d rather die than be on a ventilator, but when the time comes, they choose to live. Doctors would incur penalties when situations change and a living will is not adhered to. As a patient advocate, I see these difficult situations and know that government should not be involved.
The writer is chairwoman of the Committee to Reduce Infection Deaths.