Wednesday, August 26, 2009

HR 3200 Health Care Reform part 4

I have been writing recently about the House proposed health care reform bill HR 3200 and why I think it is a bad way to go about reform. I do want to comment today about two different topics, that of the so called "death panels" as well as some of the positive aspects of the bill.

First of all there are no "death panels".  Pages 424-434 do  cover advance care planning consultations. I have read this section a number of times and I can see there are two areas that I believe have led to the concerns. One is the requirement for there to be a consultation between the patient and the doctor at minimum every five years regarding advance care planning. The bill outlines what must be included in this consultation.There are a number of things but I think the areas of concern are "An explanation by the practicioner of the continuum of end-of-life services and supports available" and the "reasons why the development of such an order (regarding life sustaining treatment) is beneficial to the individual and the individual's family". This coupled with  a requirement for there to be developed quality measures on end of life care and the monitoring of physician's adherence to these quality measures (page 432)  can lead one to conclude that there could be external pressure imposed by the government to try to limit life sustaining treatments. I have to say that this is worded vaguely enough that it may be possible that that is exactly what is intended. I say this partly because of the great costs of end of life care to Medicare which I will discuss in another blog. But there are no "death panels" per se.

Secondly the latter half of the bill includes a great deal which I hope can be incorporated into any health care reform bill and those are incentives to increase the number of people going into primary care specialties and the Public Health Corp along with scholarships for disadvanteged students, prevention and wellness services grants, school based health clinics and increased incentives to make it easier and more attractive to get into nursing.

I will discuss later more about end-of-life services and how this is an issue that we can't just hope will go away.

Thought for the day

" How good it is to sing praises to God for He is gracious and a song of praise is fitting"

The psalmist

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