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The brouhaha over end of life counseling that caused the first of many leaks that have begun to sink the Obamacare boat was written by an assisted suicide advocate Congressman from Oregon named Earl Blumenauer—working in close association, with—surprise, surprise!—the assisted suicide advocacy group Compassion and Choices.  Rita Marker traces the history of the clause in an important piece in the American Thinker. From her column:

Blumenauer’s “end-of-life” terminology is part and parcel of Section 1233.  Clearly expressing his ownership of the section, he described an incident that took place when he was presiding over House proceedings.  Writing about Section 1233 in the Huffington Post, Blumenauer stated, “Actually, I know a little bit about this section because it’s a bill that I wrote which was incorporated into the overall legislation.”called the “Advance Planning and Compassionate Care Act.”

In fact, a portion of that bill, (Sec. 211, p. 50) makes up almost the entirety of Section 1233. Although Blumenauer and other defenders of Section 1233 vociferously deny that it could have anything to do with assisted suicide, his earlier bill acknowledged that assisted suicide would be included in such consultations.  Since federal law currently prohibits federal funding from being used for “items and services” related to assisted suicide, Blumenauer inserted language into HR 2911 (Sec. 111, p. 19) stating that advance care planning “shall not be construed to violate the Assisted Suicide Funding Restriction Act of 1997.”   That exception did not make its way into HR 3200, probably because any reference to assisted suicide would raise red flags.

That’s very interesting to know, isn’t it?  Supporters of the section have been shocked, shocked, that anyone could think that there was an agenda at work. And wait, there is another bill in the Senate that would apparently make end of life counseling anything but voluntary for the physicians:

Blumenauer is not the only lawmaker to propose advance care planning consultations.  Senator Mark Warner (D-VA) introduced a similar bill, curiously called the “Senior Navigation and Planning Act of 2009” (Warner told Medical Futility that he submitted the legislation because Congress is considering health care reform and he would like to see some of his ideas incorporated into that legislation.   His bill (Sec. 6, p. 14) would force doctors to provide information on advance directives and other end-of-life planning tools in “a form and manner, and at a time, determined to be appropriate by the Secretary [of Health and Human Services].” The consequence for not doing so would be severe.  No payment would be made to physicians for any items and services furnished after January 1, 2014,  unless they agreed (under a process established by the Secretary) to provide individuals with information on advance directives and other end-of-life planning tools.

Technically, a patient would not be forced to have an advance care planning consultation. However, physicians would be unlikely to treat them unless they agreed to do so since doctors who didn’t provide the end-of-life talk would not be paid for any other services.

Hmmm.  Now perhaps we know why an explicit voluntary clause for both patient and doctor was not put into HB 32oo.  Remember what I have been saying: It’s not the bill you have to worry about as much as the regulations.

Oh, and guess what, SB 1251 creates an advisory panel that would have bioehticists and other assorted people with a special interest in the field as members. From the legislation:
(a) Establishment- The Secretary of Health and Human Services shall establish the Senior Navigation Advisory Board (in this section referred to as the `Advisory Board’).
(b) Membership- The Board shall be comprised of advocates, researchers, government officials, health care providers, ethicists, caregivers, and other individuals with expertise in issues related to end-of-life care.

We know in which direction that boat would sail!

I don’t see why anyone would be surprised. This entire area of controversy is primarily about cutting costs. And many think the best way to do that is to tilt the playing field toward self rationing by seniors. And if that doesn’t work, futile care theory will finish the job.

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