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Posted by Dr. Lachlan Forrow August 26, 2013 02:03 PM
Can you think of any health care bill that bipartisan members of today's House of Representatives could join in supporting?
What could possibly unite Tea Party Congressman Reid Ribble (R-WI), who has proudly voted several times to repeal or "defund" Obamacare, and Congressman Jim McDermott (D-WA), a leading advocate of a single-payer health care system? What common ground could there be for a conservative like Congressman Phil Roe (R-TN), who labels the Affordable Care Act (aka "Obamacare") as a "job destroyer", and Sandy Levin (D-MI), who has condemned Republican efforts to defund the Affordable Care Act as a "blind obsession"?
All four are among the first 18 co-sponsors of H.R. 1173, the perfectly-named "Personalize Your Care Act of 2013" -- perfectly-named because the name succinctly captures, in precise, accurate, descriptive terms, exactly what the bill intends to achieve.
The bill would authorize several important new steps to ensure that a person's medical care is reliably "personalized" -- i.e. is anchored in the patient's own goals and preferences for care:
1. Allow Medicare and Medicaid to cover "Voluntary Advance Care Planning" Consultations
This would allow a patient and her/his physician (or nurse practitioner or physician assistant) to have a visit every five years, or more often if there is "a significant change in the health, health-related condition, or care setting of the individual", to discuss the patient's "preferences and values", and if desired to incorporate those "into the medical plan, an advance directive, [or] a physician order for life-sustaining treatment."
2. Support development of "Advance Care Planning Standards for Electronic Health Records"
The bill would instruct the Secretary of Health and Human Services to "adopt...standards for a qualified electronic health record with respect to patient communications with a health care provider about values and goals of care, to adequately display...the patient's current advance directive", as well as any "physician order for life-sustaining treatment".
3. Ensure "Portability of Advance Directives"
The bill would stipulate that "An advance directive validly executed outside the State in which such a directive is presented must be given effect by a provider...to the same extent as an advance directive validly executed under the law of the State in which it is presented."
In introducing the bill, lead sponsor Congressman Earl Blumenauer (D-OR) explains (see this wonderful short video clip) how this bill would support things that the overwhelming majority of all Americans already favor, cost nothing, and quite possibly even save Medicare money on expensive, high-burden, hospital treatments that fully-informed patients may choose to forego in favor of time at home.
All that now needs to happen is for Congress to unite behind the bill and pass it this fall, so that it can take effect on the bill's specified effective date of January 1, 2014. If that seems like a no-brainer, we all need to remember that a similar proposal was derailed in 2009 when Sarah Palin screamed "death panels", even though that outrageously-false allegation was declared "lie of the year" by PolitiFact.com, condemned by AARP as a "gross, and even cruel, distortion...especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives", and exposed by Jon Stewart in an unforgettable two-part interview of Betsy McCaughey as utterly baseless.
In 2009 Sarah Palin and her allies won. Will 2013 be different?
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About the authorLachlan Forrow, MD is Director of Ethics Programs and Director of Palliative Care Programs at Boston's Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School. More »
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