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Health Insurance Reform Daily Mythbuster: Impact on Seniors

July 29, 2009

Myth: “Congress would make it mandatory, absolutely require, that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner.” — Betsy McCaughey, former Republican lieutenant governor of New York

Fact: The provision extends Medicare coverage to cover the cost of patients voluntarily speaking with their doctors about their values and preferences regarding end-of-life care–empowering older Americans on this critical issue. These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time.

Independent analysis by Pulitzer Prize-winning judged the comment a “Pants on Fire” “outright distortion”, writing:

McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would “tell [seniors] how to end their life sooner” is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn’t just wrong, she’s spreading a ridiculous falsehood.

More on the provisions:

Advance planning consultations are not mandatory; this benefit is completely voluntary.
The provision merely provides coverage under Medicare to have a conversation once every five years if — and only if — a patient wants to make his or her wishes known to a doctor. If desired, patients may have consultations more frequently if they are chronically ill or if their health status changes.

There is no mandate in the bill to complete an advance care directive or living will.
If a patient chooses to complete an advance directive or order for life sustaining treatment, these documents will help articulate a full range of treatment preferences, from full and aggressive treatment to limited, comfort care only. Patients that choose to have these documents and can customize them so that their wishes are appropriately reflected.

There are no government-chosen professionals involved.
The legislation simply allows Medicare to pay for a conversation between patient and their doctors.

In addition, trusted senior groups such as the AARP are supporting this measure and insurance reform. In a statement, AARP Executive Vice President John Rother wrote:

This measure would allow Medicare to pay doctors for taking the time to talk with individuals about difficult end-of-life care decisions. It would help provide people with better information on the positives and negatives–both physical and financial–that different treatments can mean for them and their families…This measure would not only help people make the best decisions for themselves, but also better ensure that their wishes are followed… To suggest otherwise is 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.

Myth: “…the Democratic [health care] plan cuts Medicare and takes away choices for millions of seniors. What does all this mean? Higher costs for the medicine and treatments you need.” — House Republican Leader John Boehner of Ohio

Fact:America's Affordable Health Choices Act includes several key provisions that improve Medicare benefits and health care for seniors, including the following:

Strengthens Medicare upon which millions of seniors rely
Preserves all of the choices in Medicare of doctors and hospitals that seniors have now and highly value.

Provides a permanent fix to Medicare payments to doctors
Ensures that seniors can keep the doctor they have now by ensuring that doctors in Medicare receive fair and appropriate reimbursements for their services, rather than facing steep cuts in payments.

Ensures that millions of seniors will save hundreds of dollars on their prescription drugs
Fills the “donut hole” in the Medicare prescription drug benefit (where drug costs are not reimbursed at certain levels).

Improves Medicare benefits for seniors
Eliminates co-payments and deductibles for preventive services under Medicare.

Limits cost-sharing requirements in Medicare Advantage plans to the amount charged for the same services in traditional Medicare coverage.

Improves the low-income subsidy programs in Medicare, such as by increasing asset limits for programs that help Medicare beneficiaries pay premiums and cost-sharing.

Computerizes medical records so seniors won't have to take the same test over and over or relay their entire medical history every time they see a new provider.

Extends solvency of Medicare by 5 years or more.

In addition, the AARP, the Center for Medicare Advocacy, along with many other organizations, are supporting reform – AARP:

We are pleased by the House TriCommittee's health care reform bill, which makes important strides towards making sure that every American has access to affordable, quality health care choices…… Those of our members in Medicare pay close to 30% of their incomes on out-of-pocket expenses and they deserve relief, especially in the prescription drug doughnut hole, where they get no benefit while paying premiums. This bill would make great strides for all of our members and their families.

President Obama:

We all know that right now, we’ve got a problem that threatens Medicare and our entire health care system, and that is the spiraling cost of health care in America today. As costs balloon, so does Medicare’s budget. And unless we act, within a decade — within a decade — the Medicare trust fund will be in the red… this is what health insurance reform is all about: protecting your choice of doctor; keeping your premiums fair; holding down your health care and your prescription drug costs; improving the care that you receive — and that’s what health care reform will mean to folks on Medicare… I’m confident that we can do the right thing once again, and pass health insurance reform and ensure that Medicare stays strong for generations to come.