End of life choice is a difficult talk for anyone and has been at the center of political controversy since the passage of the Affordable Care Act. However, as public mood has shifted, Medicare is now calling for the ability to reimburse doctors for visits in which they talk about end of life options with a patient. Currently, reimbursement if only possible on the first visit which critics say hurts patients by depriving them of knowledge about advance care plans. Private insurance companies have begun to cover these visits and doctors in some states have been encouraged for years to work these talks into normal office visits. But any change is likely to be slow due to strong opposition from groups that fear governmental agencies will use doctors to encourage people to accept death rather than fight for life. Legislation has been introduced to allow Medicare to cover advance care planning but has not found enough traction to pass into law. One thing is for sure though, this is an issue that will only grow in importance as a record number of American’s enter old age.
See Kristian Foden-Vencil, Medicare: Doctors Should Get Paid For End-Of-Life Talks, OPB, August 18, 2015.
Special thanks to Jim Hillhouse for bringing this article to my attention.
