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Medicare and Medical Futility


The media are cooing over the news that Medicare will reimburse doctors $86 for half-hour consultations about the kind of treatment patients would—or would not—want should they become incapacitated. Such coverage was slated to be part of Obamacare, but was dropped after it became controversial when Sarah Palin warned against “death panels.”

Now, six years later, Medicare’s coverage of these important conversations (and private insurers are sure to follow) has brought nary a peep of protest. Nor should it. Making treatment desires known in advance—and appointing a trusted surrogate to carry out your wishes if you become incompetent—is only wise.

End-of-life care conversations became controversial because Palin and others feared that patients would be pressured to refuse expensive treatment and would be given little opportunity to choose care. With the continuing emphasis on medical cost cutting—and the possibility of future health care rationing in the air—it was and is a reasonable concern. But today’s advance directive forms make it easy to opt for care. To assuage fears of pressure, moreover, the regulation makes it clear that the discussions are to be voluntary, at the discretion of the patient, offered but not required as part of Medicare’s annual “wellness exam” benefit.

Read more at the Weekly Standard.

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