Due to the weather, some customers may experience late delivery of The Roanoke Times. We apologize for the delay.
Sen. Mark Warner will try again to give throughtful consideration to a touchy topic.
Monday, April 1, 2013
The Senate is in recess for Easter, and Sen. Mark Warner has been touring Virginia, talking about the budget, immigration reform — and end-of-life care.
The latter hasn’t been a front-burner issue for most Americans since propaganda about “death panels” died down after Congress passed health care reform.
It’s a public policy issue, though, that Warner knows well and is not likely to forget. He has spoken frequently about the agonies of watching his mother die of Alzheimer’s disease. Now he’s telling audiences that when he returns to Washington this month, he will reintroduce the Senior Navigation and Planning Act, a bill he first offered in 2009.
Among other things, it would provide for Medicare and Medicaid coverage of advanced illness care management services, and require doctors to tell patients with specified diseases about advance directives and other end-of-life planning tools. Not surprisingly, it died in committee.
The misinformation campaign leading up to passage of the Patient Protection and Affordable Care Act had created so much public fear around the subject that the Obama administration had cut a simple provision in the House-passed health reform bill to pay doctors for an advance care planning consultation with their Medicare patients every five years — giving them a chance to think about end-of-life care options and make their wishes known while they were able.
The new law did authorize annual wellness visits, however. And after the furor died down, the administration achieved its well-intended purpose through the regulatory process. It made a rule that voluntary advance care planning during an annual visit will be covered by Medicare.
That is well and good, a compassionate service to people as they age. It can benefit families, as well — no small thing. If thinking through future treatment options inspires open conversations, they will be spared much of the stress and grief of making choices for loved ones in crisis because they’ll know what their wishes likely would be.
An administrative rule can change with administrations, however. And Warner’s bill would go further to educate the public about end-of-care issues, and ensure at-home hospice patients the care they need.
Likely, there is some political risk in starting this conversation again — an indication how badly it’s needed.
Weather JournalMidday update: More ice likely later