The Year of Moving Forward

The Year of Moving Forward
At our 4 person wedding reception in DC

Tuesday, August 11, 2009

End of life issues

We all get these crazy emails forwarded by our Republican friends who accept what they say on blind faith without checking things out and forward them to everyone they know. One such email I got said this.

"ON PAGE 425 OF OBAMA’S HEALTH CARE BILL, the Federal Government will require EVERYONE who is on Social Security to undergo a counseling session every 5 years with the objective being that they will explain to them just how to end their own life earlier. Yes...They are going to push SUICIDE to cut medicare spending!"

So I looked at it. In the health care bill (which is not in its final form) are these words on page 425:

Advance Care Planning Consultation

Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years.

it goes on to explain:

‘‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.

‘‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.

‘‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.

‘‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).

‘‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.

Two things need to be said.

First of all, if your doctor is doing what he or she should be doing, they are already discussing these things with you.

Advance directives, living wills and health care proxies are good things, and they make life (and death) much simpler when the end of life comes. If certain things are decided in advance, the wishes that were determined by the person in question can be carried out without the emotions and rivalries of the survivors coming into play.

If you have not taken this step, you need to. Information about advance directives in Alabama (state specific resources, as described in the bill) can be found here. An advance directive for our state that you can download, print and use can be found here.

Second, if you think that the government is turning your life into a math equation trying to figure out who's going to die when and putting a dollar mark on your life, this is already being done by the insurance companies.

Insurance companies want to make money, and price their products so that they do. To do this, and to ensure solvency, they develop projections of future insured events such as death, sickness and disability. They develop mathematical models of the causes of death or particular illnesses and the timing of the events.

They produce life tables (or mortality tables) with rates of surviving or death and morbidity tables with rates or a disease. From these tables they can predict the probability of you dying at a certain age, or how many more years you should live, etc. Here is a sample life table. These can be developed for the entire country or for any group or cohort of people.

Then they add other risk factors such as smoking, age, etc., and using math and statistics they predict when you will die. Then they can figure how much to charge for their product based on how much will need to be paid out when.

This is easiest to understand when applied to life insurance and end of life. But the same type of statistics are used in determining health insurance rates (that generate huge profits).

So, while insurance companies are very interested in when you die and whether they should pay for certain treatments for particular individuals, there is nothing in this bill that indicates the government would be a proponent of ending your life earlier. However, the government is interested in making the end of your life easier for both you and your love ones to endure.

So, there is no forced euthanasia or suicide of the elderly in this bill.

Again, spreading such misinformation is not only malicious, it shows the ignorance of those doing so.

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