The Centers for Medicare & Medicaid Services is now finalizing the rules to start paying for doctors discussing end of life care with their Medicare patients. That would be what Republicans used to call "death panels" and what the American public strongly supports, according to this month's
Kaiser Family Foundation survey.
There is broad support (81 percent) for requiring Medicare to cover discussions between doctors and patients about end-of-life treatment options. Similarly, the public supports private health insurance covering these discussions as well (83 percent).
About 9 in 10 (89 percent) say doctors should discuss end-of-life care issues with their patients. But, relatively few (17 percent) say they’ve had such discussions with a doctor or other health care provider, including 34 percent of people age 75 or more, 23 percent of people age 65-74, 19 percent of those age 50-64 and 12 percent of those age 18-49. In addition, those who report having a debilitating disability or chronic condition are more likely to say they have discussed their end-of-life care wishes with a health care provider than those without a disability (31 percent vs. 13 percent). A third of the public says they have participated in a discussion with a doctor about another family member's wishes about their care at the end of life, including 46 percent of those ages 50-64. Across age groups, many say they would want to have such a discussion about their own end-of-life care (50 percent overall).
It's not just the public, of course, who
value these discussions. Medical groups like the American Medical Association, and advocacy groups like the AARP and the Alzheimer's Association have called for them and for coverage of them by Medicare and private insurance. Outside of the politics of Obamacare, pretty much everyone thinks they're a very good idea.
Making these discussions part of everyday medical practice makes sense financially—huge amounts of money are spent keeping people alive in the final days of their lives. That happens in some cases because patients and their families choose that every medical intervention be done, but far more often because these discussions don't happen. Look at the results above: just 34 percent of people over age 75 have had this discussion with their doctor. But more than the financial aspect, giving people the opportunity to determine how they exit this life—giving them that dignity—is a reflection of a more humane society at large. It's about time we start on the path to getting there.