Clearing up some misconceptions
In his Aug. 19, 2009, letter, William Slater discusses some provisions of H.R. 3200, America's Affordable Health Choices Act of 2009. Mr. Slater chiefly focuses on Sec. 1233, which deals with Medicare reimbursement of doctors (rather than you paying the bill) every 5 years for advance planning meetings with their patients. It appears there is some confusion on Mr. Slater's part, which is understandable given the legalese in the proposed bill. I will attempt to translate and clarify the confusion and try to dispel some common misinformation regarding this proposed legislation.
Section 1233 relates to meetings between a patient and doctor when a patient desires to discuss end-of-life issues. There is no requirement that end-of-life issues must be discussed, but the patient may initiate discussions. In that case, the doctor is required to explain advance care planning, important end-of-life medical issues, including end-of-life services and support available to the patient (ie. hospice care), and suggest persons the patient may wish to discuss those issues with (such as family members, friends or their attorney), and provide a list of free resources the patient may call for additional information, including legal services that may be free.
The doctor is also required to explain the sort of end-of-life care decisions you, as the patient, may choose and why those decisions are important. Often, these end-of-life decisions are what we see on medical shows; whether or not we want to be resuscitated after a heart attack, or whether or not we want to be put on life support and feeding tubes (the Terri Schiavo situation of a few years ago). There are a variety of documents you can sign which direct your doctor and the hospital what they should do and who can make medical decisions for you if you aren't capable of making them.
Section 1233 does not require or mandate the types of things stated in Mr. Slater's letter. If a patient desires, it requires a doctor provide information and answer a patient's questions about end-of-life issues and advance care planning. This has been occurring for decades and duplicates requirements passed by the Republican Congress and signed into law by President Bush in 2003.
As to Mr. Slater's other comments related to Sec. 1714, no where on pages 769 to 770 is found the language "increasing birth intervals between pregnancies." The language of Sec. 1714 relates to income levels in determining eligibility requirements under the Social Security Act and limitations on benefits related to family planning services and supplies, and medical diagnosis and treatment services provided pursuant to a family planning service in a family planning setting after cervical cancer.
Thank you for allowing me to provide some illumination regarding this most important issue.
Tom Bartlett-Svehla
Mundelein