More Important Than Reimbursement
U.S. Rep. Earl Blumenauer (D-OR) and 33 other members of
the House of Representatives recently sent a letter to Centers for Medicare
& Medicaid Services (CMS) Administrator Marilyn Tavenner asking her "to adopt
recommendations that would adequately reimburse Medicare providers for having
voluntary discussions about end-of-life care and planning with patients.”
According to the letter sent to CMS on Sept. 24, the time
doctors currently spend having discussions with their patients about
end-of-life care and planning is not reimbursed under Medicaid and Medicare.
Unfortunately, without this incentive, these conversations are
"Patients who wish to make clear their goals, values, and wishes
through discussions with their trusted providers should have the opportunity to
do so,” Blumenauer notes in a press release about the letter. “In order to have these conversations, providers must
have the adequate time, space and reimbursement to conduct the complex and
time-consuming discussions necessary to learn about the goals and values held
by their patients and plan appropriately for their care.
“Every organization that has seriously considered this issue,
from the American Medical Association to the Institutes of Medicine, knows we
have to start respecting people’s choices about how they face the end of life,”
continues Blumenauer. “Making this simple change will have a profound effect on
the way patients and their families spend their final days, and everyone
deserves that dignity.”
While I fully support the recommendations in the letter from the
representatives to CMS, and although I understand healthcare is a business and also
recognize that the culture in the U.S. rewards those who make the most money they
can by charging as much as they can for their services at every turn, I have to
ask how any physician can justify on moral and ethical grounds refusing to speak to a dying
patient about their wishes at the end-of-life just because they may not get
paid for having the conversation.
Is there really nothing left that is more important than money?
The other signers of the letter, all of whom are Democrats, were:
Henry A. Waxman (CA-33), Suzanne Bonamici (OR-01), Peter DeFazio (OR-04), Ted Deutch (FL-19), Sander Levin (MI-09), Jim McDermott (WA-07), Lois Capps (CA-24), Rosa DeLauro (CT-03), Keith Ellison (MN-05), Sam Farr (CA-17), Rush Holt (NJ-12), Rick Larsen (WA-02), Barbara Lee (CA-09), Betty McCollum (MN-04), James P. Moran (VA-08), Chellie Pingree (ME-01), Alcee Hastings (FL-20), Jared Huffman (CA-02), Ron Kind (WI-03), John Larson (CT-01), John Lewis (GA-05), James P. McGovern (MA-02), William Owens (NY-21), Mark Pocan (WI-02), David Price (NC-04), Linda Sanchez (CA-38), Allyson Schwartz (PA-13), Mike Thompson (CA-05), Peter Welch (VT-At large), Bobby Rush (IL-01), Janice Schakowsky (IL-09), David Scott (GA-13), and Chris Van Hollen (MD-08).