Worse still, the legislation states that the Medicare system will rate a doctor’s “quality” and adjust reimbursement based on the percentage of the doctor’s patients who create living wills and the percentage who adhere to them (p. 432). Paying doctors for consultations is fine. Penalizing them based on their patients’ choices is wrong.
The “adhere to” part is especially dangerous. Some people say “they’d never want to be on a ventilator,” but when the time comes, they choose it over death. Under the House bill, doctors would incur penalties when families don’t adhere to end of life plans — a horrible conflict of interest.
As a patient advocate, I see these difficult situations and know that government should not be involved. As you can see, my concerns are unrelated to and do not mention “death panels.” Your “Words and Meaning” column incorrectly identifies me as a “proponent of the ‘death panels’” interpretation. Even Jon Stewart made it clear I had not made such a claim.