Can 575,000 people be wrong?

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James M. Berklan
James M. Berklan

Perhaps it's a rare sign of level-headedness and civility in this day and age. But I found it stunning Tuesday when I read that more than a half million people had taken advantage of new Medicare coverage that pays for end-of-life discussions with their doctors.

And there was hardly a peep about it.

What a contrast to the hysteria of 2009 when hack politicians and talk-show hosts with too much air time on their hands warned against these talks. It wasn't the first, or even most egregious, instance of political grenade-tossing in history.

But it paved the way for a more irresponsible era, where rolling political smoke bombs regularly into the tent to get a rise out of the public became expected programming. It's an ugly development that predates, but no doubt contributed to, the election of a Commander-in-Chief who regularly jerks the country's puppet strings 140 characters at a time.

So the calmness that met the end-of-life planning statistics is nothing short of a marvel.

This is because the end-of-life planning coverage was infamously torqued less than a decade ago into the term “death panels” by opportunistic rabble-rousers. If I could find a short enough video clip that shows the person most often identified with the exploitative phrase — one-time vice president candidate Sarah Palin — I would. But they all seem to be (go figure) too long-winded.

Nearly twice as many people as predicted consulted with their physicians about end-of-life care in 2016, according to federal statistics cited by Kaiser Health News. That's the first year that Medicare reimbursed for such consultations.

The number is expected to rise by leaps and bounds, as well it should. Long-term care providers and other experts frequently extol the virtue of advance directives and care planning, and that's what this coverage is about: making informed decisions.

According to statistics, more than 22,000 healthcare practitioners took part in the Medicare-sponsored program in 2016. That number is likely depressed because many physicians — and individuals — don't realize the option exists. A provision of the Affordable Care Act, it was approved in 2015.

It pays physicians $86 for the first 30-minute office session and roughly $75 for subsequent visits. So there is consideration for doctors taking part. In addition, advocacy groups are trying to spread the word among physicians to encourage greater use.

Less than 1% of Medicare beneficiaries took advantage of the benefit in 2016. In an age where hospice use is on the rise, it seems logical that more people would be interested in holding informed discussions about their healthcare near the end of life. Goodness knows we all like to hold them when we think we still have plenty of years left to kick around.

There is still a political tug-of-war going on, however. In January, Rep. Steve King (R-IA) introduced the Protecting Life Until Natural Death Act, which would stop Medicare reimbursement for advance-care planning appointments. The fate of that bill is unclear, but it probably could use some end-of-life consultation of its own.

Often glossed over in the debate about this coverage is that the benefit is voluntary. In addition, a person's choices would be carried out by a legal document guided by the beneficiary's own wishes.

In other words, person-centered care in its purest form.

Follow Editor James M. Berklan @JimBerklan.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.