Legislation that Could End Unwanted Medical Treatment
By Daniel Wilson Roughly 25 million Americans have been subjected to unwanted medical treatment at some point in their lives, and that means we have a healthcare system that is not listening to patients.
We all say we believe in patient-centered health
care, and now we have a bill in the U.S. Congress that would put our money
where our mouths are. Literally.
Senators
Mark Warner (D-VA) and Johnny Isakson (R-GA) introduced legislation this month
that would make sure Medicare recipients and their doctors know how much or how
little treatment those patients would want as they approach the end of life.
The Care Planning Act of 2015 would specifically create a Medicare benefit for
people facing grave illness to work with their doctor to define, articulate and
document their personal goals for treatment.
Given
my organization's commitment to improving care and expanding choice at the end
of life, we believe this legislation sets the right goals and is smart about
how it achieves them.
The
Care Planning Act will go a long way toward ensuring that once a Medicare
recipient has determined and documented their treatment preferences, those
preferences go with them.
Ideally, everyone has an advance directive completed,
but only a minority of us does, and they are often ignored, anyway.
The
Warner/Isakson legislation creates additional layers of insurance that the
patient's wishes WILL be honored, across a variety of settings. It brings in
the patient's family members, friends, religious figures and wider health care
team to create a community of individuals who will understand and support the
choices the patient makes.
It even allows for training of people in the
patient's inner circle of family and caregivers in helping implement their plan
when the time comes.
In
short, this legislation recognizes that having our preferences documented is
not enough. It is built around the understanding that people need a care plan
they create in collaboration with loved ones and experts alike, and that the
plan needs to be regularly revisited.
The bill further recognizes that the
providers a patient meets across a range of medical moments and settings all
need to be focused on the patient's plan, as do the patient's advocates.
Importantly,
Senator Warner's and Isakson's bill also takes accountability seriously. It
will fund HHS to develop rigorous measures of success, where success means a
patient's documented care plan is completely followed by health care providers.
Success also means that health care providers facilitate their patients in
articulating and documenting their wishes, whether it's a family doctor during
an annual appointment or an ICU doctor after a patient is stabilized. Success
means every provider a patient comes into contact with is focused on the
patient's goals for treatment, and getting those goals met.
One
way this legislation ensures its goals will be achieved is by providing
reimbursement for advance care planning consultations. It's called a Planning
Services benefit, and it is paid to health care providers under Medicare Part
B.
In our fee-for-service system, this is the best way to ensure Medicare
beneficiaries have a real voice determining the amount of and type of care they
receive.
Compassion
& Choices is proud to support the Care Planning Act of 2015, alongside a
growing list of organizations including the American Academy of Family
Physicians and the American Geriatrics Society.
It gets us closer to the
patient-centered care everyone supports, and with its bipartisan sponsorship,
there is every reason it should pass and give American health care consumers
more power in our health care system.
Wilson
is National and Federal Programs Director, Compassion & Choices.
