With charges, countercharges, information, disinformation, flat-out lies, and half truths being disseminated on all sides of the health reform debates, how is a poor citizen to learn the real story? Today begins the first in a series of occasional posts called Straight Talk that will sort out information and misinformation for readers who may feel themselves caught in the middle and not knowing who to believe. We invite you to send us examples of questionable claims on which you would like us to comment. Direct your questions to trudyal530 [at] aol.com. The entire series is archived here.
In mid-July, Betsy McCaughey, identifying herself as a former lieutenant governor of New York state and chair/founder of the Committee to Reduce Infection Deaths, penned op-eds in two editorially conservative newspapers: The Wall Street Journal and the New York Post. The first, published in the Post on July 17, rambled on about people being forced into “qualified” health plans with limited access to specialists and treatments. It sounded scary, but McCaughey didn’t tell readers that the term “qualified plans” may mean plans that will offer minimum benefits as protection against being underinsured and potentially bankrupt when illness strikes. That’s a good thing.
McCaughey then went on to mention “one troubling provision in the House bill” that, she said, “compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care.” She posited that the sessions cover “highly sensitive matters” and that the mandate “invites abuse.” Seniors, she said, “could easily be pushed to refuse care.”
The day before the Post published another of her op-eds, entitled “Deadly Doctors”, McCaughey appeared on former Sen. Fred Thompson’s radio show, saying that “Congress would make it mandatory—absolutely require—that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner”—an inaccurate assertion that apparently scared the bejesus out of Thompson’s listeners.
In the Journal op-ed, which was mostly about seniors being denied care, she offered more scary stuff. McCaughey claimed that the House bill:
Ensures that seniors are counseled on end-of-life options, including refusing nutrition where state law allows it (pp 425-446). In Oregon, some cancer patients are being denied care by the state that could extend their lives and instead are afforded the benefit of physician-assisted suicide instead.
To set the record straight, we checked in with Washington and Lee law professor Timothy Jost, an expert on consumer-driven health care. Jost told us that the bill allows Medicare to pay for voluntary consultations between doctors, nurse practitioners, and physician assistants about advance planning for the end of life. Medicare will pay for the service every five years, or more often if warranted by changes in a patient’s health. Consultations can cover such issues as hospice and palliative care, setting up a durable power of attorney, and advance directives which instruct medical providers about your wishes for end-of-life care. In my other writings, I have urged consumers to set these up, but according to Howard Brody, who directs the Institute for the Medical Humanities at the University of Texas, Galveston, only about one-quarter of Americans have done so.
“There is nothing new here,” Jost explained. The proposed legislation builds on the Patient Self-Determination Act of 1990, signed into law by George H.W. Bush. That law requires hospitals, nursing homes, hospices, and home health agencies to provide the same kind of information contemplated in the House bill. “Anyone who has been though the death of a parent knows the value of this service,” Jost said. “It is impossible to believe that this innocently got twisted into this ‘death panel’ legislation.”
In the op-eds, McCaughey did not mention her affiliation with a group called Defend Your Health Care—which, according to a receptionist at the Committee to Reduce Infection Deaths, is her policy organization. The group’s bare-bones Web site spotlights some of McCaughey’s appearances in print and on television, and offers links to the House and Senate bills and various other articles about health care reform—like one by Charles Lane, an editorial page staffer at The Washington Post, who is worried that the consultations may not be so voluntary; and a Wall Street Journal opinion piece by a woman with cancer, who fears that comparative effectiveness research studies will lead to rationing and will prevent cancer patients from getting all the tests and treatments they need. These articles reinforce points McCaughey has been making.