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July 30, 2009 • Volume 9, Issue 30
The opponents of health reform will say anything to stop it, no matter how untrue. The latest falsehood alleges that the America’s Affordable Health Choices Act of 2009 (HR 3200) would require older adults to obtain counseling “that will tell them how to end their life sooner,” in the words of Betsy McCaughey, an employee of the conservative Hudson Institute. Representative Virginia Foxx, Republican of North Carolina, went a step further, implying that the House Democrats’ health reform bill would “put seniors in the position of being put to death by their government.”
These falsehoods are designed to scare older adults and gin up opposition to health reform. In fact, HR 3200 provides Medicare coverage for a consultation with a doctor—not a government official—in which the patient can express her preferences regarding end-of-life care. The patient is not required to have this consultation, and there is no mandate for the patient to complete an advance directive (such as a living will) or forego aggressive treatment of a life-threatening illness.
In fact, HR 3200 makes substantial improvements to Medicare. The bill would phase out the Part D “doughnut hole,” the built-in gap in Medicare drug coverage that requires older adults and people with disabilities to pay the full price for their prescriptions while still paying the premiums for the drug plan. Although it would take until 2023 to fully close the doughnut hole, people with Medicare will benefit immediately as the gap is narrowed with each passing year. The enhanced coverage is paid for by securing lower prices for prescription drugs covered under Medicare Part D. In addition, brand-name drugs for people who are in the doughnut hole would be subject to a mandatory 50 percent discount.
The real threat to the lives of older adults and people with disabilities comes when they cannot afford to buy the medicines they need to treat a serious illness. That is happening right now when people enter the doughnut hole. Closing the doughnut hole is the right thing to do, and we need to pass health reform to make that happen. Please write your senators and representatives and tell them to Remember Medicare and pass health reform.
On July 28, President Obama held a town hall meeting at AARP headquarters in Washington, D.C., where he took questions from seniors about health care reform. The following is a transcript of one exchange between a caller and the president.
Question: “I have heard lots of rumors going around about this new plan, and I hope that the people that are going to vote on this is going to read every single page there. I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die. This bothers me greatly and I'd like for you to promise me that this is not in this bill.”
THE PRESIDENT: “You know, I guarantee you, first of all, we just don't have enough government workers to send to talk to everybody, to find out how they want to die.
“I think that the only thing that may have been proposed in some of the bills —and I actually think this is a good thing—is that it makes it easier for people to fill out a living will.
“Now, Mary, you may be familiar with the principle behind a living will, but it basically is something that my grandmother—who, you may have heard, recently passed away—it gave her some control ahead of time, so that she could say, for example, if she had a terminal illness, did she want extraordinary measures even if, for example, her brain waves were no longer functioning; or did she want just to be left alone. That gives her some decision-making power over the process.
“The problem is right now most of us don't give direction to our family members and so when we get really badly sick, sadly enough, nobody is there to make the decisions. And then the doctor, who doesn't know what you might have preferred, they're making decisions, in consultation with your kids or your grandkids, and nobody knows what you would have preferred.
“So I think the idea there is to simply make sure that a living will process is easier for people—it doesn't require you to hire a lawyer or to take up a lot of time. But everything is going to be up to you. And if you don't want to fill out a living will, you don't have to. But it's actually a useful tool I think for a lot of families to make sure that if, heaven forbid, you contract a terminal illness, that you are somebody who is able to control this process in a dignified way that is true to your faith and true to how you think that end-of-life process should proceed.
“You don't want somebody else making those decisions for you. So I actually think it's a good idea to have a living will. I'd encourage everybody to get one. I have one. Michelle has one. And we hope we don't have to use it for a long time, but I think it's something that is sensible.
“But, Mary, I just want to be clear: Nobody is going to be knocking on your door; nobody is going to be telling you you've got to fill one out. And certainly nobody is going to be forcing you to make a set of decisions on end-of-life care based on some bureaucratic law in Washington.” (President Obama, AARP Tele-Town Hall on Health, July 2009)
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Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.
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