Video: Fox News continues to spread myth of 'mandatory' end-of-life consultations

HR 3200 does not mandate end-of-life care.  AP Photo Hans Pennink

The phrase "mandatory end-of-life consultations" is repeated again and again by conservative media without ever providing real support the claim.  In the video below the Fox hosts conveniently slip in the phrase in order to take another jab at health care reform.  What they never do is actually analyze the health care bill to justify the claim.  There is a good reason.  Nowhere does any of the health care bills mandate end-of-life consultations.

The portion of the health care bill that opponents claim, and I stress claim,   mandates end-of-life consultations is page 425 of HR 3200.  Most opponents curiously never cite the actual section of the bill where the alleged language or provide a link to the language.  I will.  The section number is 1233 which can be found here for you to read yourself.

The language that opponents emphasize and misinterpret is the portion which says an end-of-life consultation shall consist of visit with a physician or nurse every five years which includes the formation of a living will, etc.  Opponents claims shall=must and so everyone must have such a visit.  There are a number of problems with these claims.

First, notice how the statute refers to an optional end-of-life consultation with a health care practitioner and not the government bureaucrats that opponents claim will come to the houses of elderly.  There is a reason for this, the law actually provides additional coverage for older people who want to visit their doctor or nurse to arrange for advanced care directives.  So if, for example, my eighty year old grandma does not want to be kept on a respirator forever she can chose to have a visit with her doctor to have an advanced care directive made so that she passes the way she wants to and not the way the hospital decides.  Does this sound scary?  No it does not but opponents had to twist the language to try and make the bill seem scary to defeat reform.

Secondly, you will notice that in the statute nowhere does the law say that older people shall have these consultation or must have these consultations or that they are forced to have these consultations.  Instead it says that an end-of-life consultation shall consists of blah blah blah.  The statute is defining what an end-of-life consultation is not mandating everyone have end-of-life consultations.  To give an example, suppose I say that a car shall have four wheels.  Does this mean that everyone shall have a car?  Or that everyone shall have four wheels?  No of course not but again opponents twist the language to mean something it does not.  To use a more realistic example, current Medicare regulations stipulate what shall constitute a doctor's visit.  Are seniors forced to go to doctor's visits right now?  No.  Just because the statutes defines what an end-of-life consultation shall include it does not mean everyone shall have that end-of-life consultation.

Finally, for those who argue government will use the provision to end care for the elderly they have no proof to validate their claims.  If the argument is, as the Fox News puts it, that government health care=denial of care for seniors then why are people not currently denied care on widescale basis through Medicare.  After all, Medicare is government run and the closest thing we have to socialized medicine yet the elderly still receive more than adequate care under the program.  The reality is that because there are limited resources some people will always be denied some care no matter what the system.  Every system, including our current system, has some kind of rationing.  If you do not believe me look up how many ninety year-olds are currently getting heart transplants in our current system.  Right now care is rationed by insurance companies and mostly limited on the basis of wealth.  Reform will actually provide a more equitable system.