Hospital backs bill on pay for end-of-life planning

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Hospital backs bill on pay for end-of-life planning

Posted: Sept. 12, 2009
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La Crosse — Gundersen Lutheran has long been a pioneer in ensuring that the care provided to patients in their final months complies with their wishes. More recently, it has taken the lead in seeking to have Medicare compensate physicians for advising patients on end-of-life planning.

The hospital got its wish this spring when House Democrats inserted that provision into their health care reform bill - only to see former Alaska Gov. Sarah Palin seize on it as she warned about "death panels" that would deny care to the elderly.

Despite widespread debunking, those warnings have led lawmakers to say they will drop the provision.

"It's really distressing," hospital official Bud Hammes said. "These things need to be addressed."

La Crosse became a pioneer in addressing end-of-life questions in the mid-1980s, after Hammes, a native of the city who has a doctorate in philosophy from the University of Notre Dame, arrived at Gundersen as director of medical humanities, charged with educating resident physicians about ethics.

He noticed a "troubling pattern," he said, in which family members struggled to make medical decisions, such as whether to continue dialysis after a stroke.

"We'd turn to the family and say, 'We need your input. If your mother or father could speak now, what would they tell you?' And the family would say, 'If we only knew,'" said Hammes, 59.

Backed by a few other hospitals, Gundersen set out to change the federal rules to reward end-of-life planning.

After sporadic bipartisan attempts in recent years to add consultation payments to Medicare, Rep. Earl Blumenauer (D-Ore.), submitted legislation this spring, with several Republican co-sponsors, that included a provision to reimburse doctors for consultations. A few months later, House Democrats tucked similar language into their health care reform bill.

Then the uproar began. Gundersen officials were particularly upset when Sen. Charles Grassley (R-Iowa) whom they had considered an ally, said the government should not "pull the plug on Grandma."

Gundersen officials still are fighting to keep consultation payments in the bill. The discussions do not promote less aggressive care, Hammes said. "We're not trying to talk them into anything. We're trying to understand their values and goals, and tell them what medical science can and can't do," he said.

- Washington Post

http://www.jsonline.com/business/59087992.html