Here’s a point that almost no one understands about the new regulation issued by Medicare concerning end-of-life counseling. Joseph Lawler, in his post at AmSpecBlog about this latest bureaucratic fiat, reminds us that Avik Roy raised the conflict of interest issue last summer.

It comes down to this: if the government is funding health care, and simultaneously funding end-of-life counseling, the government has a conflict of interest.

 How’s that?

The government has a financial incentive to encourage people to “pull the plug on granny,? regardless of whether or not that is consistent with granny’s, or her family’s, wishes.

The same logic supports the First Amendment: 

It is, at bottom, the same reason we insist on a free, independent press (and free speech in general): when the government controls the media, it has a conflict of interest; i.e., an incentive to promote journalism that is favorable to the government.

Avik goes to point out that this is not mere theory:

It has played out in the Veterans Administration health system. The VA’s guide to end-of-life planning, “Your Life, Your Choices,? was written by a prominent advocate of physician-assisted suicide, and steers veterans into feeling guilty about keeping themselves alive at others’ expense.

And, according to Philip Klein, the revival of the end-of-life counseling program was the work of none other than Donald Berwick. And it’s not surprising that conflicts of interest don’t worry him. For Berwick, they are a way of life.

Oh, and he also doesn’t need to worry about receiving this kind of end-of-life counseling himself. He has already arranged to opt out of Medicare.

Comments 2

  1. glenn wrote:

    Ludicrous logic. The government is not involved – it is only allowing doctors to be paid for their time. Seems to me that families should know the many options involved so THEY can decide. This is simply an issue of individuals receiving information on which THEY can make decisions – and doctors being paid for their time. Let’s stop politicizing it.

    Posted 31 Dec 2010 at 10:07 am
  2. Wakefield Tolbert wrote:

    What do you make of this “Medicare for All? mantra? Seems to me prohibitively expensive, since my understanding is that much of Medicare service is outsourced to help control costs, and is currently confined to a portion of the population, whereas the other portion helps chip into pay; an arrangement that gets radically reworked if you attempt to have all 330 million of us under the Medicare banner.

    Also, speaking of claims denial, what is your take, or rather solution, to the very real perception that regardless of what one thinks of the “Death Panels? charge against O-Care and claimed as the Orwellian nightmare scenario under Euro-Canadian care, we actually have that NOW in US care even IF you have fantastic health insurance coverage?

    How? Well, insurance companies no more than government will pay for granny forever to “wind down? the clock on an IV or dialysis tree. They, like government, don’t have endless funds to plunk down on the old folks or preemie babies, those with terminal illnesses, et al.

    Posted 16 Mar 2011 at 6:23 am

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