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Taking Control Of Your Life

Shimmy Blum

A new federal regulation giving doctors and incentive to discuss “end-of-life” issues with their patients is raising new concerns in Orthodox Jewish circles that the medical community will have more say over who shall live, and more significantly, who shall die, and when.

Wednesday, January 05, 2011

President Barack Obama’s race to remake the US healthcare system took another step forward on January 1st. The New York Times revealed that the Obama administration quietly circumvented Congress, unilaterally instituting a new Medicare regulation that compensates doctors for an annual discussion to help patients “prepare an advance directive in the case where an injury or illness causes the individual to be unable to make health care decisions.”

During the heated debate over “Obamacare” health reforms early in the president’s term, a similar provision was dropped due to public and Congressional opposition for fear that it would be tantamount to the establishment of “death panels,” where the medical bureaucracy would decide whether a terminally ill patient was worth keeping

Administration officials took pains to stress that the end of life discussions will remain voluntary. Patients and their families will still be in charge of actual life-and-death decisions. However, many in the religious community, as well as in the political world, are fearful of the “death panel” phenomenon and the concept that gives rise to it — health care rationing — where medical care would be apportioned to patients based on the “priority” their lives are designated by, either by hospital or government officials.

“While consultations with doctors regarding the need to execute a health care proxy can be innocuous, and perhaps even beneficial, the new Medicare regulation doesn’t mitigate the concerns over the Obama administration’s attitude on end-of-life issues and health care rationing,” says New York Attorney Eytan Kobre, an expert on elder care law and the editor of Mishpacha’s US desk says.

Kobre noted Obama’s appointment of rationing advocate Donald Berwick as Medicare chief and the recent controversy over the government decision to stop Medicaid and Medicare coverage for the $90,000 a year Avastin drug treatment for breast cancer patients, as cause for concern over whether the administration is heading down the road of increased rationing and assessing the monetary value of patients’ lives.

The Wall Street Journal and other conservative outlets raised several other concerns that may result from implementation of the new regulation. Among other red flags regarding the administration’s intentions, they cited the administration’s establishment of an Independent Payment Advisory Board for Medicare and the 2009 federal stimulus package’s $1.1 billion allocation for researching the “comparative effectiveness” of various medical treatments.  

Kobre adds, “It was reported in the New York Times that Congressman Earl Blumenauer wrote in an e-mail that ‘the longer this goes unnoticed, the better our chances of keeping it.’ If the regulation is so innocent,” concludes Kobre, “why were its supporters so intent on keeping it secret?”


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