The new health care law that the Obama Administration put into place in 2010 has had its share of misfires and controversy. And one of the biggest was the “advance care planning” services that could be offered as part of each Medicare beneficiary’s “annual wellness visit.”
“Many favored what became known as the end-of-life counseling provision available to Medicare beneficiaries,” notes Alan Weinstock, an insurance broker at MedicareSupplementPlans.com,“including lots of doctors and providers of hospice care.”
Medicare Provision for Advance Care Planning
The health care bill signed into law in March did not mention end-of-life planning. In fact, the proposed rule, published for public comment in July, did not even include advance care planning.
However, as recently as November 2010 Medicare regulations published in the Federal Register set reimbursement rates for physician services including language saying that end-of-life planning was covered as part of regular physical examinations.
Administration officials now cite procedural reasons for changing the rule. And while politics seemed to play a part in the decision as well—the Republicans have been gearing up to try to repeal the new health care law—the Obama administration noted that this change to the Medicare provisions should not stop Medicare beneficiaries from having voluntary discussions with their health care practitioner.
Having the End-of-Life Discussion
There are five steps to handling end-of-life issues.
First, face your emotional and spiritual concerns. This includes confiding in someone about how you truly feel.
Next, talk to your health care professional. While your doctor may not be able to predict your future, he or she can help you understand the longest amount of time you might have, possible complications and any additional treatments that are available. Your physician may also be able to give you a sense of what your final few weeks could be like.
It is recommended that you determine your priorities, the things you want to finish. Then focus on these.
Absolutely, don’t forget to talk to those you love. Discuss your illness, the care you will need and what you are feeling. Make sure to wrap up business and get your estate in order. Update your will and settle old debts.
Finally, enjoy the life you have left. Don’t fret over the small stuff. Do what you want to do and when you want to do it. Don’t waste energy keeping up appearances or worrying about medical matters.
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