Heads up: Section 1233 again.
Last March Nancy Pelosi told the American people that she and her colleagues "have to pass the bill so you can find out what’s in it.” Americans had already seen one part of the proposed healthcare legislation, and didn't like what they saw: The infamous Section 1233 of HR 3200 would have federalized “voluntary” end-of-life “consultations.” The section was eventually dropped.
It appears that Section 1233 is still alive and kicking.
The “advance care planning” portion is in a rule from US Department of Health & Human Services, Centers for Medicare & Medicaid (CMS) here: http://www.ofr.gov/OFRUpload/OFRData/2010-27969_PI.pdf [NOTE: link went inactive following 11/29. As of 12/1 the document is available at http://tinyurl.com/3akk88e]
The POLST part is included in pending legislation, HR 5795 “Personalize Your Care Act of 2010." Here are two links to information about this bill: one via GovTrack here, and another via Library of Congress here. Text of the bill is here as a PDF.
CMS posted the preliminary rules on Election Day; formal rules are to be published in the Federal Register on November 29. The rules include a discussion of the definition of “voluntary,” although some of the more nuanced meanings of “voluntary” may have been missed (just ask any recipient of a “voluntary” TSA pat-down). The rule also includes a discussion of signature requirements for “orders” versus “requisitions” in context of diagnostic tests. The American Bar Association’s Charles Sabatino, who supported Section 1233, calls the new rules “a big step forward.”
Congressman Earl Blumenauer (D-OR) introduced HR 5795 this past July. It is a revised version of the legislation that he and Senator Rockefeller (D-WV) introduced last year. Blumenauer introduced HR 2911, and Rockefeller introduced S. 1150 in 2009, both titled “Advance Planning and Compassionate Care Act of 2009”. Both bills included:
- Section 211 (Advance Care Planning) was almost identical to Section 1233 of HR. 3200 – the section that was dropped from the final bill signed in March.
- Section 112, which would have provided funding to expand POLST.
It is Section 112 of the Rockefeller and Blumenauer bills (S 1150 and HR 2911) that is now Section 3 of HR 5795. Portability of advance directives and standards for electronic health records are also addressed in HR 5795.
Blumenauer is the congressman most often associated with POLST He is, incidentally, an advocate of legalized assisted suicide, and Rockefeller has spent decades trying to push through legislation on behalf of the organizations that evolved from the Euthanasia Society of America.
Shortly before the election, Blumenauer told a radical pro-assisted suicide group that he had reintroduced what had been known as the "death panel" legislation. He complained that Section 1233 had been dropped due to “organized opposition” from “all of the Sarah-Palin-Fox-News-tin-foil-hat” people, but “it’s not stopping us from moving forward.” Over the summer he had reintroduced the bill with a new name: the “Personalize Your Care Act of 2010” (HR 5795).
“Personalize” leaves the impression that this bill might put medical treatment decisions back in the hands of the individual, keeping the discussion between patient and physician. It implies that the patient might as easily “choose life” as to forgo treatment. This is pretty slick marketing, considering it is coming from the same Oregon liberals who pushed not only assisted suicide, but rationing for “equitable distribution of resources” for “the common good.” The bioethicists at Oregon Health & Science University (OHSU) who devised the “citizen parliaments” that gave Oregon its rationing scheme are some of the same bioethicists who put the fine tuning on POLST.
Blumenauer, in his remarks to the Oregon activists, went on to say that Oregon leads the way in health reform. Well, yes. Oregon health care is infamous for two things: assisted suicide, and rationing. Blumenauer’s bill would impose both on the whole country.
Note: For more information on the history and implications of POLST, see "POLST: 'Self-Determination' or Imposed Death?"in LifeTree's Resources section.
posted 11/24/10 by IW revised 12/2/10 by IW