Medicare has announced plans to reimburse doctors for discussions with patients about end of life situations—whether they would want to be kept alive, and how, should they become too sick to speak for themselves. The proposal would apply to nurse practitioners and physician assistants as well as to physicians. An earlier proposal to provide this benefit was derailed when the “death panel” epithet was attached to it. Elder law expert Brian Andrew Tully discusses the Medicare proposal in this report.
Tully points out that, while such discussions have never been a required part of care for elderly patients, good doctors have often had these conversations with their patients about what they might want should they encounter some dire situation late in life.
Tully doesn’t think that the reimbursement proposal is prompted by any decrease in end-of-life discussions between doctors and patients. Medicare is at its core a health insurance plan for the elderly, and financial issues will arise for everyone involved. One group that has pushed for these kinds of discussions is hospice providers, whose role in the health care system is to provide end-of-life care for people.
Tully believes that most physicians have already been trained in how to talk with their patients about end-of-life decisions. The non-medical side of these conversations has to do with advance directives. The documents a patient might need to have include a health care proxy and a living will. People should have a qualified elder law attorney help and counsel them and prepare the documents they will need in order to be sure that their wishes are carried out.
Tully believes that the issue of end-of-life care is something that a family should discuss. Parents should talk with their children about the issues involved. Tully also believes that a person’s doctor should be part of the discussion. The demand and the need for such discussions will surely increase with an aging population.
Brian Andrew Tully is a founding partner of Tully & Winkelman, P.C. He is certified as an Elder Law Attorney by the National Elder Law Foundation and has been striving to help seniors since 1998. The law practice focuses on Life Care Planning which helps people find and pay for good long-term care by bundling asset protection, public benefits qualification, care coordination, nursing home advocacy and crisis intervention. The Firm also encompasses traditional elder law, estate planning, special needs planning, probate and trust administration. The Legal Broadcast Network is a featured network of the Sequence Media Group.