Health Reform Watch: The Return of the End-of-Life Care Debate


On the eve of 2011, the week started with the return of a phrase that you might not have thought about since 2009 — “death panels.” The New York Times reported over the weekend that, in a little-noticed government regulation issued earlier this month, the Obama administration decided to pay Medicare doctors for talking to their patients about end-of-life treatment options.

The rule is similar to — though not exactly the same as — a provision that was originally included in the health care reform legislation, but left out of the final draft after opponents branded it with the toxic “death panel” term. The Times writes:

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

A Slow Start for High-risk Pools

A program designed to provide a refuge for uninsured patients with pre-existing conditions is having trouble attracting the people it’s meant to serve. The high-risk pool program, one of the first provisions of the health reform law to go into effect, uses $5 billion in federal funds to offer insurance to people who have been rejected from the private market because of a pre-existing condition.

But, the Washington Post reports, high insurance premiums in the pools have kept the expected flood of applicants to a trickle. Last spring, Medicare’s chief actuary predicted 375,000 enrollees; as of early last month only 8,000 had enrolled.

What’s in a Name?

Kaiser Health News reports that health care reform has a problem — a branding problem. Democratic analysts and pollsters are ruing the fact that opponents’ catchy-but-pejorative name, Obamacare, has caught on, while supporters of reform haven’t been able to come up with a good nickname themselves — they’ve stuck with the “wonky, clunky” Affordable Care Act.