CMS indicates that it is again considering compensating physicians for discussions and advice with patients concerning end of life decisions. The American Medical Association requested consideration of the issue last fall.
On August 7, 2009, former Alaska governor, Sarah Palin, labeled a provision in the Affordable Care Act providing for the service as authorizing “death panels” funded by the government as a cost savings invitation to euthanasia. In January of 2011, CMS ditched a similar plan to introduce compensation by regulation, apparently for political reasons. Betsy McCoughly, Michele Bachman, Newt Gingrich and other political and media personalities railed against the concept of governmental involvement in funding end of life discussions between patients and physicians for philosophical and/ or political reasons. A poll at the time suggested that about 85% of the public was aware of the issue and about 35% thought the allegations to be true.
Dr. Atul Gawande, the physician and writer, suggested that fueling the issue was the fear of missing out on an expensive end of life treatment, for economic reasons, that may extend a patient’s life, when the appropriate concern should be the fear of undergoing an expensive end of life procedure with little hope of benefit and large potential for unpleasant side effects.