Rep. Boehner Comes Out Against Providing Seniors With Choices

July 24, 2009 4:01 pm ET — Melinda Warner

On July 23, 2009 House Minority Leader John Boehner released an outrageous statement saying that Democratic efforts to reform health insurance will result in the encouraged euthanasia of America's senior citizens.

Senior citizens are faced with a myriad of decisions in their twilight years: wills, granting power of attorney, funeral arrangements, and, given a choice, if they would rather die at home or in a hospital.  Rep. Boehner and his Republican cohorts, desperately grabbing onto any and everything that might help kill health insurance reform, are now trying to portray a generous provision for seniors as a way for the government to encourage suicide.

Rep. Boehner's "Analysis" Of The Bill Is Incorrect At Best, Repulsive At Worst

Rep. Boehner: "Section 1233 of the House-drafted legislation encourages health care providers to provide their Medicare patients with counseling on 'the use of artificially administered nutrition and hydration' and other end of life treatments, and may place seniors in situations where they feel pressured to sign end of life directives they would not otherwise sign.  This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law.  At a minimum this legislative language deserves a full and open public debate - the sort of debate that is impossible to have under the politically-driven deadlines Democratic leaders have arbitrarily set for enactment of a health care bill.

"This provision of the legislation is a throwback to 1977, when the old Department of Health Education and Welfare proposed federal promotion of living wills for cost-savings purposes described as 'enormous.'  At that time, the late Cardinal Joseph Bernardin of Chicago decried this effort by saying: 'The message is clear: government can save money by encouraging old people to die a little sooner than they otherwise would.  Instead of being regarded with reverence, and cherished, human life is subject in this view to a utilitarian cost-benefit calculus and can be sacrificed to serve fiscal policy and the sacred imperative of trimming a budget.'

"With three states having legalized physician-assisted suicide, this provision could create a slippery slope for a more permissive environment for euthanasia, mercy-killing and physician-assisted suicide because it does not clearly exclude counseling about the supposed benefits of killing oneself.

"Health care reform that fails to protect the sanctity and dignity of all human life is not reform at all." [, 7/23/09]

In fact, the bill is written to allow senior citizens access to a professional medical counselor who will provide them with any information they might need - regarding will preparation, medical power of attorney, and, yes, end of life decisions.  These counseling sessions are not mandatory, they are simply made available to those who wish to use the service because they are unable to receive the information from another source.

"Advance Care Planning Consultation" Would Provide Seniors With Professional Advice On Will Preparation, Power Of Attorney, And Other Complicated Issues. reported: "Indeed, Sec. 1233 of the bill, labeled 'Advance Care Planning Consultation' details how the bill would, for the first time, require Medicare to cover the cost of end-of-life counseling sessions. According to the bill, 'such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.'" [, 7/16/09]

Bill Provides Funding For Seniors To Have Access To Serious Medical Information.  As reported by, "Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, said the bill doesn't encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration. 'These are very serious conversations,' he said. 'It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families.' In no way would these sessions be designed to encourage patients to end their lives, said Jim Dau, national spokeman [sic] for AARP." [, 7/16/09]

Patients Suffer When Their Doctors Are Not Aware Of Their Wishes.  According to CNN: "Discussing end-of-life care is difficult for everyone involved, but it should be done early on, doctors say.  Many aging parents and grandparents resist talking about it because of the emotional pain the issue will cause their younger relatives; and the children who will become responsible don't want to appear ungrateful or self-serving by mentioning it, [Dr. Arthur Kellerman, Emory University] said. Many doctors don't want to talk about it either, he said.  'There are a lot of my colleagues who don't bother having that conversation. They just intubate them, and ship them up to an ICU, and say 'next,'' Kellerman said." [, 7/23/09]

  • Doctors Can Misinterpret What Their Patients' Wishes Are. According to CNN, a study found a large "disconnect between what patients wanted and what their doctors thought they wanted...'Just a few simple words like, 'This must be a very scary time for you. Tell me what your thoughts are,'' can make a big difference, said lead author Dr. Joan Teno, professor of community health and medicine at Brown University School of Medicine." [, 7/23/09]

Patients Are Unable To Convey Their Wishes Because Of A Lack Of Doctor Availability.  CNN reported: "Some people have signed advance directives to their children -- legal documents stating what they want to happen in terms of end-of-life decisions -- but don't talk to their children about them, Kellerman said...Beyond the advance directive, doctors need a plan for care with the patient to make sure that the person's goals are honored, Teno said. A problem behind a general lack of communication between doctors and patients is the shortage of primary care physicians in the United States, Rich said. A 2008 study found that the U.S. could face a shortage of up to 44,000 family physicians and general internists by 2025, according to researchers from the University of Missouri." [, 7/23/09]

Medicare Will Pay For Increased Counseling If The Senior Citizen Becomes Ill And Would Like Additional Information.  According to "Medicare will cover one session every five years, the legislation states. If a patient becomes very ill in the interim, Medicare will cover additional sessions." [, 7/16/09]

Counseling Is NOT Mandatory.  In regards to the "mandatory" assertion, reported: "For his part, Keyserling said he and outside counsel read the language carefully to make sure that was not the case. 'Neither of us can come to the conclusion that it's mandatory.' he said. 'This new consultation is just like all in Medicare: it's voluntary.' 'The only thing mandatory is that Medicare will have to pay for the counseling,' said Dau." [, 7/16/09]