The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual … or upon admission to a skilled nursing facility, a long-term care facility… or a hospice program. [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care?…

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.