Government-subsidized end-of-life conversations . . . What could possibly go wrong with that?

Thanks to Mark Levin for his plain-language critique last week of the proposed CMS payment codes for (endless) end-of-life conversations. Levin speaks for many elderly, sick and vulnerable patients and their families who are being pressured into “letting go,” and this even without government-paid end-of-life talks.

Thanks, also, to Right Scoop for posting the audio, so that it gets the attention it deserves.

Levin read portions of the New York Times story [Medicare Plans to Pay Doctors for Counseling on End of Life, 7/8/2015] breaking it down and cutting through the propaganda as he went along.

I’ll link to the audio here; an unofficial transcript is posted below.  (Audio for the entire 7/9/2015 program is available to download free at )


Mark Levin:  This is the biggest story of the day; just like yesterday the biggest story was — not the Confederate flag — …the biggest story yesterday was Obama nationalizing zoning so that he could destroy the suburbs in the country. And nothing happens. Not even a peep. Where’s Boehner? Boehner’s looking for signs of the Confederacy on Capitol Hill…”

Listen to this story and see how screwed up our news media are; see how screwed up our priorities are …

[New York Times:] Medicare …which insures 55 million older and disabled Americans, announced plans on Wednesday to reimburse doctors for conversations with patients about whether and how they would want to be kept alive if they became too sick to speak for themselves.

This is a family matter, ladies and gentlemen; families have these discussions. Children with their parents. Not the federal government paying doctors and nurses to have this discussion, so they can just wipe them off the Medicare rolls. And trust me they are going to pressure hospitals to do this stuff, and doctors and nurses to do this stuff. They’re already pressuring people to push them out the door. Let’s continue:

The proposal would settle a debate that raged before the passage of the Affordable Care Act, when Sarah Palin labeled a similar plan as tantamount to setting up “death panels” that could cut off care for the sick. The new plan is expected to be approved and to take effect in January, although it will be open to public comment for 60 days.

This is the game …”we have a 60-day public comment.” Public comment on what?!  98% of the public doesn’t even know what’s going on, and it’s not their fault. Federal government shouldn’t even be involved in these things, and the government is involved in everything. Let’s continue:

Medicare’s plan comes as many patients, families and health providers are pushing to give people greater say about how they die — whether that means trying every possible medical option to stay alive or discontinuing life support for those who do not want to be sustained by ventilators and feeding tubes.

That’s not what this is. This is the government pushing to say that you don’t want to be kept alive. They want those beds empty. They want to move you out. And it’s happening right now. I know people in their 80s and 90s, they’re having this done to them. Trying to push them out, push them out, at the direction of the federal government. Here’s the Chief Medical Officer for the Centers for Medicare and Medicaid, Patrick Conway:

“We think that today’s proposal supports individuals and families who wish to have the opportunity to discuss advance care planning with their physician and care team,”… “We think those discussions are an important part of patient- and family-centered care.”

Oh it sounds so swell, and wholesome. “This is family-centered care.” … it’s not family-centered care. It’s get the [heck] out of the hospital.

Conway said a final decision on the proposal would be made by Nov. 1. The plan would allow qualified professionals like nurse practitioners and physician assistants, as well as doctors, to be reimbursed for face-to-face meetings with a patient and any relatives or caregivers the patient wants to include. Dr. Conway said the proposal did not limit the number of conversations reimbursed.

That is, pressure; pressure! You have an 80-year-old, 90, 95-year old father or mother or grandparent; you’re trying to get them the best care you can, which is very, very difficult in Obama’s America; you already have the hospitals pressing you to “Well, you know… ” Have you had this conversation if you have an elderly parent or grandparent? “Well, you know, they are 90″ or “well you know, they are 87; they’ve lived a full life…” Have you had that [happen]?  I’ve heard this. Is that the kind of conversation they’re getting paid to have?

““The reality is these conversations, their length can vary based on patients’ needs,” he said. “Sometimes, they’re short conversations — the person has thought about it. Sometimes, they’re a much longer conversation. Sometimes, they’re a series of conversations.”

Now, Medicare has a zillion codes … code after code; thousands of codes. Thousands. And now they’re going to add codes for end-of-life discussions. End of life. “How many have you had … You’ll get reimbursed for how many you had.  You had ten? Okay. What was the outcome?”

What was the outcome.

You never thought you’d live to see this day, did you?

This is the New York Times, now, making the case for the federal government…

. . . Major medical organizations endorsed Medicare’s proposal. The National Right to Life Committee opposed it on grounds that it could lead to patients’ being pressured to forgo treatment.

Of course! That’s the whole purpose! Why have a discussion otherwise? Because the default position is to keep the person alive; to talk to the family: “well, what do you want to do?”  Well, keep them alive!  “Let’s have some conversations! (for which we’re reimbursed.)”

The reimbursement rate paid under the proposal and other details will be determined after public comments are received, …. People covered by Medicare account for about 80 percent of deaths each year.

It’s just not enough! You old people aren’t dying fast enough! Why do you keep hanging on?

Because Medicare often sets the standard for private insurers as well, the new policy would prompt many more doctors to engage patients in such discussions about their preferences.

Let’s just look at this. So, if they’re having discussions with the patients, that means that the patients are not senile; they don’t have Alzheimer’s or dementia of some form, right? That means they’re competent enough to have a discussion.

And they’re lying there in the hospital, on their back, maybe on a respirator, who knows!, maybe not. They’re trying to get better, maybe they had this conversation with their family, and the nurse and the doctor are paid to say “You know what, Charlie, look, you’re 89, you’re 89; I’m not saying anything’s going to happen to you, but you’re 89.  Maybe you have a 10% chance of walking out of here, Charlie; what do you want to do?”

Now that person, that 89-year-old, 87-year-old, 91-year-old, 73-year-old, whomever, whatever, should be focused on getting better, trying to keep their spirits up. Even if it is their last days! They don’t need to talk to a stranger about “end of life options.” Funded by Medicare.

And of course it will never be abused. They don’t abuse people at the VA, or the IRS, or the EPA. No no no; never. Every federal employee is good-hearted, noble and virtuous. Every doctor and nurse, good-hearted noble and virtuous. Let’s continue.

Efforts to support end-of-life planning were derailed in 2009 during the debate over [Obamacare]. The next year, Medicare decided through its regulatory powers to allow coverage for “voluntary advance care planning” in annual wellness visits.

Annual Wellness Visits? So the person isn’t necessarily even in the hospital and they want to have a conversation about how they end their life. Or whether they end their life. And this is supposed to be health care. This is supposed to be medical care. Do you want your government doing this?

But soon after, the Obama administration capitulated to political pressure and rescinded that part of the regulation. . . .
As a big part of the American population ages, and more people live longer with grave illnesses, a growing number of people want to be able to talk over options with their doctors —

So, fine! What does that have to do with the government encouraging, through Medicare, doctors and nurses to have that discussion? If somebody wants to have the discussion, well, have the discussion.

. . . about whether they want to die at home or in the hospital, or under what circumstances they would want life-sustaining treatment.

I want to tell you what’s going on here. Not only does Medicare want to cut costs by cutting benefits to the people they’re supposed to be supporting — senior citizens, and the sickest among them; the most elderly among them — but it wants to come between the family and the patient. There is no reason for a doctor or a nurse to be affirmatively raising these issues, and to be PAID, be subsidized, to raise these issues. That’s what families do.

Burke Balch, the director of the National Right to Life Committee’s Powell Center for Medical Ethics, said his organization objected to Medicare’s plan under current circumstances. “We feel there is pervasive bias against treatment that is occurring in advance care planning that involves nudging individuals to reject lifesaving medical treatment.”

He’s exactly right. Otherwise why would the government do this?

And by the way, I don’t want to hear any more about how compassionate the left is; how compassionate Medicare is; how compassionate the federal government is. The only reason this regulation is going to happen is because they want to cut costs, and they want to cut off the breathing tube to senior citizens. There’s no other reason to have it. And they want to come between children and their parents. That’s what they’re doing. Shouldn’t this be issue number one today, all over the country?