In a “reversal of an earlier reversal,” the Obama administration recently “pulled the plug” on its regulatory efforts to reimburse physicians for providing patients with counseling and advanced care planning information. This concept was jettisoned during ACA’s debate and ultimate passage. We all recall the “death panel” controversy and the ensuing debate that ultimately cost this reform provision its life.
Those of us who care for patients at the end of life cringed when the death panel image was resurrected. End-of-life care discussions can provoke emotion, fear and outright dread. Despite greater acceptance of hospice and palliative care in recent years, underlying attitudes and expectations have not changed much. The outcry in response to the news of the regulatory change reflected the distaste and discomfort with the mere mention of terminal illness, treatment and care options.