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End-of-life talks not supported by Medicare

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The Obama administration has agreed to remove references to end-of-life planning from Medicare guidelines for annual physical exams covered under the new health care law, which took effect Jan. 1.

Despite receiving praise from many physicians and health care providers, advanced care planning and advance directives, which allow patients to indicate whether or not they wish to receive aggressive life-sustaining treatment, were deleted for procedural reasons, according to White House officials. However, there is little doubt that political factors played into the decision to drop the contentious provision.

Republicans, who now hold a majority in the House, have vowed to see the law repealed, and end-of-life planning was a hot-button issue for opponents of the health law. Former Alaska governor Sarah Palin referred to end-of-life discussions as “death panels,” while Speaker of the House John Boehner called them a step toward “government-sponsored euthanasia.”

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An administration official explained that the provision was included in Medicare regulations but was not present in the bill as it was passed. This prompted administration officials to remove it from Medicare guidelines. However, said the official, “This should not affect beneficiaries’ ability to have these voluntary conversations with their doctors.”

The removal of the guidelines for end-of-life care was criticized by some in the Department of Health and Human Services, who argue that such discussions help ensure patients receive the manner and extent of care they want.