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Talk-show falsehoods

Hysteria masks value of ‘Page 425’
By the Rev. Jackson Day

In 1881 as my great-grandfather lay dying, he called his children in one by one to give them his final words. My grandfather, then age 9, never forgot that his father was able to die at home surrounded by family.

For many of us, our greatest fear about our own passing is that our health-care system will keep us from dying such a death. Our fear is that we will end our days with tubes and electrodes connected to every orifice and patch of skin, and with our minds sedated into oblivion.

I had no idea how great a gift my father gave us for his last days until we actually needed to turn to his living will.

I had no idea how great a gift my father gave us for his last days until we actually needed to turn to his living will. He had requested no extraordinary measures. Each lawyerly clause describing a circumstance in which he wanted no extraordinary care concluded in clear English prose affirming the will of God that no one could mistake: “and then let me die.”

As my sister and I navigated the painful, confusing interactions with hospitals and doctors, our father’s living will gave us clarity. We who loved him and desired above all to do what he wanted when he could no longer speak for himself, had something tangible, written, signed, to rely on.

Widespread agreement

Widespread agreement exists that such end-of-life planning is good. The 2004 United Methodist General Conference, the denomination’s highest policy-making body, adopted a resolution called “Faithful Care for Persons Suffering & Dying”. It was readopted last year, and is Resolution 3205 in our 2008 Book of Resolutions. The resolution states that The United Methodist Church acknowledges that God is sovereign over life and death, and:

Care for the dying is an aspect of our stewardship of the divine gift of life. As human interventions, medical technologies are only justified by the help that they can give. Their use requires responsible judgment about when life-sustaining treatments truly support the goals of life, and when they have reached their limits.

The United Methodist Church acknowledges that God is sovereign over life and death.

Resolution 3205 reflects the work of our theologians and pastoral counselors. It has provided an ethical support for pastors, United Methodist health-care personnel, and families as they wrestle with the painful realities of facing a loved one’s last days.

In 1990 Congress passed, and President George H. W. Bush signed, the Patient Self-Determination Act (PSDA). That act “encourages everyone to decide now about the types and extent of medical care they want to accept or refuse if they become unable to make those decisions due to illness.” The PSDA requires all health-care agencies to recognize the living will and durable power of attorney for health care.

In 2003, under the Republican administration of George W. Bush, “the Agency for Health care Research & Quality issued a 20-page report outlining a five-part process for patients to discuss end-of-life care with their physicians.” But who would pay for such a discussion? Medicare doesn’t cover it.

Page 425

This year, U.S. Rep. Earl Blumenauer, D-Or., teamed with Rep. Charles Boustany, R-La., a physician, to introduce a bipartisan, standalone bill that would permit Medicare to pay for such consultations. Writers of HR3200, the health-care reform bill currently in the U.S. House of Representatives, included their concept into HR3200.

Medicare can pay for one every five years, unless there is justification to have one sooner.

Beginning at about page 425 of a 1,018 page document. It describes such consultations and says Medicare can pay for one every five years, unless there is justification to have one sooner.

Isn’t this the way we would like it to be: United Methodists, Democrats, Republicans, working together over time, to give people the chance to talk to a doctor and make up their own minds about what is right in their family?

But it hasn’t worked out that way. In the past several works a furor erupted. The Internet was flooded with scare messages with titles such as “Page 425 Health Care Plan, Are We Being Prepped for Suicide?” In the way partisan politics can turn things inside out, the voluntary physician consultations turned into sessions “to teach the elderly the fine art of suicide.”

31 million ‘hits’

If you do a search on the Internet for all sites containing “425” and “health,” you get as many as 31 million hits. Many of them reflect this hysteria. One, for instance, assures you:

Page 425 and the pages that follow say nothing of the kind.

On page 425 it says in black and white that EVERYONE on Social Security, (will include all Senior Citizens and SSI people) will go to MANDATORY counseling every 5 years to learn and to choose from ways to end your suffering (and your life). Health care will be denied based on age. 500 Billion will be cut from Seniors health care. The only way for that to happen is to drastically cut health care, the oldest and the sickest will be cut first. Paying for your own care will not be an option. Now, contact your representative in Washington!! Tell them to read page 425 if they don’t read anything else. Surely some of them have parents.

Page 425 and the pages that follow say nothing of the kind.

Nevertheless, House Minority Leader John Boehner, R-Ohio, and Republican Policy Committee Chair Thaddeus McCotter, R-Mich., issued a statement that this proposal “may start us down a treacherous path toward government-encouraged euthanasia.”

Rush Limbaugh and Sean Hannity touted a New York Post article, which in turn cited an interview that talk-show host and former U.S. Senator Fred Thompson, R-Tenn., gave to Betsy McCaughey, former New York lieutenant governor and now a fellow at Washington’s health-interest-funded Hudson Institute. She said, “Congress would make it mandatory, absolutely require, that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner.”

This seems to be the trigger that set off the talk-show explosion. Go to Thompson’s talk-show site and you can listen to them discuss what he calls this “dirty little secret.” McCaughey sounds knowledgeable and concerned. Thompson sounds as shocked as if he had no idea before the interview what appalling news she was about to bring.

A myth

House Speaker Nancy Pelosi, D-Calif., responded, calling McCaughey’s statement a myth. “The provision extends Medicare coverage to cover the cost of patients voluntarily speaking with their doctors about their values and preferences regarding end-of-life care — empowering older Americans on this critical issue,” Pelosi explained. “These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time.”

McCaughey isn't just wrong, she's spreading a ridiculous falsehood.

The facts about 425 are as follows:

  • Advance planning consultations are not mandatory; this benefit is completely voluntary. The provision merely provides coverage under Medicare to have a conversation once every five years if, and only if, a patient wants to make his or her wishes known to a doctor. If desired, patients may have consultations more frequently if they are chronically ill or if their health status changes.
  • There is no mandate in the bill to complete an advance-care directive or living will. If a patient chooses to complete an advance directive or order for life sustaining treatment, these documents will help articulate a full range of treatment preferences, from full and aggressive treatment to limited, comfort care only. Patients that choose to have these documents and can customize them so that their wishes are appropriately reflected.
  • There are no government-chosen professionals involved. The legislation simply allows Medicare to pay for a conversation between patient and their doctors.”
  • Independent analysis by Pulitzer Prize-winning concluded:

    “McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would "tell [seniors] how to end their life sooner" is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn't just wrong, she's spreading a ridiculous falsehood.”

    The effect of this hysteria is to frighten seniors about what health reform may do to the government’s Medicare program on which they rely. If you care about The United Methodist Church’s Resolution #3205 and about keeping political discussions factual, not fearful, let the people you talk with know the facts. It is a shame that people are distorting the truth about a provision that could contribute so much dignity to situation fraught with stress.

    Editor’s note: The Rev. Jackson Day is a consultant with the United Methodist General Board of Church & Society’s addictions and health-care program area. He is a member of the Baltimore-Washington Conference of The United Methodist Church.

    Source: General Board of Church and Society, The United Methodist Church

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