Euthanasia and Reform: What is the Truth?

Put "change" and "death" in the same conversation with "health care reform," and you've got a powder keg ready to explode. And no surprise, it has -- with many Americans now genuinely worried that the Democrats' health care reform bill will get cost savings from seniors by rationing their care or euthanizing them.

In addition to a broader debate about whether a reformed health care system would expand or reduce Americans' access to care, the crux of the euthanasia controversy centers on a five-page amendment in the 1,000-plus page bill that discusses "advance care planning consultation." Depending on whom you believe, that's either code for assisted suicide, or a program to encourage Americans to have a plan to put their affairs in order.
What's the truth?

First a little background.

* On July 14, Rep. John Dingell (D-Mich.) and eight fellow Democrats introduced H.R. 3200, the health care reform bill, in the House. The bill includes Section 1233, "Advance Care Planning Consultation," which requires Medicare to pay for one session of end-of-life counseling every five years.

* On July 18, Rep. John Boehner (R-Ohio) said that the House's health care reform bill could be "a slippery slope for a more permissive environment for euthanasia, mercy-killing and physician-assisted suicide because it does not clearly exclude counseling about the supposed benefits of killing oneself."

* On July 23, Betsy McCaughey (New York's former Republican lieutenant governor) wrote in The Wall Street Journal that the House bill would "pressure the elderly to end their lives early."

* Last week, Sarah Palin wrote that she doesn't want her parents or her disabled son "to stand in front of Obama's 'death panel' so his bureaucrats can decide . . . whether they are worthy of health care. Such a system is downright evil."

Editorials from the left have ensued, with most accusing the GOP of "trying to scare seniors to death." But rather than joining the fray, we thought we would just read the bill instead. Here's what we found.

* In Section 1233 of the original version of the House bill, Congress requires Medicare to cover one session of "advance care planning consultation" every five years for Medicare patients to talk about living wills, hospice care, durable powers of attorney and lots of other topics nobody wants to discuss. Did the bill require that Medicare patients get this counseling? No. Did it specifically prevent counselors from raising assisted suicide and euthanasia with patients as an option? No, Rep. Boehner was right on that point.

* Enter Rep. Mike Ross (D-Ark.), the Blue Dog Democrat who struck a deal with Rep. Henry Waxman (D-Calif.) to narrow the health care bill's scope and cost. Ross' amendment to the bill spends two of its 28 pages on the question of end-of-life care. Specifically, Ross makes it illegal for counselors to promote or list as an option suicide or assisted suicide. Ross also states that the counseling is optional, and that seeking counseling on a living will, for example, will not be interpreted by a hospital as declining full and aggressive treatment.

Before a final bill gets to President Obama, if a final bill gets to President Obama, the details of this language could change. The House has not passed its health care reform bill yet, and the Senate Finance Committee has not voted on health care reform at all. But the language now in House's health care reform bill, specifically in the Ross amendment, does not promote euthanasia or assisted suicide. It prevents health care providers from discussing it.