From the Gavel - Speaker of the House - Fact Check

Health Insurance Reform Daily Mythbuster: Impact on Seniors

July 29th, 2009 by Karina

Myth: “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.” – Betsy McCaughey, former Republican lieutenant governor of New York

Fact: 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. These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time.

Independent analysis by Pulitzer Prize-winning PolitiFact.com judged the comment a “Pants on Fire” “outright distortion”, writing:

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.

More on the provisions:

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.