My scare about the insurance company refusing to pay me the $100,000 for my loved one’s treatment, and all of us going broke because of it, had hardly subsided when I read this in Chicago Tribune today – “After aneurysm, Assurant Health causes further headaches” (http://www.chicagotribune.com/news/columnists/chi-tue-problem-insurance-0929sep29,0,1926150.column). There we go again. And now just before I sat down to write this, Michael Moore delivered a very grim prophecy to Anderson Cooper on CNN that healthcare will go nowhere because the Senate apparently did not include the Public Option in their version of the bill today.
All that is enough to shake me up. I must plan the end of my life myself. Now. But where do I start? Well, let’s see what the bill really says. I went to these sites to grab the relevant part of section 1233 which talks about the end of life planning aspect:
http://www.opencongress.org/bill/111-h3200/text
http://dailydose.us/2009/08/08/section-1233-of-the-house-healthcare-bill-the-euthanasia-clause/
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
What I got from them was jargon that would need me hours to untangle. What I’d like to know out of it is: Where do I start, what do I need to do to plan the end of my life, and how do I do it? So untangle I must. Here is the cleaner version of section 1233 (relevant part, with some formatting clean up done so that you and I can read it) that I will use as a guideline to make my own list. That list I will share with you on this blog as it unfolds.
QUOTE (SEC. 1233. ADVANCE CARE PLANNING CONSULTATION)
...
(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
(F) (i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include—
(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;
(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decision maker (also known as a healthcare proxy).
(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State—
(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that—
(I) ensures such orders are standardized and uniquely identifiable throughout the State;
(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;
(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.
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UNQUOTE
