In response to wild rumors of “death panels” and other distortions,  Republicans have forced a minor provision out of the proposed legislation to reform health care coverage in the U.S. That provision was designed to authorize payment for counseling services to help seriously ill and aged sort through questions that face them upon checking into a medical facility.

Sen. Charles Grassley

Anybody who has been hospitalized in the last four or five years has seen, among the pages of crap you have to sign, questions about “extraordinary medical procedures” and suggestions about a “living will.” These very terms can be confusing and scary for older folks (my mom is 98). If there is a knowledgeable family member on hand, whom the patient trusts, these are not a big problem. However, many of our seniors are alone when a medical emergency occurs. The nurses doing the admission don’t have the time, or the training, to go over all these issues and are cautioned against giving patients any advice.

The stricken provision was to authorize payment for counselors trained to explain these issues and to consult with the patient, and any available family members or significant others, on how to make and implement a decision.

Here is a direct quote from Sen. Grassley, appearing at a public gathering yesterday (August 11, 2009) in his home stae of Iowa:

There is some fear because in the House bill, there is counseling for end-of-life,” Grassley said. “And from that standpoint, you have every right to fear. You shouldn’t have counseling at the end of life. [emphasis added]

How does this impact hospice care, you ask? Well, a great deal of what hospice workers do is just this kind of counseling. They the terminally ill, and their loved ones, find a way to talk meaningfully and openly about difficult issues and arrive at a decision that everyone can accept.  Since this is a major component of their work, and the Repubs (led by Glen Beck, Rush Limbaugh and that guy shaking a finger in Sen. Arlen Specter‘s face) are martialed against it, one has to question how the hospice movement can effectively survive.