[Davis Democrats] Voluntary action opportunity: A "death panel" that will "pull the plug on Grandma"? Take action to counter this fiction!

John Chendo jac07 at dcn.org
Thu Aug 13 19:44:30 PDT 2009

------ Forwarded Message
From: K/D Wagstaff <kjwag at dcn.davis.ca.us>
Date: Thu, 13 Aug 2009 12:34:00 -0700
Subject: A "death panel" that will "pull the plug on Grandma"? Take action
to counter this fiction!

Dear Friends,
Following this note is the actual language of the specific provisions in one
of the key pending health care reform bills that are being twisted to
generate controversy, rumor and fear.
The provisions are clearly and simply aimed at including  "advance care
planning consultation" with patients on the list of services that can be
paid by Medicare. There is no death panel.
No bureaucrats are allowed to get involved.
The health practitioners who may provide the consultation may ONLY be your
doctor, nurse practitioner or physician assistant.   All of the discussions
are, in fact, protected under HIPPA, which is the current Health Information
and Patient Protection Act, a federal law.  Specified practitioners would be
able to bill for providing assistance for patients in the preparation of
what have been used and described for about 25 years as 'living wills'.
I know what I am talking about.  I participated in developing the original
'living will' law, and worked on implementation of HIPPA.
The parameters of this new Medicare benefit would match very closely the
patient consultation service that hospitals, health plans and doctors all
over America have been providing for years.  Millions of people, aided by
these consultations, have been able to create simple, legally-binding
documents that require doctors to follow the patients' wishes, and no one
else's, in any circumstance where the patient is terminally ill and unable
to tell the doctors whether or not to use 'extraordinary measures' to
sustain the patient's health.
patient can direct that all medical, technological and pharmaceutical
efforts be taken to sustain life, regardless of how grim the diagnosis may
be and no matter how long the patient might live.
direct that under these circumstances he or she be kept pain free and
comfortable but that no heroic measures be taken. The patient specifically
names in the document the person or persons who will be the legal agents to
insure the terms of the advance directive, or living will, are carried out.
These are the facts.  Despite these facts-

The recent Republican VP nominee, Sarah Palin, and Charles Grassley, a key
Senator in the current negotiations with the White House, have stated
(respectively) that these provisions create "death panel" to which all
Medicare recipients must report, and will "pull the plug on Grandma"!
These statements are blatant falsehoods and, coming from Grassley in
particular, who has intimate knowledge of the matters at hand, appear to be
a calculated and sinister attempt to undermine the President and the
Leadership of the Congress on health care reform.

We as responsible citizens must act. And it is easy to act- do it now!
Please call President Obama, and Senators Boxer and Feinstein to urge that
the Democrats and the White House cease negotiating with Grassley and push
instead for a 50-vote reconciliation bill that incorporates this and other
progressive provisions-- including a public plan option!  It is clear that
the Republicans' "negotiations" are merely a stall to prevent Obama and the
Democrats from achieving one of the biggest social improvements since FDR.
One of the Republican leaders has actually said that health care must become
Obama's "Waterloo".  (If you want you can call Grassley's office in
Waterloo, Iowa!  The link is

Health Care reform is a main objective that President Obama was elected to
achieve. This is a moment in history that may not happen again for a
Thank you for reading this and for taking action.
Ken Wagstaff
Retired Director, California Board of Medical Quality Assurance
Former Principal Health Consultant, California State Legislature


The President's web page, in particular the information at the bottom of the
page (after the box for written comments), includes all contact details:
For California's Senators, please call the nearest office and ASK for a
person knowledgeable about the health reform legislation.
Senator Dianne Feinstein
United States Senate
331 Hart Senate Office Building
Washington, D.C. 20510

Phone: (202) 224-3841
Fax: (202) 228-3954
TTY/TDD: (202) 224-2501

San Francisco 
 One Post Street, Suite 2450
 San Francisco, CA 94104
 Phone: (415) 393-0707
 Fax: (415) 393-0710

Los Angeles 
 11111 Santa Monica Blvd., Suite 915
 Los Angeles, CA 90025
 Phone: (310) 914-7300
 Fax: (310) 914-7318

 2500 Tulare Street, Suite 4290
 Fresno, CA 93721 
 Phone: (559) 485-7430
 Fax: (559) 485-9689

San Diego 
 750 B Street, Suite 1030
 San Diego, CA 92101
 Phone: (619) 231-9712
 Fax: (619) 231-1108

Senator Barbara Boxer
United States Senate

Washington, D.C.
 112 Hart Senate Office Building
 Washington, D.C. 20510
 (202) 224-3553

 501 I Street, Suite 7-600
 Sacramento, CA 95814
 (916) 448-2787
 (916) 448-2563 fax

San Francisco
 1700 Montgomery Street, Suite 240
 San Francisco, CA 94111
 (415) 403-0100
 (415) 956-6701 fax

Los Angeles
 312 N. Spring Street, Suite 1748
 Los Angeles, CA 90012
 (213) 894-5000
 (213) 894-5042 fax

 2500 Tulare Street, Suite 5290
 Fresno, CA 93721
 (559) 497-5109
 (559) 497-5111 fax

San Diego
 600 B Street, Suite 2240
 San Diego, CA 92101
 (619) 239-3884
 (619) 239-5719 fax


p.425 (amends the law to add a new benefit under Medicare)
ŒŒAdvance Care Planning Consultation
ŒŒ(hhh)(1) Subject to paragraphs (3) and (4), the
term Œadvance care planning consultation¹ means a con-
sultation between the individual and a practitioner de-
scribed in paragraph (2) regarding advance care planning,
if, subject to paragraph (3), the individual involved has
not had such a consultation within the last 5 years. Such
consultation shall include the following:
ŒŒ(A) An explanation by the practitioner of ad-
vance care planning, including key questions and
considerations, important steps, and suggested peo-
ple to talk to. 16 
ŒŒ(B) An explanation by the practitioner of ad-
vance directives, including living wills and durable
powers of attorney, and their uses.
ŒŒ(C) An explanation by the practitioner of the
role and responsibilities of a health care proxy.
ŒŒ(D) The provision by the practitioner of a list
of national and State-specific resources to assist con-
sumers and their families with advance care plan-
ning, including the national toll-free hotline, the ad-
p. 426 
vance care planning clearinghouses, and State legal
service organizations (including those funded
through the Older Americans Act of 1965).
ŒŒ(E) An explanation by the practitioner of the
continuum of end-of-life services and supports avail-
able, including palliative care and hospice, and bene-
fits for such services and supports that are available
under this title.  
ŒŒ(F)(i) Subject to clause (ii), an explanation of
orders regarding life sustaining treatment or similar
orders, which shall include‹
ŒŒ(I) the reasons why the development of
such an order is beneficial to the individual and
the individual¹s family and the reasons why
such an order should be updated periodically as
the health of the individual changes;
ŒŒ(II) the information needed for an indi-
vidual or legal surrogate to make informed deci-
sions regarding the completion of such an
order; and  
ŒŒ(III) the identification of resources that
an individual may use to determine the require-
ments of the State in which such individual re-
sides so that the treatment wishes of that indi-
vidual will be carried out if the individual is un-
p. 427 
able to communicate those wishes, including re-
quirements regarding the designation of a sur-
rogate decisionmaker (also known as a health
care proxy). 

ŒŒ(2) A practitioner described in this paragraph is‹
ŒŒ(A) a physician (as defined in subsection
(r)(1)); and  
ŒŒ(B) a nurse practitioner or physician¹s assist-
ant who has the authority under State law to sign
orders for life sustaining treatments.

ŒŒ(B) The level of treatment indicated under subpara-
graph (A)(ii) may range from an indication for full treat-
ment to an indication to limit some or all or specified

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