It's alive! End-of-life counseling in health bill

It's alive. The Medicare end-of-life planning provision that 2008 Republican vice presidential nominee Sarah Palin said was tantamount to "death panels" for seniors is staying in the latest Democratic health care bill unveiled Thursday.

The provision allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and painful decisions families face when a loved one is approaching death.

For years, federal laws and policies have encouraged Americans to think ahead about end-of-life decisions, and make their wishes known in advance through living wills and similar legal documents. But when House Democrats proposed this summer to pay doctors for end-of-life counseling, it touched off a wave of suspicion and anger.

Prominent Republicans singled it out as a glaring example of government overreach.

Sen. Charles Grassley, R-Iowa, at the time a lead negotiator on health care legislation, told constituents at a town hall meeting they had good reason to question the proposal.

"I don't have any problem with things like living wills, but they ought to be done within the family," he said. "We should not have a government program that determines you're going to pull the plug on grandma."

Thursday, the sponsor of the provision said the barrage of criticism may have actually helped.

"There is nothing more basic than giving someone the option of speaking with their doctor about how they want to be treated in the case of an emergency," said Rep. Earl Blumenauer, D-Ore. "I think the outrageous and vindictive attacks may have backfired to help raise awareness about this problem, which is why it's been kept in the bill."

The legislation would allow Medicare to pay for a counseling session with a doctor or clinical professional once every five years. The bill calls for such sessions to be "completely" voluntary, and prohibits the encouragement or promotion of suicide or assisted suicide.

The counseling provision is supported by doctors' groups and AARP, the seniors' lobby. It was not included in health care bills passed by two Senate committees.