Death panels – Oregon style

by Gayle Atteberry

Even though it was 85 degrees outside that day, a snowball was made. It is a small snowball, but it is not going to melt. In fact it is going to grow and before long, it will be so big that no one will be able to move it.

I attended a little-noticed meeting recently of the “Health Evidence Review Commission”, a committee which is part of the Oregon Health Authority and is bringing Oregon’s health plan in line with Obamacare. It is a committee that no one knows or cares about, except it is one that will soon rule, and perhaps ruin, your life.

Up for very little discussion (to their shame) and a vote that day was a guideline concerning Medicaid patients. The guideline said that “treatment with intent to prolong survival is not a covered service for patients who have progressive metastatic cancer” and are not able (in the view of the physician) to be helped. Palliative care is all that will be provided. [Palliative care is care to address the pain and stress, but not to try to fight or cure the disease.]

In order to qualify for treatment coverage, the patient must undergo a “discussion” and, evidently if he can prove he can live anyway, then he can get treatment.

Many things are wrong with this picture and I, representing Oregon Right to Life, testified against this dangerous guideline, the FIRST of its kind under Obamacare.

To be fair, unbeknownst to most all people, the Oregon Health Plan already had this guideline. Although equally wrong and deadly as the new guideline, the old one was contained to a small group. Now those who will be subject to this ruling will expand to a much larger group, and it will be rigorously enforced.

ORTL, along with others, testified that this guideline is in direct conflict with the Affordable Care Act, which ensures health benefits may not be denied on the basis of expected length or quality of life.

I explained our concern about the mandatory discussion. We all know one of the key objectives in Obamacare is to save money. It is also no secret there is serious prejudice against money spent on end-of-life care. It is becoming less of a secret that these “discussions” are framed so as to talk patients out of expensive care into less-costly comfort care

I read two powerful testimonials from cancer victims and a letter from Dr. Charles Bentz, a physician who has cared for hundreds of cancer patients and created a curriculum for palliative care for Providence St. Vincent Hospital. I was interrupted and told to hurry, my time (3 minutes) was about up. So much for serious consideration of this life an death topic.

Representatives from the American Cancer Society, a patient’s right’s group and a pharmaceutical company also testified in opposition. With only 48 hours notice, that was all who could be mustered.

Other than derision of our testimonies, assurance that this guideline is more expansive and better than the old, and assurances it would only be used for those where further care was completely hopeless, little discussion was held. The PR for this rule is down pat….even a handout was provided with all the “good points” of the new rule.

The chairman noted “how could they know if this rule was in conflict with Obamacare?” They would let others deal with that question, he said. He also explained that so many more people would be added to Medicaid, how could they possibly have money to give everyone the health care they wanted?……a telling comment.

The retired oncologist railed at me saying that he had seen hundreds of breast cancers and if a woman only had two more weeks to live, what difference did trying to help her make anyway? To this last remark, the patient’s rights gentlemen retorted that his mother died of stage 4 cancer and if he could have had two more weeks with her, it would have made a LOT of difference! The oncologist’s coldness of heart and explosive anger made me very glad he is now retired.

The snowball looks small now because it affects only Medicaid patients and claims to have “safeguards” so only the most hopeless of conditions will be under its ruling. I have seen enough to tell you that something like this is never contained. ”Safeguards” do NOT work! The one who determines whether or not the patient is “hopeless” is the physician. We see the “quality of life” instead of the “sanctity of life” overtaking the medical field. Cost containment demands will soon rule even the best of doctors, who will be forced to “live within the government’s means.”

Soon all health exchanges in Oregon will be operating under the same rule, and since this has to do with Obamacare, other exchanges and plans will begin using the same criteria.

Even though few will even know this happened, and even fewer will be concerned, this was “the cold day in h—“ that we hoped would never come. We will now watch the snowball formed today grow and grow.

Gayle Atteberry is the Executive Director of Oregon Right to Life