Most Americans say doctors should talk with their patients about their healthcare options at the end-stage of life and that Medicare and private insurance should pay for those conversations. Despite such views, a poll finds relatively few report ever having such discussions with a health professional.
Results from the latest monthly survey released Wednesday by the Kaiser Family Foundation tracking public views regarding healthcare-related issues related to healthcare released Wednesday by the Kaiser Family Foundation found that nine in 10 polled favored physicians having end-of-life talks with patients, while eight in 10 said those talks should be covered by Medicare and private insurance.
Views appear to shift when those surveyed were asked whether they personally would want to have end-of-life discussions with a healthcare provider. While 83% of those polled said they would be comfortable talking about end-of-life issues with a spouse or partner, only half reported they would be comfortable discussing those issues with a doctor or health provider, with only 17% saying they have actually engaged in such talks.
Proponents of end-of-life care planning say it can reduce the occurrences of terminally ill patients undergoing unwanted procedures that limit their quality of life in their final months while increasing health spending.
In July, the CMS included a proposal within a draft of Medicare's physician payment rule that would compensate doctors for end-of-life counseling, which they could begin billing in January of 2016 once the rule is finalized.
Advanced-care planning was made a controversial issue only a few years ago when opponents of the Affordable Care Act accused the Obama administration of employing “death panels.” The legislation initially included a provision that would have had Medicare pay doctors to hold end-of-life consultations, but was eventually taken out of the final bill that passed.
Those polled were also asked about their views on the so-called “Cadillac Tax,” a provision within the healthcare law that imposes a 40% excise tax on excessively expensive employer-sponsored health plans that a number of lawmakers are seeking to repeal. Approximately 60% of those surveyed said they were opposed to the tax, though the poll found 27% of those who had a negative view changed their minds when told the tax could help lower healthcare costs. Likewise, 15% of those who initially said they were in favor of the tax changed their view when told the plan was likely to cause workers to pay higher out-of-pocket health costs.
The survey was conducted Sept. 17-23 and involved polling more than 1,200 people on a variety of topics related to health reform. It found overall public opinion remained mixed on the Affordable Care Act, with 45% of those surveyed having a negative view of the law compared with 41% who saw the ACA favorably.