Senator Blumenauer

With all the discussions about advance care planning this summer in regards to health care reform, it is nice to take a step back from all of the hyperbole and hear from the person who actually introduced this legislation into the bill.  Senator Blumenauer (D) from Oregon wrote an excellent opinion column in the New York Times on Sunday recalling his own motivations, and concerns when the seemingly benign legislation wound up into the highly emotional charged family meetings.  Some highlights from the piece:

But now that I and my fellow lawmakers in the House have passed a health care bill, I’m finally free to explain what I learned as the author of the now-famous end-of-life provisions.
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...I found it perverse that Medicare would pay for almost any medical procedure, yet not reimburse doctors for having a thoughtful conversation to prepare patients and families for the delicate, complex and emotionally demanding decisions surrounding the end of life.
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My Republican co-sponsor, Charles Boustany of Louisiana, told me he had many end-of-life conversations as a cardiovascular surgeon but unfortunately they often were too late. He wished that he could have spoken to patients and their families when they could have reflected properly, not when surgery was just hours away.

The editorial should serve as important historical reference when we reflect back on this legislative debut of the modern palliative care era.