Monday, December 27, 2010

On End-of-Life Care and Other Regulations, What Are Democrats Hiding?

In case you missed it due to holiday plans or winter weather, the New York Times reported a very interesting story about the Administration’s efforts to expand end-of-life counseling in Medicare.  (The Wall Street Journal has a follow-up story this morning that can be found here.)

What’s most interesting about this story is the way in which advocates of end-of-life counseling “though pleased, have kept quiet” regarding the regulatory change.  In fact, the article quotes one supporter as sending the following message to end-of-life counseling advocates:

We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded….Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response.  The longer this goes unnoticed, the better our chances of keeping it.”

These developments of course raise interesting questions about both this particular change, and what it means for implementation of the health care law going forward:

  • If this provision is so innocuous, then why are its advocates hoping it goes unnoticed, and sending around e-mails asking that no one attract attention to it?
  • Why has Barack Obama’s Administration gone from promising health care negotiations would be televised on C-SPAN to hoping that potentially controversial provisions can be slipped into regulations without drawing public attention?
  • When the Times article notes that this “strategy may become more prevalent in the next two years,” what other types of controversial provisions will the Administration attempt to implement through regulations that it could not enact by law?