Mr. Speaker, from sweeping changes to how care is delivered, to the rise of personalized medicine, patients today have more treatment options when facing advanced illness than ever before. With these medical advances, the line between life…
Mr. Speaker, from sweeping changes to how care is delivered, to
the rise of personalized medicine, patients today have more treatment options when facing advanced illness than ever before. With these medical advances, the line between life and death can sometimes be blurred, which has changed the way we must talk about how we want to live and die.
Despite these enormous changes, confronting an advanced illness or the end of life remains one of the most difficult and challenging situations any family faces.
There is substantial evidence that suggests the care individuals want to receive at the end of life is not necessarily the type of care they do receive. Patients, in fact, often receive aggressive treatment that not only substantially shortens their length of life, but its quality. At other times, patients find the health care system instead undervalues the quality of their life, withholding treatments they would otherwise want to receive.
Issues surrounding the end of life and advanced illness management become even more important when looking at the rapidly aging population in the United States. In 2014, Americans ages 65 and older made up 15 percent of the total population; by 2060 that share is projected to grow to 24 percent.
A recent survey conducted by The Economist and the Kaiser Family Foundation found that the majority of U.S. adults say the government is not prepared to deal with the aging population. The same survey found that a large majority of Americans believe both that patients and their families should have a greater say in which treatment options they receive, and that most Americans don't believe they have enough control over their medical decisions at the end of life. This must change.
Individuals should have every opportunity to actively participate in making decisions about their health care throughout their lives and should receive care consistent with their values, goals, and informed preferences. Patients should feel empowered to make informed choices about the health care they want and to have those care decisions honored by their providers and family.
During passage of Affordable Care Act, I saw an opportunity to apply lessons learned in Oregon with its landmark comprehensive palliative care programs, which give patients more of a say about the medical treatment they want at the end of life. I worked to ensure that Congress included a payment for doctors to talk to patients and families about advance care planning in the Affordable Care Act. Unfortunately, this provision wasn't included in the final legislation due to a breakdown of the legislative process.
After years of advocacy, the Centers for Medicare and Medicaid Services designed a benefit allowing doctors to receive reimbursement for voluntary advance care planning conversations with their patients. For the first time, Medicare will pay for these critical doctor-patient discussions in the same way it pays for any other medical service.
Yet our work to improve end-of-life care is far from over, and it is for these reasons that I am introducing the bipartisan, bicameral Patient Choice and Quality Care Act of 2017. This legislation will strengthen advanced illness care by establishing a new model of care delivery that to better manage advanced illness, improve quality of care, and enhance training, resources, and tools for providers, patients, and their families.
Ideally, health care should work in sync with social, psychological, and spiritual support as the end of life approaches. Care near the end of life must be patient-centered and family-oriented. This legislation is supported by patient advocates, physicians, nurses, and the faith community, who understand how improving care delivery for advanced illness fundamentally improves quality of care and quality of life. To that end, I ask my colleagues to join me and support this important legislation.