[Congressional Record (Bound Edition), Volume 159 (2013), Part 8]
[House]
[Page 11977]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            END-OF-LIFE CARE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, I arrived at my office this morning to a 
Politico with the front page headline ``Blumenauer's Death Panel Bill 
Lives On.''
  It's actually a terrific article by Joanne Kenen, but the terrible 
headline about nonexistent death panels symbolizes why, three 
Congresses later, we still have not helped families deal with the most 
difficult circumstances any of us will ever encounter.
  This issue hit me with full force 10 years ago in the midst of the 
Terri Schiavo case, where we watched one family's tragedy turn into a 
national media circus and a political spectacle all because one 27-
year-old woman didn't have a conversation with her loved ones to make 
her wishes known about what would she want if the unthinkable happened. 
And she was caught in the terrible circumstance of being in a 
vegetative state--brain dead--for 8 years with no likelihood of 
recovery.
  It's not really unthinkable. It's just that many of us would rather 
not think about it. Too rarely do we have this conversation, yet 
virtually every one of us will be in these circumstances with ourselves 
or with a loved one unable to make their wishes known about health care 
because of permanent or temporary incapacity.
  This is not just about end of life. It could be any decision: about 
whether or not to amputate a leg or to have an operation that carries 
with it significant risks. Who speaks for each of us when we're unable 
to speak for ourselves?
  The public overwhelmingly thinks that people should have the 
information and that their insurance or Medicare should pay for that 
conversation with a medical professional. Unfortunately, today, 
Medicare will pay tens of thousands of dollars for a 93-year-old man 
with terminal cancer to have a hip replacement who will never walk 
again but will not pay for a conversation with that same person and 
their family to understand the circumstances they face and what their 
options are, to understand their choices and have those choices, 
whatever they might be, respected, known, and enforced.
  This actually won't cost us anything. The evidence is that people who 
know more use their information to choose wisely--very often less 
intense medical interventions. Overall, it could actually save money.
  Doctors are perhaps the best example. They certainly can afford 
medical care. They certainly know about it. Yet, because they know what 
works and what doesn't, they make their wishes known and strategically 
choose their health care. As a group, they actually end up using less 
medical care in their last year of life, but arguably have a higher 
quality of life. Everybody should have the same choice as a doctor.
  I'm in the process of visiting with each and every Member of the 
House to see if we can do something that will give people the care they 
want that is overwhelmingly supported by the public and that won't cost 
the Federal Government any net cost.
  I urge my colleagues to examine the bipartisan legislation H.R. 1173, 
the Personalize Your Care Act of 2013, that Dr. Phil Roe and I have 
introduced to help families in their time of greatest need. I think 
it's worth a look. I think it's worth your support.

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