[Congressional Record (Bound Edition), Volume 160 (2014), Part 3]
[House]
[Pages 4275-4276]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       PERSONALIZE YOUR CARE ACT

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Recently, the Reverend Billy Graham, in his latest 
book, talked about the situation that families face in the difficult 
circumstances surrounding end of life.
  Reverend Graham said:

       Refusing to act on the practical issues that confront us as 
     we grow older or simply ignoring them often becomes a sure 
     recipe for turmoil and conflict within a family.

  Former Senate Majority Leader Bill Frist, who was a physician long 
before he entered politics, said in an op-ed that appeared in one of 
the Capitol Hill publications:

       In the absence of advanced care planning, patients are much 
     more likely to receive medical interventions that can 
     actually prolong or worsen their suffering and will certainly 
     increase expense for their loved ones.

  Yesterday, I had an opportunity to work with the American Society of 
Oncology, who gave us further evidence. They have a report and 
recommendations that are coming forward that I think ought to be 
commended to each and every one of us. They pointed out that palliative 
care is not an either/or choice in terms of therapies. They found in 
one study that people who receive both palliative care and chemotherapy 
lived 3 months longer and more comfortably than people who just got the 
medical intervention.
  Additionally, further in their study, they pointed out that it isn't 
just the patient; it is the people who help serve ill patients who 
receive palliative care therapy. They suffer less emotional

[[Page 4276]]

stress. ICU and hospital deaths are associated with more psychiatric 
illness among bereaved caregivers compared with home hospice.
  Yet, as they pointed out, the sad truth is, for many insurance 
companies and our Federal Government, that although patients are 
entitled to make informed choices about their palliative care and 
treatment options, our Nation's health care system currently places no 
value on conversations that can guide these decisions.
  It is true; Medicare will pay $100,000 on a complex surgical 
procedure on a 90-year-old woman with terminal cancer, but it won't pay 
$200 for her and her family to understand the circumstances that they 
face, understand what their choices are and make sure that their 
choices, whatever they are, are respected.
  It, frankly, is embarrassing to me that Congress and the 
administration have not been able to respond to an issue that is 
supported by 90 percent of the American public, that will cost us no 
money, and that will assure that patients receive better treatment and 
we reduce the stress on their families.
  That is why my friend, Congressman Phil Roe, himself a physician from 
Tennessee, and I have introduced the Personalize Your Care Act, H.R. 
1173. This would provide for voluntary advance care planning 
consultation in Medicare and Medicaid every 5 years or in case there is 
a change in health status. It would provide grants to establish or 
expand physician orders for life-sustaining treatment programs, require 
that certified electronic health records display current advance 
directives and physician orders for life-sustaining treatment--what 
people want--and help make sure that their wishes follow them when they 
cross State lines.
  Currently, we have over 50 bipartisan cosponsors of this simple, 
commonsense approach to give American families what they need and what 
they say they want. I would strongly urge my colleagues to look at this 
legislation, to join us in cosponsoring it, and move in Congress and 
with the administration to remedy this serious oversight.

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