[Congressional Record (Bound Edition), Volume 161 (2015), Part 8]
[House]
[Page 11099]
[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. One of the most difficult and challenging situations 
any family faces is dealing with circumstances surrounding the end of 
life.
  Earlier this week, NPR ran a fascinating story on a little-known fact 
that physicians die differently than the rest of us. They are more 
comfortable. They are more likely to spend their final days surrounded 
by loved ones. They seldom die in an ICU or even in a hospital setting. 
That is because doctors understand what works and what doesn't. Doctors 
are very clear about their wishes, and they choose quality of life and 
concern for their families as well as their own well-being.
  I have been working in this area of end of life care for more than 6 
years. The Ways and Means committee unanimously approved my legislation 
as part of the Affordable Care Act to provide greater support for 
families with that decision making process.
  It did pass the committee unanimously as part of the Affordable Care 
Act, even despite the furor of the 2009 lie of the year about death 
panels, on the strength of some of the most compelling testimony that 
was delivered not by expert witnesses, but by Members of the committee.
  One of our Republican Members discussed how his mother didn't get the 
care that she needed at the end of her life. Another physician Member 
of the committee explained how he had these conversations repeatedly, 
but unfortunately they were often much later than they should have 
been. There wasn't adequate time for the family to prepare.
  Well, there has been a sea change on this issue in part because of 
rising public awareness. Support for our bipartisan legislation, the 
Personalize Your Care Act, which I have worked on for years now with 
Dr. Phil Roe, has made great strides forward.
  We have had advocates like Dr. Bill Frist, former Republican leader 
of the Senate, who has spoken eloquently and written forcefully about 
the need to help families under these trying conditions.
  The Reverend Billy Graham has written about how it is Christian 
responsibility to take this on for ourselves and spare our loved ones 
uncertainty.
  Dr. Atul Gawande recently published a brilliant work, ``Being 
Mortal,'' which quickly climbed to the top of the best seller list for 
The New York Times.
  The Institute of Medicine has put out a seminal, over 600-page report 
about dying in America that talked about the problems and opportunities 
to provide more choices and protect people's wishes.
  Yesterday was another important landmark where the administration 
published a proposed fee schedule for next year in which they have 
assigned an activity code with payment for advanced care planning.
  Now, of course, this is merely a proposal and CMS is still seeking 
comment, but it is a historic step forward for a decision that will be 
finalized this fall. It is yet another indication that we can and will 
do a better job of meeting the needs of America's families under the 
most difficult of circumstances.
  We will make sure Americans have all the information they need to 
make the right decisions for themselves and their family and then to 
assure that those decisions, whatever they may be, are honored and 
enforced.
  Medicare will pay for thousands of expensive medical procedures, and 
now, for the first time, the government is placing a value on this 
important conversation between a patient and their chosen medical 
professional.
  Now it is the job of the rest of us to do our part to spare our loved 
ones. Who will speak for us if we are unable to speak for ourselves, 
and what will they say?

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