McCaughey falsely claims bill makes end-of-life counseling for seniors “mandatory”

McCaughey first made claim on Fred Thompson's radio show. On Thompson's July 16 show, McCaughey claimed of the House tri-committee health care reform bill:

And one of the most shocking things I found in this bill, and there were many, is on Page 425, where the Congress would make it mandatory -- absolutely require -- that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go in to hospice care. And by the way, the bill expressly says that if you get sick somewhere in that five-year period -- if you get a cancer diagnosis, for example -- you have to go through that session again. All to do what's in society's best interest or your family's best interest and cut your life short. These are such sacred issues of life and death. Government should have nothing to do with this. [fredthompsonshow.com, interview archives, 07/16/09]

House bill does not make end-of-life counseling mandatory

Advance care planning is not mandatory in the House health care bill. Section 1233 of America's Affordable Health Choices Act of 2009 -- which includes “Page 425” -- amends the Social Security Act to ensure that advance care planning will be covered if a patient requests it from a qualified care provider [America's Affordable Health Choices Act, Sec. 1233]. According to an analysis of the bill produced by the three relevant House committees, the section "[p]rovides coverage for consultation between enrollees and practitioners to discuss orders for life-sustaining treatment. Instructs CMS to modify 'Medicare & You' handbook to incorporate information on end-of-life planning resources and to incorporate measures on advance care planning into the physician's quality reporting initiative." [waysandmeans.house.gov, accessed 7/29/09]

Rep. Blumenauer: “Myth: Patients will be forced to have this consultation once every five years.” Rep. Earl Blumenauer (D-OR), who co-authored the provision, released a fact sheet on advance planning consultations in the House health care bill that states: “Myth: Patients will be forced to have this consultation once every five years. Fact: Advance planning consultations are not mandatory; this benefit is completely voluntary. The provision merely provides coverage under Medicare to have a conversation once every five years if -- and only if -- a patient wants to make his or her wishes known to a doctor. If desired, patients may have consultations more frequently if they are chronically ill or if their health status changes.”

Claim begins to spread through conservative media

In New York Post, McCaughey claims bill “compels seniors” to “submit” to counseling sessions. Following her appearance on Thompson's show, McCaughey made a similar claim in a July 17 New York Post op-ed, writing that "[o]ne troubling provision" of the bill “compels seniors to submit to a counseling session every five years ... about alternatives for end-of-life care,” adding that the “mandate invites abuse, and seniors could easily be pushed to refuse care.”

Hannity: Seniors “forced to undergo, quote, 'end-of-life counseling,' apparently to encourage them to check out before their time is up.” On his July 17 radio show, Sean Hannity referred to McCaughey's Post op-ed, saying: “Now, she [McCaughey] actually uncovered in this bill a particularly outrageous provision -- and by the way, there will be more to come in the Obamacare plan. According to McCaughey, she's saying under the House provision and the House version, perfectly healthy senior citizens are going to be forced to undergo, quote, 'end of life counseling,' apparently to encourage them to check out before their time is up.”

Ingraham: "[M]andatory counseling session" by “government bureaucrat” is “frightening.” On the July 17 edition of Fox News' The O'Reilly Factor, guest host Laura Ingraham said: “The fact that a government bureaucrat will come to an old person's house as a mandatory counseling session -- first of all, stay away from my father, who is 83 years old. I do not want any government bureaucrat telling him what kind of treatment he should consider to be a good citizen. That's frightening.”

American Thinker: Bill will “require mandatory counseling for all seniors.” In a July 21 post on the conservative blog American Thinker, Don Parker asserted: “The House version of the Health Care Bill is going to require (p 425-430) mandatory counseling for all seniors at a minimum of every five years, more often if the senior is sick or in a nursing home.”

Limbaugh: Bill provides for "[m]andatory counseling." On his July 21 show, Rush Limbaugh said:

You know what we ought to do? We ought to put together a single page cut-and-paste fact sheet at RushLimbaugh.com that people could cut and paste and fax to the White House so that [President] Obama will know what is in the bill.

I'll bet he doesn't know that there is end-of-life counseling for senior citizens on page 425 to 430. What is this counseling going to be? Why would you need mandatory counseling for all seniors, and who's going to pay for this? Mandatory counseling for all seniors at a minimum of every five years, more often if the seasoned citizen is sick or in a nursing home.

McCaughey: Bill will "pressure the elderly to end their lives prematurely." In a July 23 Wall Street Journal op-ed, McCaughey again claimed the bill will “pressure the elderly to end their lives prematurely,” referring to the provision she characterized as “ensur[ing] that seniors are counseled on end-of-life options, including refusing nutrition where state law allows it.”

PolitiFact: McCaughey's claim is a “ridiculous falsehood”

McCaughey's original claim gets “Pants on Fire” status. On July 23, PolitiFact.com reported: “On the radio show of former Sen. Fred Thompson on July 16, 2009, McCaughey said 'Congress would make it mandatory -- absolutely require -- that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.' ” PolitiFact.com stated:

For our ruling on this one, there's really no gray area here. McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would “tell [seniors] how to end their life sooner” is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn't just wrong, she's spreading a ridiculous falsehood. That's a Pants on Fire.

Despite debunking, Fox News, Wash. Times continue to advance false claim

Hannity: Bill includes “mandatory advisory counseling sessions with the elderly.” On the July 27 edition of Fox News' Hannity, Fox News contributor Dick Morris stated that senior citizens are “getting that this is creeping euthanasia.” Hannity replied that “they're going to have mandatory advisory counseling sessions with the elderly about their, quote, 'options.' I mean it's eerie.”

Fox News' Johnson claimed health care reform “a subtle form of euthanasia.” Fox News legal analyst Peter Johnson Jr. said on the July 27 Fox & Friends, “Some people are saying, well, this is a health care reform, other people say -- maybe me -- that this is a subtle form of euthanasia. And when you start looking at the proposals, you say, God, what's happening? One of the proposals, Section 1233, talks about advanced care planning consultations. And that's a fancy term where a doctor goes to you every five years once you're 65, or more if you're chronically ill, and explains to you the benefits of so-called palliative care, of not giving active treatment.” Johnson later added, “The hospital room becomes the waiting room -- you know, do not go gently into that good night.” [Fox & Friends, 7/27/09]

Wash. Times uncritically reported McCaughey's claim. In a July 28 article, The Washington Times reported:

Elizabeth McCaughey, widely credited (or blamed) for helping sink Hillary Rodham Clinton's national health care proposal in the 1990s, is back again, wading through the details of a massive health care proposal, and has made a startling claim circulated widely among conservative and religious blogs. The bill pending before the House would require 'end-of-life' counseling for senior citizens, she said in a recent interview on the Fred Thompson radio show in which the health care scholar and former New York lieutenant governor warned people to 'protect' their parents from the plan. [The Washington Times, 7/28/09]

Fox's Johnson: Provision “is kind of our 2009 Brave New World, Soylent Green, 1984, Aldous Huxley kind of world.” Johnson said on the July 28 Fox & Friends, “Advanced care planning consultation is kind of our 2009 Brave New World, Soylent Green, 1984, Aldous Huxley kind of world where you come in and see a doctor at age 65, and if you're chronically ill you come in every year, and your doctor who will be trained -- and they will spend billions of dollars on training doctors to be counselors -- that you have options. You don't have to go into a hospital.” Co-host Brian Kilmeade commented, “ultimate exit strategy.” [Fox & Friends, 7/28/08]

McCaughey backpedaled on claim when confronted by criticism

McCaughey walked back her claim in a Politico article. According to a July 28 Politico article, when asked about criticism of her claim that the bill makes counseling “mandatory,” McCaughey claimed that she was right about the effect (if not the literal wording) of the legislation. McCaughey stated that "[i]n so many words" the bill would make end-of-life counseling mandatory because “although it is presented in the bill as a Medicare service, when a doctor or a nurse approaches an elderly person who is in poor health, facing a decline in health, and raises these issues, it is not offering a service. It is pressuring them.”

McCaughey softened rhetoric on other claims in the past. After McCaughey repeatedly claimed that provisions in the economic recovery act would permit the government to dictate treatment, she was confronted by CNN health care reporter Elizabeth Cohen, who subsequently reported: “I had a PDF of the bill up on my computer. I said, 'Show me where in the bill it says that this bill is going to have the government telling your doctor what to do.' And [McCaughey] directed me to language -- it didn't actually say that. But she said that it was vague enough that it would allow for that to happen in the future.”

AARP, Obama forced to address “rumors” during health forum

AARP moderator stated that the provision would allow Medicare to “cover consultation.” During a July 28 AARP health care forum, moderator Michael Cuthbert said: “As I read the bill, it's saying that Medicare will, for the first time, cover consultation about end-of-life care.” Cuthbert's statement was a response to the questioner who said: “I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die.”

Obama made clear the intent is to “simply make sure that you've got more information, and that Medicare will pay for it.” In his follow-up to Cuthbert, Obama stated, “But understand what the intent is. The intent here is to simply make sure that you've got more information, and that Medicare will pay for it.” Obama later added: “So if Medicare is saying you have the option of consulting with somebody about hospice care, and we will reimburse it, that's putting more power, more choice in the hands of the American people, and it strikes me that that's a sensible thing to do.”

AARP slams McCaughey's “Health Reform Scare Tactics”

AARP Executive VP: McCaughey's commentary “rife with gross -- and even cruel -- distortions.” In a July 28 press release, AARP executive vice president John Rother stated that “Betsy McCaughey's recent commentary on health care reform column in various media outlets is rife with gross -- and even cruel -- distortions.” Criticizing McCaughey's “distortions” with regard to comparative effectiveness research and end-of-life counseling, Rother added that AARP will “fight the campaign of misinformation that vested interests are using to try to scare older Americans in order to protect the status quo.”

Special Report reports White House statements that consultation is not mandatory

Goler, Baier note White House says counseling optional. On the July 28 edition of Fox News' Special Report, White House correspondent Wendell Goler said of the provision, “The White House says even though Medicare would reimburse for the counseling session, it wouldn't conduct them.” Goler further reported, “Press secretary Robert Gibbs accuses the President's critics of misrepresenting the bill.” Later, host Bret Baier explained, "[The White House] is saying that this particular section of this bill is not mandatory. It's a consultation. It's to try to drive costs down in the long haul." [Special Report with Bret Baier, 7/28/09]

Debunkings, McCaughey's backtracking doesn't stop media echo chamber

York says according to bill, “there will be consultation ... to discuss ... end-of-life issues.” On the July 28 edition of Special Report, Washington Examiner chief political correspondent Byron York falsely claimed that a provision in a House health reform bill “says that there will be consultation between a caregiver and a patient to discuss things like hospice care and other issues -- other end-of-life issues,” which he claimed raised the question of “whether there's any coercive element to this.” [Special Report with Bret Baier, 7/28/09]

Washington Post promoted falsehood. In a July 29 Post article about President Obama's AARP forum on health care, Ceci Connolly wrote that "[o]ne woman asked Obama about 'rumors' that under the proposed legislation, every American over age 65 would be visited by a government worker and 'told to decide how they wish to die,' " but did not report that the “rumors” are not true, as Cuthbert and Obama noted during that forum.

Hannity: “I don't want somebody at the end of my life from some bureaucrat counseling me about whether or not I need antibiotics.” On the July 30 edition of his Fox News show, Sean Hannity said of health care reform, “And I think on top of it, then we get all the things that happen in the single payer system in Canada and Great Britain, and we have rationed care. The end of life counseling. I don't want somebody at the end of my life from some bureaucrat counseling me about whether or not I need antibiotics.”

Buchanan: “Now we're hearing all this stuff about people at the end of their life are gonna get visited by some guy.” On the July 31 edition of MSNBC's Morning Joe, MSNBC contributor Pat Buchanan said: “We've been talking about the other side now, which is the apprehension and fear on the part of people who've got good health insurance and would like to have other folks taken care of, but they say wait a minute, we're gonna get taxed, and now we're hearing all this stuff about people at the end of their life are gonna get visited by some guy.” After Rep. Elijah Cummings (D-MD) said, "[T]hat's why we've got to straighten out some of these untruths. Some of these things are actual lies," host Joe Scarborough replied: “Are you saying you do not have the Grim Reaper clause in this health care bill? They're all saying the Grim Reaper's gonna come visit them.” Cummings responded, “That is absolutely untrue.”

Conason declares McCaughey “source” of falsehood

Salon's Conason says McCaughey the “source” of the " 'elderly euthanasia' hoax." In a July 31 Salon article, Joe Conason wrote: “It appears that McCaughey is the source of the 'elderly euthanasia' hoax now circulating on the Internet, talk radio and in right-wing media, which claims that Democratic health bills will force old, ill Medicare recipients into making plans for their own deaths. Two weeks ago, on former Sen. Fred Thompson's radio program, she warned that 'the healthcare reform bill would make it mandatory -- absolutely require -- that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.' The nonpartisan Politifact.com Web site described this claim as a ”'ridiculous falsehood.' "

Transcripts

From the July 17 edition of Westwood One's Fred Thompson Show:

McCAUGHEY: And one of the most shocking things I found in this bill, and there were many, is on Page 425, where the Congress would make it mandatory -- absolutely require -- that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go in to hospice care. And by the way, the bill expressly says that if you get sick somewhere in that five-year period -- if you get a cancer diagnosis, for example -- you have to go through that session again. All to do what's in society's best interest or your family's best interest and cut your life short. These are such sacred issues of life and death. Government should have nothing to do with this.

From the July 17 edition of Fox News' The O'Reilly Factor (accessed from the Nexis database):

INGRAHAM: Yes -- well, first of all, I know a lot of doctors personally. The doctors have not spoken all through the AMA. The fact that a government bureaucrat will come to an old person's house as a mandatory counseling session -- first of all, stay away from my father, who is 83 years old. I do not want any government bureaucrat telling him what kind of treatment he should consider to be a good citizen. That's frightening.

ELIZABETH CARPENTER (associate policy director, New America Foundation): I think what we want is for you and your father to have a conversation about what he wants when his...

INGRAHAM: That is none of your business. The democrat party has consistently.

CARPENTER: Right now you and your father might not have the information...

(CROSSTALK)

INGRAHAM: That is none of your business. That is not the government's business. The democrat party has routinely said, hands off our bodies, it is all about choice, it's pro-choice, don't touch our bodies, and keep your hands off when it comes to abortion.

But when it comes to the elderly who have paid into the system their entire lives, basically the message from President Obama is, OK, we hope, we hope, we hope you consider these other alternatives.

CARPENTER: Well, whether or not you take advantage of that information ultimately is going to be up to you and your dad.

From the July 27 edition of Fox News' Hannity (accessed from the Nexis database):

MORRIS: It has to be the all or nothing. And we point out in “Catastrophe” how terrible that approach will be. I think that what's going on right now is Hillary's health care proposal lost because of middle class voters. His health care proposal is losing because of senior citizens. They are getting that this is creeping euthanasia. That essentially what you're saying is no, there's a two-year wait for this, you can't have this, you can't have that.

But by the way, hospice care if available.

HANNITY: But they're going to have mandatory advisory counseling sessions with the elderly about their, quote, “options.” I mean it's eerie.

From the July 30 edition of Fox News' Hannity (accessed from the Nexis database):

RICKEY MEDLOCKE (musician): I have one lung. I operate off of one lung. I have a respiratory illness. It's a low grade form of cystic fibrosis. I've had it ever since I was a small child. I don't want -- I like the doctors that I have right now. They know how to treat me . They've kept me alive all these years. They're still keeping me alive even through all this rock 'n' roll stuff, right?

The deal is I don't want anybody telling me what treatment I can get, when I can get it, who I'm going to get it from and giving me maybe a low form of that treatment, even if I get it.

So for me, I look at it this way. I still think this is a country of freedom. You've got freedom of choice. You should be able to have the freedom of choice instead of somebody telling you what you're going to get and when you're going to get it.

And furthermore, you know what? If this happens, I agree with her -- taxes are going to go sky-high, we're going to be paying for it. And then there you go.

HANNITY: And I think on top of it, then we get all the things that happen in the single payer system in Canada and Great Britain, and we have rationed care. The end of life counseling. I don't want somebody at the end of my life from some bureaucrat counseling me about whether or not I need antibiotics.

NOELLE NIKPOUR (Republican strategist): Absolutely.

HANNITY: I don't want that.