Elderly book end-of-life talks once labeled 'death panels'

"The more and more that that happens, the more patients, families and doctors will become comfortable with it," said Dr. Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine .

The Centers for Medicare and Medicaid Services quietly tucked the change allowing for payment for end-of-life counseling into a massive package of regulations last summer, with billing permissible as of Jan. 1.

Some doctors had already incorporated end-of-life planning into regular visits, and certain private insurers began offering reimbursement for it before Medicare announced its change.

Diamond arrived for his appointment at Hackensack University Medical Center on a mundane day in which he had reviewed investments, had a dentist appointment and ate a couple slices of pizza for lunch.

For years before the Affordable Care Act was written, there was bipartisan consensus on the value in helping people understand their desires at the end of their lives and make those wishes known.

A 1991 law passed under President George H.W. Bush requires hospitals and nursing homes to help patients who want to prepare living wills and advance directives and similar efforts gained particular resonance after the 2005 death of Terri Schiavo, the brain-damaged Florida woman whose family fought for years over whether she'd want to be kept alive in a vegetative state.

[...] just months before being tapped as Republican presidential candidate John McCain's running mate, then-Alaska Gov. Sarah Palin signed a proclamation recognizing Healthcare Decision Day to spread word of a statewide campaign about the importance of advance directives.

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care