End-of-Life Lessons From the Cheapest Place to Die

End of Life Debate.

What was once a personal conversation between a family and their doctor has turned into a public battle over whether the government should be involved in such sacred decisions.

The debate over the government's involvement was prompted by a proposal in some of the health-care reform legislation on Capitol Hill that would allow Medicare to reimburse doctors for talking with patients every five years about what type of end-of-life care they want.

VIDEO: A provision in health care reform legislation prompts passionate debate.
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At town hall meetings, in e-mails, online and on talk radio, inflammatory and often incorrect claims about the proposal are popping up faster than the Democrats can refute them.

"Adolf Hitler issued six million end of life orders," says a man at a Pueblo, Colorado rally against Obama's health care reform, in one popular YouTube clip. "He called his program the Final Solution. I kinda wonder what we're gonna call ours."

Former Alaska Governor Sarah Palin weighed in over the weekend writing in a FaceBook post:

"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. Such a system is downright evil."

Conservatives critics are calling it a path towards government sponsored euthanasia.

"You see when discussion about whether or not the continuation of one's life has a nexus with the U.S. treasury saving money, that's a very dangerous recipe for those who can often time be the most vulnerable amongst us," explained Republican Michigan Congressman Thaddeus McCotter.

But the proposed legislation -- contained in House committee versions of the health care bill -- does not call for a "panel" or a "board" to make decisions. It simply allows doctors to be paid for talking to their patients about decisions that might eventually have to be made by them or their families.

On Saturday President Obama said the criticism is misleading Americans.

"Let me start by dispelling the outlandish rumors that reform will promote euthanasia," Obama said. "That's simply not true."

"The intent here is to simply make sure that you've got more information and that Medicare will pay for it," the President said at another townhall meeting with seniors.

About 33 percent of an American's total medical spending comes in the last year of life. Obama has argued millions of dollars could be saved if Americans simply talk more about what they want for end-of-life-care.

Model for End-of-Life Care?

Those types of discussions are a normal, everyday occurrence in La Crosse, Wis.

"It's not unusual to hear that kind of conversation here in the coffee shop," said Todd Ondell, 60, owner of Grounded Specialty Coffee. "I think it's an awareness that the community has about those types of conversation and the fact that they have to have them."

In 1991, Gundersen Lutheran hospital in La Crosse initiated the program that is known around the country as "Respecting Choices" to urge families to talk about how they should care for their loved ones before a crisis hits. The program has now spread city-wide.

Typically, hospital staff members begin meeting with patients when they are 55 or 60 years old.

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