Brace yourself for a reprise of the death panel debate of 2009.  The AMA will soon formally recommend to CMS that physicians be paid—or “reimbursed” in health care-speak—for talking with Medicare patients and their families about “advance care planning,” including living wills end-of-life treatment choices.

If it sounds like a rerun of the debate sparked by an early draft of the Affordable Care Act, it is.  But the AMA, as well as most health care experts, hopes that the outcome will be different.  The 2009 debate resulted in removal of the advance care planning provision from the Act.

Most experts agree that it is crucial that people be fully informed about their options while they are still competent and able to make sound choices.  When they aren’t, decisions fall to someone else—typically a relative or group of relatives—who may not know what the patient wanted.  Too often the practical effect of a patient’s failure to attend to advance care planning is continuation of treatment that is painful, costly and futile.

The AMA’s decision to make the recommendation was triggered by a request from the Illinois State Medical Society for formulation of specific billing codes for such planning.