As the legislative session winds down (about two weeks left), long hours and controversial bills have been the norm in the House.
This past Wednesday and Thursday, the House took up a bill related to the Patient Choice at End of Life law, also known as the Death With Dignity Act. That law, which was passed in the last biennium, provides immunity for doctors who prescribe medication for the purpose of hastening a patient’s death. The law provides a number of protections, among which are the requirements that the patient must make two oral requests for medication to be self-administered for the purpose of hastening the patient’s death; the patient must make a written request for such medication in the presence of two witnesses who are not interested persons (e.g., family members, acquaintances); a physician must determine that the patient is, in fact, terminally ill, is capable, and is making an informed and voluntary decision; and the physician must inform the patient of the patient’s diagnosis, prognosis, range of treatment options, availability of palliative or hospice care, and the probable result of taking the prescribed medicine. The law also provides that these protections would sunset on July 1, 2016. After these protections sunset, physicians would still be immune from prosecution for prescribing medications that would hasten death. Apparently, to get this law passed, this sunset provision was included to get the votes of certain lawmakers who did not want the state involved in the matter.
The bill before the House would repeal the sunset provision and thus would keep the protections in place. Before voting on whether the repeal should go to a third reading the House considered an amendment that would have repealed the law in its entirety. After long debate, this amendment was defeated by a 60 to 83 vote, and the bill then was passed to a third reading.
The next day several amendments were offered at third reading to modify certain requirements of the law and to impose additional reporting requirements. Most were defeated except for one directing the Department of Health to adopt rules to facilitate the collection of certain information. The bill then passed, thus the protections of the Act will be retained.
I did vote for the bill, as I think having some control over one’s end-of-life choice is important, so long as protections are in place that ensure the choice is appropriate and informed. Representative Komline summed it up well when she said at the close of debate that “They take this medication when the time for hope is over. They’re not choosing death. They’re just choosing the way they die.”
On Thursday, the House next took up S.9, a Child Protection Bill. I have provided a description of this bill in a previous post. When the bill was first introduced in the Senate, it included a provision that would have created a felony for failure to protect a child. This provision sparked significant controversy primarily because it could act as a disincentive for people to get involved in trying to protect children. The bill that passed excluded any new or enhanced crimes and overwhelmingly passed the House.
Also on Thursday, the House started its consideration of a health care bill. My next article for The Other Paper, which I will post on Thursday, will address the main aspects of this bill. Here, I will mention three aspects of the bill that The Other Paper article will not address.
First, the bill was amended to include tobacco substitutes (electronic cigarettes) in current law regulating the display, sale, and use of tobacco products. In addition, it imposed a tax on the sale of tobacco substitutes.
Second, the bill relies on revenues generated through expanding the sales tax to include sales of candy and soft drinks, increasing taxes on tobacco products, and imposing a meals tax on items purchased from vending machines. These taxes, and the tax on tobacco substitutes, are appropriate sources for funding health care reform. The prices of these products do not fully reflect their costs to society, namely in the increased costs of health care due to obesity and tobacco use. Taxing these products internalizes some of the external societal costs that they impose – it makes the price of the product more accurately reflect their true cost. In addition, by increasing their prices, their consumption and use should decrease, with the resulting decrease in health care costs.
Finally, the bill includes provisions establishing performance milestones for Vermont Health Connect (“the Exchange”). Among these milestones will be the delivery of functioning technology by May 31, 2015 that addresses change of circumstances, and delivery of a fully automated system by October 1, 2015 that allows for 2016 plan enrollment. The bill provides for the independent review of the Exchange by the Joint Fiscal Office and requires the Agency of Administration to explore alternatives to the Exchange in the event the General Assembly decides to seek an alternate path to Vermont Health Connect.
Fortunately, it was not all controversy and work this past week. On Wednesday morning, I sang the devotional with the Statehouse Singers (see prior post). And on Thursday evening, after 10 hours on the House Floor, I participated in the annual Cabaret. This fund raising event features skits, jokes and songs performed by representatives, senators, and Statehouse staff, poking fun at each other and our work. I played guitar and sang a solo, the Gun Bill Blues, sang to the tune of Fulsome Prison Blues, and accompanied Judiciary Committee members in a tune about gaining weight over the course of the Session because of eating too many snacks in the Committee room. After a long, tiring day, the event was a welcome respite.