Dr.RW discusses aspects of this general issue here quoting two sources with significant insight content from Kathleen Parker and Wesley Smith. Smith's quote is particularly noteworthy;
The bill might not create punishments [ in regard to quality measurement that the Secretary may enact concerning physicians who fail to counsel] , but the regulations that would be created in the shadows outside the direct democratic process could.
So the question arises is the bill written is such a way as no one really knows what it means which in turn raises the question "Are the bill's authors (whoever they are) merely bad at statute composition and are unable to clearly delineate what is to become law or is the ambiguity really quite artfully, purposely inserted so that HHS technocrats can do pretty much what they want"?
In another posting Dr. RW offers this comment:
Although a good palliative care service can save an institution money its focus is on what's best for the individual patient. Sometimes those goals are in conflict, sometimes not, but an excellent palliative care team will manage the conflict appropriately by putting the individual patient first, no matter the impact on the medical commons. When an end of life counseling provision is part of a bill with a clear agenda to control costs some degree of skepticism is appropriate.
How many other sections of the House bill suffer (or benefit) from this same type of opaque wording?