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Advance Directives: Let's Make a Law

Philip Betbeze, for HealthLeaders Media, April 11, 2014

One of healthcare's most prominent CEOs has a great idea for cutting healthcare costs—forcing Medicare recipients to complete a living will and medical power of attorney as a condition of receiving benefits. Unfortunately, implementing common sense measures like this is among the things Congress is worst at.

All right, I'll admit it. I've been avoiding writing this column for weeks.

My thought: As soon as I've done my own advance directive, I can actually write this thing and advocate it. Until I do, I can't write the column.

The result: Life got in the way and I've been sitting on a great column for weeks.

I've been avoiding it for the same reasons most people don't write advance directives for themselves—they don't like to think about their own ultimate demise.

That's unfortunate, but entirely understandable. I'm extremely biased, of course, but I believe myself to be one of the more practical and common-sense people I've ever met (I think my wife agrees, in most respects).

But that's never filtered down to advance directives, and the fact that this column is intended to promote them, and in fact, encourage their enshrinement into law, means I'd better not be a hypocrite about it. Let me just say that the allure of a slam-dunk column provided powerful motivation, and the fact that you're reading about it now means I have done my advance directive.

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3 comments on "Advance Directives: Let's Make a Law"


YeahRight (5/8/2014 at 3:30 PM)
I will never have a public advance directive. I will have a private letter to the person(s) I choose to represent me when I am unable. I will do this because I saw first hand the abuse that came when a hospital thought they had decision making powers. If my father had had an advance directive they would have killed him. Hell, they tried to anyway, with me as his medical power of attorney protesting all the way. Had they had a "legal" document to back them they would have proceeded against my will to stop treatment of a man who, once released from their dubious "care" went on to live another decade.

Alene Nitzky (4/14/2014 at 10:53 AM)
It's nice to see media attention to healthcare leaders acting on behalf of the public's well-being, taking the bull by the horns, and not solely for their own personal gain, and just worried about their voiced opinions affecting patient satisfaction scores. I have often wondered if organizations like the ACHE ever discuss the moral and ethical obligations of health care leaders to the public they serve, and the people who do the hard work in their organizations. We need to work toward a more humane health care system, for all: patients, families, health care workers, and the public.

donaldstumpp (4/11/2014 at 2:58 PM)
To your point Phil about even just getting started on the healthcare problem with the Medicare or even over 50 population, maybe the first step if for Medicare Advantage plans to lead the way. 25% of Medicare patients choose them and since it is a choice, maybe MA plans could make this part of their enrollment. If 1 in 4 of the Medicare population is doing this, maybe the stigma begins to go away and there's more voluntary adoption.