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Advance Directives: Let's Make a Law

Philip Betbeze, for HealthLeaders Media, April 11, 2014

Fine says big strides can be made through this simple requirement, though he acknowledged in an opinion piece recently in the Arizona Republic that making it so could develop into a hot-button political issue—see my note about "death panels," above.

But it's not, he argues in a call to action for his fellow hospital and health system leaders:

"Of course, there might be concern among some about the appropriateness of government involvement in making this intensely personal matter a requirement of applying for Medicare benefits. I would ask these people to consider the fact that the completion of these documents preserves and strengthens individual choice, keeps the highly personal discussion about dying within the privacy of the family and has the real potential to save tens of billions of dollars," Fine says. "This issue plays out in our institutions. We own it. Let's start the dialogue with our elected leaders to fix the problem."

If it took a column deadline to force me to take a hard look at my own mortality.

It'll likely take this proposed requirement to make the two thirds of Americans who don't have an advance directive pay attention. Unfortunately, things like this are ripe for political hay to be made, and as a result, implementing such a common sense requirement is among the things Congress is worst at.

Let's hope the urgency of the healthcare cost problem might surmount those potential hurdles, and get this done.  Fine could certainly use other healthcare leaders' support.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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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.