Why health policy should more actively encourage living will, power of attorney documentation
Every day in the hospitals across the country that we lead and operate, the lack of a "living will" or "medical power of attorney" significantly contributes to divisive conflict within families huddled over dying loved ones. One child insists that mom or dad just wants to be left alone to go peacefully without complex, uncomfortable and sometimes painful treatments that won't change the inevitable; and another child insists that the parent wants everything that can be done, to be done, even if the chances of survival are futile.
Of course, healthcare leaders are well aware that a solution to this emotionally and financially draining scenario is a relatively easy action that can have an immediate impact: Make sure those documents are completed and accessible. The short time spent preparing them has a very real potential to significantly improve the quality of life, provide peace of mind and dignity for families — and decrease healthcare costs.
The great majority of health systems and hospitals make every effort to encourage patients and their families to complete these documents. Yet various surveys indicate that only about one-third of Americans have made their choices known through these documents.
In 2010, the media reported that Medicare paid $55 billion for care during the last two months of patients' lives. I question how effective these expenditures were in supporting better patient care and improved quality of life. Further, with the growing number of baby boomers coming into the Medicare program every day, that number is surely increasing.
I believe now is the time to significantly enhance our efforts by asking elected officials in Washington to consider making the completion of a living will and medical power of attorney a requirement in the Medicare application process.
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.
This issue plays out in our institutions. We own it. Let's start the dialogue with our elected leaders to fix the problem.
Peter S. Fine is president and CEO of Banner Health in Phoenix.