Former Speaker of the House Newt Gingrich defended former Governor Sarah Palin’s “Death Panel” claims on TV last weekend. Yet just like Mrs. Palin, Mr. Gingrich has advocated advanced care directives, especially their adoption by entire healthcare communities. And unlike Mrs. Palin, his reasons for doing so were economic.
More than 20 percent of all Medicare spending occurs in the last two months of life. Gundersen Lutheran Health System in La Crosse, Wisconsin has developed a successful end-of-life, best practice that combines: 1) community-wide advance care planning, where 90 percent of patients have advance directives; 2) hospice and palliative care; and 3) coordination of services through an electronic medical record. The Gundersen approach empowers patients and families to control and direct their care. The Dartmouth Health Atlas has documented that Gundersen delivers care at a 30 percent lower rate than the national average ($18,359 versus $25,860). If Gundersen’s approach was used to care for the approximately 4.5 million Medicare beneficiaries who die every year, Medicare could save more than $33 billion a year.
Wisconsin, like every other state and the District of Columbia, has laws to facilitate Advance Care Directives, but no one has claimed they were euthanasia before. And the last part of the paragraph sounds like Mr. Gingrich cribbed it from the Republicans’ latest Demon Doctor of the OMB (on detail from NIH) Ezekiel J. Emanuel, MD, PhD.
Image by Mike Licht. Download a copy here. Creative Commons license; credit Mike Licht, NotionsCapital.com
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