Gundersen
Lutheran Health System, a physician-led, not-for-profit integrated delivery
system serving more than 550,000 people in Wisconsin, Iowa, and Minnesota,
implemented a program promoting advance care planning. According to an analysis
done by the Commonwealth Fund, Medicare spends $8,000 less per patients treated
at Gundersen Lutheran than the national average—and roughly $10,000 less at
Gundersen Lutheran during the last six months of life than at other area
hospitals. The analysis specifically attributed these lower costs to the
completion of advance directives associated with the health system’s promotion
of advance care planning. [1]
How does Gunderson save
this money?
A group of national and local
disability rights groups had pointed words regarding Gundersen
Health Care System Respecting Choices advance care planning documents entitled “Tube
Feeding: What You Should Know” and “Help With
Breathing: What You Should Know.” In a letter to
Bernard Hammes, Ph.D., the Director of Medical Humanities and Respecting
Choices, the groups wrote,
However, using frequently identical
language, both documents reflect a strong bias against using these medical
devices for any purpose other than short-term recovery. The documents
describe long-term use of these devices as fraught with discomfort and
unpleasant side effects, and actively discourage individuals from even trying
them despite the certainty that they will die as a result....Many of the
undersigned individuals are among the tens of thousands of people with
disabilities who use these medical technologies on a long-term basis and are
therefore able to enjoy meaningful, productive and fulfilling lives.
The groups asked Gunderson to make
specific changes including,
·
Stop
marketing and distributing “Tube Feeding: What You Should Know”
and “Help With Breathing: What You Should Know.”
· Send a formal notice to all known purchasers and
users of these documents directing that they no longer be used due to their
misleading nature and offering to refund any related payments received for
their purchase.
The full letter can be found here.
Information on how even more advance care planning materials already in widespread use are suffused with vivid, emotional, and distorted presentations designed to persuade individuals to forego life-preserving medical treatment can be found here.
Information on how even more advance care planning materials already in widespread use are suffused with vivid, emotional, and distorted presentations designed to persuade individuals to forego life-preserving medical treatment can be found here.
What is worse, this summer, the Obama Administration has proposed a regulation using its executive power to pay doctors to conduct advance care planning conversations with seniors, to take effect January 1, 2016.But Rep. Steve King (R-IA) has introduced a bill, H.R. 3251, to prevent the Administration from implementing that funding.
You may ask Your Representative to Co-Sponsor H.R. 3251 against Biased “Advance Care Planning” Under Medicare by clicking here
[1]
S. Klein & D. McCarthy, “McCarthy D. Gundersen Lutheran health system:
Performance improvement through partnership Case study: Organized health care
delivery system 2009,” http:// www.commonwealthfund.org/~/media/Files/Publications/Case%20Study/2009/Aug/1307_McCarthy_
Gundersen_Lutheran_case_study_v2.pdf.