DEEP DESIRE TO REDUCE HEALTH CARE SPENDING USING ADVANCE CARE PLANNING CAN MEAN PREMATURE DEATH

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.

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.