Fifty years ago this week, President Lyndon B. Johnson signed legislation that established Medicare and Medicaid to protect the health and well-being of millions of Americans and improve the economic security of our nation.
Recently, Medicare proposed a new rule that would reimburse doctors for discussing advance care options with people. While such a policy is an important step in the right direction, much more must be done if it is to be applied efficiently and effectively.
Even if they are paid for their time, doctors rarely have enough time in an office visit to introduce a new concept to patients who may be there just to address a medical issue or have a check-up – not contemplate long-term values in how they would like to be treated in the event of a healthcare emergency. Advance care planning must be a critical part of everyone’s lives, from an early age. We must educate and empower people to start thinking about advance care planning long before they become a critical care patient.
Create a draft plan at home, with the input of family and loved ones, when there is time and space to think these priorities through. The purpose of discussing the plan with a doctor, then, becomes reviewing any questions or talking about one’s healthcare values. This is far superior to starting the conversation from scratch.
And for their part, doctors need training. Conversations in advance care planning require resources and patience. As part of its new rule, Medicare should direct healthcare providers to tools they can share with people on starting the conversation at home.
Once they create an advance care plan, people deserve confidence said plans can be found 24/7, anywhere in the world – in the event they want to update it as circumstances change, or because something happens where implementation of that plan is needed. This is also the best way to prevent Medicare fraud for reimbursing discussions that didn’t happen.
We wish ongoing success for the next 50 years for Medicare and Medicaid and hope they will continue to prioritize educating and empowering people to take an active role in their healthcare journey, especially when it comes to advance care planning.