Setting forth medical plans before times of health crisis

“The best way for people to retain control of their medical care as they face serious illness is to record their preferences in advance and share their decisions with their physicians and loved ones,” says Rick Pollack of the American Hospital Association.

Over 15 years ago, we acted on a bipartisan basis to place into the law a requirement that all Medicare and Medicaid provider organizations provide written information to patients at the time of admission concerning an individual’s right under state law to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives. It also required these organizations to provide written information to patients with respect to advance directives. Yet even with laws like the Patient Self Determination Act in place, only about 29 percent of Americans currently have a living will.

Rep. Mike Castle (R-Del.) and I have introduced legislation to encourage individuals to create advanced medical plans to direct healthcare decisions during times of medical emergency or serious illness. The bill, The Advance Directive Promotion Act of 2008, is endorsed by both the AARP and the American Hospital Association. It is designed to make more Americans aware of advance directives (which include a living will stating an individual’s preference for medical care and a power of attorney for this care) and provide the opportunity for them to discuss advance directives with a physician and ensure the directives are honored throughout the country.

The legislation would require the Department of Health and Human Services to conduct a national public education campaign to raise awareness of the importance of planning for care in advance of a medical emergency or serious illness, and establish a national, toll-free information clearinghouse for state-specific information on advance directives.

It would also require those healthcare providers that are currently required to provide written information regarding advance directives to also provide the opportunity for patients to discuss advance directives with an appropriately trained professional. And the Act would amend the Medicare program so that in the initial preventative physical exam, all beneficiaries receive a discussion about advance directives is included.

This legislation would also help ensure that those who did spell out their wishes in advance would have those wishes honored. The Act requires service providers to honor advance directives validly executed in other states.

With our sprawling healthcare system, the government must create procedures to encourage individuals, their families and their doctors to discuss the type of medical care they would like to receive well in advance of a crisis situation. We then have a responsibility to ensure that those directives are honored.

Levin is a member of the House Ways and Means Committee.