Living Wills Save Money? Dude, Did You Really Say That Out Loud?

Experts Dispute Remark That Living Wills Save Money, leads the Washington Post in a story about HHS Secretary Mike Leavitt, who made the incredible blunder of claiming that living wills for senior citizens could "reduce Medicare's skyrocketing health care costs." Why? Duh, he replied, because the old people will die faster. Reasons for Leavitt's conclusions were left vague.

Leavitt is proposing that physicians who bill Medicare must include a discussion of the directives in their consultations with patients. And nobody disputes that such a discussion is a good idea, or even that it might "work" in terms of getting patients' wishes on the table. But the question of whether living wills actually change outcomes in hospitals is still very much alive. There is data, but it isn't conclusive. More to the point, whether or not living wills save money would depend entirely on what people actually say in their living wills - and nothing will scare aging folks more than the idea that the government wants them to sign living wills because that way they'll die less expensively. Even if it were true - which it very likely is not - it speaks volumes about how difficult it has been to discuss advance directives in public policy without pushing hot buttons.