Healthcare update

Boehner: Republicans Voted To Turn Medicare Into Obamacare

What if Medicare required a living will?

Andrew Sullivan has a proposal to lower health-care costs that actually makes some sense. “If everyone aged 40 or over simply made sure we appointed someone to be our power-of-attorney and instructed that person not to prolong our lives by extraordinary measures if we lost consciousness in a long, fatal illness or simply old age,” he writes, “then we’d immediately make a dent in some way on future healthcare costs. A remarkable proportion of healthcare costs go to the very last days or hours of our lives.”
His idea is voluntary. But I’d make a different suggestion. What if, to be eligible for Medicare, you had to give someone power of attorney and sign a living will? You could tell your attorney, and write in your will, that you want every possible measure employed to keep you alive. You could say cost is no object, and neither is pain or quality of life. You could make whatever choice, and offer whatever instructions, you want. You just have to do it. You have to make the decision.
Right now, of course, heroic measures are the default. The simple act of making that choice would cut costs, as I suspect many, many people would prefer something besides maximal treatment, and would ensure fewer people suffered needlessly because their health deteriorated before they made their wishes clear. And although Sarah Palin managed to rechristen medical counseling about end-of-life options “death panels,” I choose to believe that that sort of childishness isn’t inevitable and that this country can make adult decisions about adult problems.
This also raises the question of what other simple choices, or policies, have the potential to change a major driver of health-care costs without requiring major reforms to the health-care system. The floor is open for ideas.
Related: Atul Gawande on end-of-life options.

Putting Your Doctor, or a Whole Team of Them, on Retainer

Even as more people are struggling to pay medical bills and being rushed through office visits with their doctors, an elite group with money has another option: exclusive medical care, around the clock and anywhere in the world, including on a yacht or private plane.
One of Dr. Glazer’s clients, for instance, has had his yacht outfitted with a system from Guardian 24/7, a company in Leesburg, Va., founded by former White House doctors that advertises itself as offering “medical protection previously available only to the president of the United States.” The company’s “ready room” will allow a doctor trained in the system to perform basic medical care remotely if something should go wrong while the patient is on the high seas.
“There is very little that we can’t do with the triage room on their yacht,” he said.
The cost of Guardian 24/7’s services ranges from $6,000 to $12,000 a month, plus an additional $700,000 for one of the company’s top-of-the-line “ready rooms” installed in a client’s home, yacht or airplane, said Jonathan Frye, chief executive.

The Changes to Save a Big Idea

Making a case for regulating medical insurance in California

It is hugely expensive to care for a child with diabetes, according to new study by the Centers for Disease Control and Prevention. The annual average medical costs for a child with diabetes is $9,061, compared to just $1,468 for a child without the disease, according to the study.

ER visits rise despite health insurance coverage

Gap grows in funding retiree healthcare