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Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review June 7, 2005 / 29 Iyar, 5765

Why the government wants you to sign a living will

By Jan L. Warner & Jan Collins


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http://www.JewishWorldReview.com | Q: My mother, 84, has been a widow for 20 years. She still lives in the home in which she raised us, has limited savings, receives Social Security, and has a Medicaid card that helps with some of her prescriptions. That's it. She has steadfastly refused to sign a power of attorney (because she did not want to lose control over her limited finances) or a living will (for fear she would not be given appropriate treatment because she was elderly and not productive to society).

Recognizing the importance of putting her wishes in writing, my brother and I tried to talk to her over the past several years until we were blue in the face. We took her to several lawyers, and even met with her physicians. Finally, last year, she agreed to sign both a power of attorney for finances and a living will, and our entire family was relieved. Then, last week, she announced that she had torn up her documents because she had heard that in order to cut costs the government was going to deny Medicare and Medicaid recipients who needed treatment when they were the sickest.

Although my brother and I have been unable to verify what she currently believes, there's no talking to her. Are there efforts to use living wills to cut health care costs for senior citizens?

A: Unfortunately, murmurs from of a number of legislators and bureaucrats at both the state and federal levels have caused concerns by the elderly and their advocates.

Before 1990, Congress was aware that a high percentage of all health care expenses were incurred during the last year of life, most within the last two months. Of the estimated 35.6 million people receiving Medicare before 1990, nearly 6 percent died each year and, of those, more than 50 percent died in hospitals at a cost of more than 30 percent of annual Medicare payments.

At about the same time, according to a study published in the Archives of Internal Medicine, the end-of-life costs for patients without advance directives were approximately three times those of patients who had prepared such documents. More than 70 percent of us will face at least one end-of-life decision in our lifetime, according to American Medical Association estimates. Yet less than 15 percent of the American population has signed advance health care directives such as a living will.

Given this background, Congress passed the Patient Self Determination Act in 1990 to try to bring awareness to Americans about advance health care directives such as living wills — and, of course, for cost containment should folks decide not to pursue extraordinary measures at end of life. The Patient Self Determination Act is the reason hospitals and other health care providers that accept Medicare and Medicaid are required to ask patients, on admission, whether they have advance health directives.

With budget cuts at the forefront of the governmental mindset today, there are moves afoot to reduce the cost of Medicaid and Medicare.

In Wisconsin, a legislative committee is considering a requirement that all Medicaid recipients file either a living will or health care power of attorney as a cost-cutting device. The reason, according to one Wisconsin legislator, is that approximately 75 percent of the cost of health care in a person's life is spent during the last two months. If signed into law, each Medicaid recipient would be forced to either sign an advance directive or lose eligibility and, presumably, the state would use the choices made in these documents to gauge their Medicaid budgeting process.

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Under federal law, patients are not required to either sign directives or file them with the government.

In early May of this year, the Secretary of the Department of Health and Human Services encouraged seniors to sign living wills to help reduce Medicare's mushrooming health care costs. According to governmental statistics, one-third of the nearly $300 billion Medicare budget is used to provide care during the final year of life. The Secretary also stated that he was considering a suggestion from a congressman that would require physicians to educate and promote directives for end-of-life treatment, in part to save a large amount of Medicare money.

While we are staunch advocates of self-determination after education, we don't believe that seniors or anyone else should be forced to make decisions to satisfy budget-cutting legislators and bureaucrats when there is plenty of other waste out there that could be cut without scaring the dickens out of seniors. We don't believe your mother tearing up her documents solves the problem, but we certainly understand her concerns.

Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.

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