But consider the implications: When discussing such matters with an otherwise healthy and possibly youngish senior, the “directives” that health care providers will elicit may be significantly different from what they would have been if the patient was actually confronting a life and death situation. One’s directives are often quite different when talking about a theoretical future versus a real situation occurring in the present. After all, the future might offer technological advances that are not available at the time of the theoretical discussion, thus making a patient reach a very different decision when that future reality arrives.
Furthermore, as typical of all Medicare regulations, there are certain requirements that must be fulfilled in terms of both the discussion and the patient directives in order for the end-of-life counseling to qualify for physician payment. And therein lies the rub. The whole idea is to get younger, healthier Medicare patients to give advanced directives that will be used at a later time to deny them care. Remember that ObamaCare cuts Medicare by $500 billion—and that doesn’t even take into account the coming demographic cataclysm that awaits the program when the baby-boomers become Medicare beneficiaries.