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Start the most difficult conversation American isn’t having- the conversation about our end of life preferences

Lawmakers Propose Incentives For End Of Life Planning

This piece was first published in Reuters Health. LMM President Randi Belisomo is a contributor.
U.S. Sen. Tom Coburn, R-Okla. WikiMedia Commons.
U.S. Sen. Tom Coburn, R-Okla. WikiMedia Commons.

If you are one of the estimated 70 percent of Americans who have not documented your end-of-life healthcare preferences, Republican Senator Tom Coburn of Oklahoma hopes a cash incentive will prompt you to do the paperwork.

Under his newly introduced Medicare Choices Empowerment and Protection Act, seniors could pocket up to $75 for completing advance directives. Directives are written instructions in which people specify what healthcare actions should be taken if they cannot speak for themselves.

“It’s just smart,” says Coburn, a family physician. “This is good medicine for a doctor to know what a patient wants.”

The bill, co-sponsored by Democratic Senator Chris Coons of Delaware, would encourage people on Medicare to register advance directives with the Centers for Medicare and Medicaid Services (CMS). Medicare beneficiaries would receive a one-time payment of $75 for creating an online directive, or $50 for creating one manually in 2015. The payment from CMS would come either as a check or direct deposit.

Inflation would determine payment in subsequent years.

“Here is an incentive to say ‘I want all the care that I can get,’ or perhaps, ‘here is the care that I want,’ and put it down,” says Coburn, who was diagnosed with a prostate cancer recurrence last year. He recently announced his retirement from the Senate effective next January.

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