HealthLeaders: A year after leaving his position as administrator of the Centers for Medicare & Medicaid Services, Don Berwick, MD, talked with HealthLeaders Media.
HLM: So how do we reduce costs of end-of-life care if Washington won’t go near it anymore?
DB: I think you’ll see, or I hope, local communities, states, civil societies pick up this issue and say, “Oh no you won’t. If you’re too scared to discuss this in Washington, well we’re not. We’re going to make it real where we live.”
The story now is in La Crosse, WI. Nobody is ordering anyone to do anything, like sign advance directives, but the whole community is now embracing the idea that they want control over their own lives. So if you live in La Crosse, the odds are you will have an advance directive, and people will know your wishes and honor them. This was first done by Gundersen Lutheran (Health System), and they did the right thing.
And there’s The Conversation Project by Ellen Goodman, the Pulitzer Prize winner, where tens of thousands of people are getting on the website and learning how to have “the conversation” that gives you control of your own life. This is a problem that will be solved by society, more likely than the federal government.