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A Health-Care Story That Answers Reader Pleas

By Andy Alexander

Last Sunday’s ombudsman’s column noted that readers say they want more explanatory stories on the health-care debate. Today’s Post has one that responds to their plea.

Reporter Alec MacGillis writes from La Crosse, Wis., about the hospital where the “Death Panel” myth began. The town’s biggest hospital, Gundersen Lutheran, started the push to have Medicare compensate doctors for offering end-of-life planning for patients. Today, MacGillis writes, more than 90 percent of the town’s 52,000 residents have advance-care directives that provide guidance to loved ones who might one day be called upon to decide when to end life-sustaining medical treatment.

In 1,600 words, MacGillis lays out a clear-headed explanation of how the advance-care directives work, as well as how the concept got hijacked by politicians and turned into “death panels” -- something opposite of what they are. His story is an example of the type of explanatory health care story readers say they want.

First, MacGillis took the reporting away from Washington and went to the scene.

Second, the piece is jargon-free. It explains the concept of end-of-life planning in terms that can be understood by ordinary readers. For example, one doctor says a loved one typically might tell family members in advance that they should stop life-sustaining treatment “when I’ve reached a point where I don’t know who I am or who I’m with, and don’t have any hope of recovery.”

Third, the story quotes average folks -- not wonks -- on how they grapple with the conditions under which the plug should be pulled.

Fourth, it’s chock full of illuminating facts. Example: “A quarter of Medicare costs – totaling $100 billion a year – are incurred in the final year of patients’ lives, and 40 percent of that in the last month.”

Fifth, MacGillis was joined at noon for an online chat that included Gundersen Lutheran officials Bud Hammes and Joan Curran. For an hour, they answered readers’ detailed questions about end-of-life planning.

Today’s Post has several other health care stories that, in varying degrees, deal with political aspects of the health care debate. All are good and necessary. But judging from online audience reports, most readers were interested in the MacGillis piece. As of mid-afternoon, it was atop the “Most Viewed Articles” list on The Post’s Web site.

By Andy Alexander  | September 4, 2009; 2:19 PM ET
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DID you read the Krauthammer column Friday, and the posts that it drew?

Are you proud of the Washintgon Post
readership? Of the corrosive stuff your
writers bring?

How will bringing America to it's knees aid your Israel first goals?

From whom will Israel get it's arms and money for wars and expansion if America is brought down? Tell the Weymouths to think.

Posted by: tryhard3 | September 4, 2009 6:08 PM | Report abuse

I have three grown children but with all this talk about swine flu I made them all write a living will. I wanted their wishes to be put down on paper so there is no confusion about how they wanted to be treated if anything God forbid were to happen to them. My husband and I both have a living will so there are no disagreements and everyone knows what we want to happen. This is something everyone should do regardless of age.

I do not understand how the media could let these cries of death panels go on without coming out against it. Without making it clear just what the proposal was in fact. It is more harmful not to have a living will so your choice on your live could be honored.

I fault he media for not doing their job, for not reporting truth and fact for letting this death panel talk get so wild and crazy. I just wish the media would do what is right for the American people. No one is taking a strong enough stand against all this crazy and hateful talk that taking this country down a path that we just don't need to go.

Posted by: cokomo2 | September 5, 2009 4:15 AM | Report abuse

It is not "death panels" that concern the average citizen. It is the fact the the health care bills include a "Health commission" that is set to decide which treatments and what care is most 'cost effective' based on statistics, not on individuals. Also, it is the fact that neither the president nor the congress will be included in the limitations. President Obama ran on the campaign promise that he and members of congress would use the same health care as the rest of the citizens. All he has to do it make that promise into law and no one would object. Under all the current plans, if Congress had been required to use the planned care, Sen. Kennedy would have died a long time ago. That is what upsets most Americans. The press is using the 'death panel' statement as an excuse to support the Obama plan.

Posted by: tenshi1 | September 5, 2009 10:53 AM | Report abuse

Let's take it out of the death panel discussion too.

The stimulus bill set up an unsupervised type of commission taking a look at the most "efficient" type of medical care (Not explained in the bill--to be defined by regulation). People will not get insurance coverage if the medical care is not "efficient" and will not have an ability to make complaint to federal court about the refusal. The person responsibile for the progam in the Obama Administration--despite his protests--bascially says that he would not be in favor of any medical procedure which does not extend life or extend quality of life (undefined--to be defined by regulation). Now, 500 billion, of "fraud" (probably to the surprise of DHS inspectors) has been discovered in Medicare programs which can be cut. THe medical care directives are somehow to be measured by a "Quality Control" committee (function undefined--to be defined by subsquent regulation).

While not death panels, there are a few gaps in the planning. If there was a provision that would specifically say that the planning was voluntarily, and that no medical or patient decisions or payments would be adversely affected by participation or nonparticipation in such a program, I agree, there would not be a problem. As it is now, problem.

Posted by: Paladin7b | September 5, 2009 9:30 PM | Report abuse

Please explain what government's proper role is in such discussions. Answer: None.

Posted by: elgropo1 | September 5, 2009 10:52 PM | Report abuse

Paladin7b is either lying to cover the "death panel" lies by Republicans, or he is ignorantly quoting Republicans. All of the bills I read (4 out of the 5 being authored, before the August break)specified that end of life counseling was voluntary.

Posted by: alysheba_3 | September 7, 2009 12:46 AM | Report abuse

Alec's article was quite good, but it was very specific. We still have not seen any articles on the basic facts such as the overhead of private insurance, the time and money both patients and physicians waste filling out complicated forms and fighting to get benefits from these insurers

In any case, this is way too little and way, way, way too late.

Posted by: lensch | September 7, 2009 8:08 AM | Report abuse

If the language in the health care bills re voluntary counseling is patterned on the programs at Gunderson Lutheran, then I'm all for it. I can't repeat this often enough. My 85+ year-old parents (and both of their aged parents before them) have been life-long patients at this fine hospital and have all suffered at one time or another critical illnesses or conditions. Their treatment at Gunderson continues to be state of the art -- and tailored to their stated wishes. At no time have they ever been steered toward lesser treatment levels. Their wishes and concerns have always been respected and for that they, and their children, are profoundly grateful. That this option be afforded voluntarily to the rest of America seems like a sound deal to me. And certainly not scary!

Posted by: chicago11 | September 7, 2009 10:42 AM | Report abuse

For the love of me I do not understand what the U.S. health care debate is all about.I live in Canada, Nova Scotia, to be exact. My wife and I were planing a trip to Alaska for next summer, I say planing, that is as far as it got. We were planing to drive, I inquired as to the cost of supplemental health coverage,I am 66, she is 63, we both have some manageable health concerns, we are both covered by our medicare plans, plus I have additional coverage thru a company paid supplemental insurance, my company insurance is void in the U.S. hence the additional coverage. The cost of such a plan for the maybe 3 to 5 days that I would be in Alaska for the both of us would be in excess of $400.00/day. I will make my trip up the Alaska highway, I will drive up to the border, and I will turn around, the cost of insurance plus the cost of pass ports, just to see more of the same. Thanks but no thanks, I will visit in my dreams.As far a government insurance plans VS private insurance plans, "pre existing conditions" they are a thing of the past.Now who in their right mind can be against that?

Posted by: donpatterson | September 7, 2009 6:59 PM | Report abuse

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