- MLP helps us examine our values and determine what is really important in our lives.
- Even if we were to read and never complete MLP, we will have thought through major medical issues in advance. Most people are fully conscious and able to speak for themselves when making these kinds of decisions. MLP makes us better prepared.
- Persons of any age can have an accident or illness that renders them incapable of speaking for themselves. The only way of assuring total control over our health care decisions is to complete both MLP and (for those of legal age) a durable Power of Attorney for Healthcare.
- MLP serves two purposes: 1) It allows us well considered forethought should we have to make a major medical decision. 2) If we complete it and attach it to a legal Power of Attorney for Healthcare form, we provide our proxy decision makers both the authority and the guidelines they need to fully represent us.
- At the present time, very few people have advance directives on file. In fact, 98% of patients arriving at hospitals incapable of speaking for themselves have no advance directive on file. The attending physician has no alternative than to provide aggressive treatment, something we may or may not have wanted. Aggressive treatment can sometimes create serious damage to our bodies. Treatment of damage created by an earlier treatment is a large factor in escalating healthcare costs.
- Those who write advance directives when they are calm and under no duress usually ask for more conservative treatment. Conservative treatment creates less collateral damage. Less collateral damage means lower cost for employers, employees and their families.
- Grieving families want only one thing: find a cure for their loved one. Families often expect futile procedures that are not covered by insurance and can result in bankrupting the family. MLP starts the conversation years in advance, taking pressure off families. When the time comes, families are more prepared. Instead of making hasty decisions based on their grief, they can focus instead on helping meet a loved one’s wants that the family clearly knows and understands.
- If our wants are unknown and we reach a condition that our physicians know will leave us in an irreversible vegetative state, physicians have only one ethical option: transfer us to a nursing home for long-term care. MLP avoids this dilemma for both doctor and family.
- Nursing homes are ideal for people who are conscious and require convalescence or higher levels of care. These residents are kept safe and enjoy the companionship of fellow residents, sometimes even life-long friends, in addition to enjoying visits from family and friends. However, patients in a persistent vegetative state miss out on these advantages.
- Medicaid is a serious burden to all State budgets because, as the population ages, more people live out their lives in nursing homes with Medicaid as the payer. It's one thing if this is what the patient wants; quite another if it is not something they would have chosen for themselves. Nearly 70% of Medicaid resources are devoted to nursing home care and care of children and adults with severe disabilities. Meeting these essential needs leaves few resources for primary and preventive care. By making patient wants clear, MLP allows more resources for primary care which detects illnesses when they can be treated at lower cost and reduces deaths from preventable illnesses.
- The physician’s code of ethics requires honoring the patient’s treatment choices. Assisted suicide and euthanasia are the two exceptions. We alone have the right to make our own medical decisions.
- If we become unable to speak for ourselves, we lose that control unless we have given Power of Attorney and guidance to someone we trust to act on our behalf. MLP encourages all users to establish a durable Power of Attorney, using MLP as an attachment. Then everyone knows our wants, and we stay in control of our medical decisions.
- In field studies, those who knew their loved one’s wishes told me with calm and satisfaction: “I gave him/her everything he/she wanted.” Those who did not know their loved one’s wishes could only look back with sadness and helplessness.
- When we create and file an advance directive, we help our employers and coworkers as well.
- Employers benefit when employees were able to help loved ones achieve their wants. These employees are less traumatized and able to return to full productivity more rapidly.
- When terminally ill persons can give calm and cool consideration of their wants, many choose quality of life over aggressive treatment. That means they experience less pain and die at home, surrounded by family and friends. Hospice care organizations are widely acclaimed by users for the help they give to terminally ill people and their families.
- Employers who choose to offer MLP as an employee benefit should not expect 100% utilization by their personnel. MLP addresses topics most prefer not to think about, so it takes time for people to become ready to address these issues. However, small financial incentives will definitely increase use.
- From a cost perspective, if there are only one or two occurrences over a five-year period total cost savings can add up to a million dollars or more. That far exceeds the cost of offering MLP.
- In looking at return on investment, companies must be aware of what to expect. For example, we cannot predict how many personnel will use MLP, what health conditions they will encounter, what choices they will make, or the cost of those choices.
- We do know, however, that people who complete advance directives when calm and unhurried tend to seek more conservative care. Conservative care results in lower costs.
- People choosing palliative care for terminal conditions versus active treatment tend to live longer, experience greater comfort, and incur much lower medical costs.
Offering MLP as a fringe benefit promotes morale. It benefits both employers and employee families. It can be said without hesitation that when we increase patient choice, we reduce healthcare costs.