A Healthcare Policy That Puts the Ending First

Over the past year, the Providence St. Joseph healthcare system has undertaken a systematic effort to get every single person age 65 and older — in other words, every Medicare patient — to lay out and document their wishes for end-of-life care, and to designate someone to make decisions on their behalf if they can no longer speak for themselves, reports Politico . That puts Providence on the cutting edge of a movement that could not only help older Americans and their families, but might help preserve Medicare itself, which is straining against rising costs and growing numbers of seniors. By 2050, according to current projections, Medicare's ranks will have grown to more than 90 million people. About a quarter of Medicare spending occurs in the last year of life, and much of that spending, surveys have shown, is on care that individuals and their families do not want.