Abstract
A previous paper (1) described some suggestions (2) for cost containment made by the administrator of the Health Care Financing Administration - the U.S. Federal Government agency, which controls Medicare, Medicaid, and the Professional Review Organizations. As a ‘cost-saving initiative’, the Health Care Financing Administrator proposed to encourage life termination of older persons covered by Medicare. The method entitled ‘Encourage Adoption of Living Wills’ would have encouraged older persons to sign documents that would preclude life-sustaining medical care. According to this proposal ‘the cost savings from a nationwide push toward living wills is likely to be enormous. Over one-fifth of Medicare expenditures are for persons in their last year of life. Thus in FY (fiscal year) 1978, $4.9 billion will be spent for such persons and if just one-quarter of these expenditures were avoided through adoption of ‘living wills’, the savings under Medicare alone would amount to $1.2 billion. Additional federal savings would accrue to Medicare, the VA and Defense Department health programs’.
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