HealthCare Consumerism Radio: Dr. Wendy Lynch, On Creating Better Consumers of Health Care – Video


HealthCare Consumerism Radio: Dr. Wendy Lynch, On Creating Better Consumers of Health Care
Hosts Doug Field, CEO of The Institute for HealthCare Consumerism (IHC), and Ron Bachman, Chairman of the Editorial Advisory Board, talk with Dr. Wendy Lynch...

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HealthCare Consumerism Radio: Dr. Wendy Lynch, On Creating Better Consumers of Health Care - Video

PJTV: Democrats Turn on ObamaCare: Failures Plague Obama’s Massive Health Care System – Video


PJTV: Democrats Turn on ObamaCare: Failures Plague Obama #39;s Massive Health Care System
It #39;s not just Republicans any longer. Now, many Democrats are turning on Obama #39;s byzantine health care system. Some are even echoing Republican arguments aga...

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PJTV: Democrats Turn on ObamaCare: Failures Plague Obama's Massive Health Care System - Video

Health Care REIT, Inc. Announces Date of First Quarter 2013 Earnings Release, Conference Call, and Webcast

TOLEDO, Ohio--(BUSINESS WIRE)--

Health Care REIT, Inc. (HCN) announced today that it will release its first quarter 2013 financial results before the market opens onMay 7, 2013. The company will also host a conference call onMay 7, 2013 at10:00 a.m. Eastern Timeto discuss these results. The companys earnings release will be available in the News section of the companys website at http://www.hcreit.com.

The conference call will be accessible by telephone and the Internet. Telephone access will be available by dialing (888) 346-2469or(706) 758-4923(international). For those unable to listen to the call live, a taped rebroadcast will be available beginning two hours after completion of the call throughMay 21, 2013. To access the rebroadcast, dial (855) 859-2056or (404) 537-3406(international). The conference ID number is 35988411. To participate in the webcast, log on towww.hcreit.com15 minutes before the call to download the necessary software. Replays will be available for 90 days.

About Health Care REIT, Inc.

Health Care REIT, Inc., an S&P 500 company with headquarters in Toledo, Ohio, is a real estate investment trust that invests across the full spectrum of seniors housing and health care real estate. The company also provides an extensive array of property management and development services. As of December 31, 2012, the companys broadly diversified portfolio consisted of 1,025 properties in 46 states, the United Kingdom, and Canada. More information is available on the companys website at http://www.hcreit.com.

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Health Care REIT, Inc. Announces Date of First Quarter 2013 Earnings Release, Conference Call, and Webcast

Advocate Health Care Named Among Nation's Top Health Systems for 5th Consecutive Year

OAK BROOK, IL--(Marketwired - April 15, 2013) - For a 5th time , Advocate Health Care is being recognized as one of the nation's premier health systems. Truven Health Analytics announced its list of the 15 Top Health Systems today.Advocate is the only health system in Illinois to receive this prestigious recognition.

Each health system that made the Truven list received top nods for clinical performance. The annual study uses independent resources and public data to gauge hospital performance in terms of clinical quality and efficiency.

Specifically, Truven looked at how the top 15 outperformed their peers in saving more lives, maintaining the highest industry standards of care and overall patient satisfaction among other measurements.

"We are honored to be included on this prestigious list," said Advocate President and CEO, Jim Skogsbergh. "The recognition is really a testament to the dedication and commitment of our physicians, clinicians and staff who provide the safest and highest quality of care to those we are privileged to serve every day."

As the largest health system in Illinois and one the largest in the Midwest, Advocate has also garnered national recognition for its highly successful Accountable Care Organization model, AdvocateCare.

"We've made substantial investments in improving coordinated care for our patients," said Lee Sacks, MD, Advocate's executive vice president and chief medical officer. "Our goal is to reduce waste and inefficiencies in the system but still deliver the safest and best health outcomes for our patients. By doing this successfully, we not only benefit the patients in our AdvocateCare model, we also help U.S. taxpayers, too."

The Truven honor also comes on the heels of Advocate being named among the top 100 integrated hospital networks by the Connecticut-based IMS Health. Additionally, Truven recently named four Advocatehospitals;Advocate Christ Medical Center in Oak Lawn, Advocate Lutheran General Hospital in Park Ridge, Advocate Illinois Masonic Medical Center on Chicago's North Side and Advocate Good Samaritan Hospital in Downers Grove among the top 100 hospitals in the country.

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Advocate Health Care Named Among Nation's Top Health Systems for 5th Consecutive Year

ASU forum tackles health care questions

Special to the Courier

ALAMOSA The Patient Protection and Affordable Care Act (PPACA), commonly referred to as Obamacare, has been the topic of information and misinformation since it was signed into law in 2010, but a forum at Adams State University Saturday cleared up a number of questions.

Talk Straight With Adams State drew a good crowd and a panel of experts, who worked to advise their listeners about PPACA.

Educational programs will begin in June of this year, while preparations will begin in October, then the PPACA will go into full effect in January 2014.

Although the state of Colorado is at least two years ahead of much of the nation in terms of health care, there is still confusion, which was addressed in detail.

Colorado has begun its own health care reform, giving it a leg up as the nation moves toward full implementation of the PPACA.

Facilitated by Adams State University Community Partnerships, the forum and panel discussion revolved around how the Act will affect citizens of the San Luis Valley.

Saturdays panel included Tom Deegan, a registered nurse and author of Healthcare: A View from the Trenches; Dr. Ned Calonge, president and CEO of the Colorado Trust; Reginaldo Garcia, PhD. UCD, Rocky Mt. Prevention Research Center; Russ Johnson, CEO of the SLV Regional Medical Center; Gigi Darricades, CEO of Valley-Wide Health Systems(VWHS); Marguerite Salazar, regional director for the U.S. Dept. of Health and Human Services (HHS); and Armando Valdez, ASU professor of health care administration.

Moderating the discussion, Valdez reminded the audience that PPACA is the law of the land and will go into full effect in 2014, though some provisions are currently being administered.

Following a welcome by ASU President David Svaldi, who exhibited his newly obtained Medicare card, Salazar began her presentation with a quote from Dr. Martin Luther King, Jr., about the severe urgency of now, which drives the transformation of health care.

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ASU forum tackles health care questions

Health Care Industry Continues to Merge Despite Misses

The abrupt end to merger talks at Fairview Health System last week still leaves complex questions about how the organization will compete and thrive in the years ahead.

The urge to merge, in ways big or small, likely won't go away, even now that South Dakota-based Sanford Health has pulled out of discussions.

"It's like musical chairs," said Martin Arrick, a health care analyst with Standard & Poor's. "No one wants to be the last one standing."

Across the nation, hospital systems, doctors' groups and free-standing clinics are feeling competitive pressure to bulk up to keep costs down and gain access to capital and well-insured patients.

That was the motivation behind the talks between Fairview and Sanford, which attracted intense scrutiny from Minnesota Attorney General Lori Swanson. Sanford walked away last week, with its CEO saying the organization's policy is to "only go where we are invited."

One issue Swanson raised was whether it was a good idea for the University of Minnesota's hospital, which Fairview has run since 1997, to come under out-of-state control. But academic medical centers have not been immune to the consolidation wave.

"All of the university hospitals are saying, 'What's the right size? What size should we be?'?" said Dr. Joanne Conroy, chief health care officer of the Association of American Medical Colleges.

Fairview, the Twin Cities' second-largest hospital and clinic system, next turns its attention to strengthening its relationship with the U. About 70 percent of the state's doctors are trained at the U's teaching hospital, which was in dire financial straits when Fairview took it over in 1997, and the U's medical center draws billions in grants for research.

But Fairview and its university hospitals face competition from the larger Allina Health, as well as the Mayo Clinic and a newly merged HealthPartners, which brings together an insurance company and a much bigger geographic footprint with Park Nicollet's Methodist Hospital and clinics.

"Academic medical centers tend to be high cost by their very nature," Arrick said. "Everyone wants to lower costs and improve quality. In a world where the pie is shrinking, you have to get bigger and bigger to do that."

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Health Care Industry Continues to Merge Despite Misses

Health care reform looks expensive to Modesto-area workers, businesses

MODESTO -- When a severe rash sent Ryan McGee of Salida to an emergency room last month, he didn't have health insurance to help pay the bill.

"It cost $500 just to be there, and I haven't even gotten the bill from the doctor," said McGee, 25.

He wishes he had insurance, but his new minimum-wage job as a store clerk doesn't include medical benefits, and McGee hasn't bought it on his own.

That's going to change in January, when President Barack Obama's Affordable Care Act will begin requiring every person in the United States to have health care insurance.

The new law, often called Obamacare, mandates that large employers offer health benefits to all their full-time employees.

That won't help McGee, however, because he works only part time.

His employer, Modesto's Boyett Petroleum, used to hire primarily full-time store clerks. But this year, it began shifting toward part-timers such as McGee to avoid the new health care law's potential costs. It's one of many calculations that businesses across the country are making.

"We're making a conscientious effort to hire part-time people," acknowledged Dale Boyett, the company's president. He said hiring part-time workers "is a cultural shift for us," but it is necessary until his company knows all the costs of providing health care to full-time employees.

The petroleum supplier employs about 70 office workers, and Boyett said "they've always had health benefits." It also has about 100 retail workers at its 12 gas stations/convenience stores, but currently it offers health benefits only to its retail managers not clerks.

Starting in January, Boyett Petroleum and other employers will have to offer health insurance to all its full-time staff members, no matter what kind of work they do. But it won't have to pay for its part-timers' insurance, thus the hiring shift.

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Health care reform looks expensive to Modesto-area workers, businesses

Heroes in health care sought

Crain's Detroit Business is seeking nominations for Health Care Heroes, a special report on health care professionals that will run in the Aug. 12 issue.

The program will honor top-notch medical innovators and patient advocates.

Our winners will be chosen in five categories:

Corporate achievement in health care: Honors a company that has created an innovative health benefits plan or that has solved a problem in health care administration.

Advancements in health care: Honors a company or individual responsible for a discovery or for developing a new procedure, device or service that can save lives or improve quality of life.

Physician: Honors a physician whose performance is considered exemplary.

Allied health: Honors an individual from nursing or allied health fields who is deemed exemplary by patients and peers.

Trustee: Honors leadership and distinguished service on a health care board.

A panel of health care judges will choose the winners.

Nominations, which are due May 13, can be made at http://www.crainsdetroit.com/nominate. Statewide nominations accepted.

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Heroes in health care sought

Health care changes could lower hospital taxes

Published: Saturday, April 13, 2013 at 3:42 p.m. Last Modified: Saturday, April 13, 2013 at 7:08 p.m.

"It's a hefty bite for the people in Southeast Volusia," said Joe Benedict, chairman of the Southeast Volusia Hospital District's Board of Commissioners.

The owner of a $115,000 homestead property that falls in the Southeast Volusia Hospital District can expect to shell out $196.95 in hospital taxes. Just over the line in the Halifax Hospital Taxing District, the owner of the same home would pay only $81.25.

But two big changes could be in store for Volusia County's hospital taxing districts, and either or both could lighten local tax bills.

Bert Fish Medical Center in New Smyrna Beach is looking to partner with a larger hospital system that would reduce the tax burden for Southeast Volusia. Meanwhile, the federal health care law could move the Sunshine State toward universal coverage, eliminating much of the reason why hospital taxing districts were created in the first place.

Gov. Rick Scott has endorsed tapping into $51 billion in federal funds and expanding Medicaid, a state-federal program that helps provide health care to the needy, to cover more than 1 million Floridians. Lawmakers so far have shot down expanding Medicaid, but they are debating alternative proposals that would extend coverage by subsidizing private insurance.

Republican Sen. Joe Negron's plan would allow the state to still tap into federal funds, but competing proposals would forego federal funds and cover far fewer patients.

Volusia County is unique in that it has three hospital taxing districts, covering the Daytona Beach area, Southeast Volusia and West Volusia. Collectively, Volusia County taxpayers contribute $47.3 million to care for indigent patients and subsidize other health care services.

When the districts were created starting in the 1920s, Florida was still developing, and health care was radically different, said Dominic Calabro, president and CEO of Florida TaxWatch.

Times have changed. Medicare and Medicaid social programs that helped to extend coverage to the elderly and needy were created during the 1960s.

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Health care changes could lower hospital taxes

Health Care's Biggest Movers and Shakers

By David Williamson and Max Macaluso, Ph.D. | More Articles April 14, 2013 |

From the impact of Obamacare to cutting-edge research, biotech buyouts to FDA decisions, the Motley Fool's health-care team sits down each weekto discuss the most fascinating developments in health care and their implications for long-term investors. In this week's edition, the team talks about the coming trend of penalizing unhealthy employees, the importance of drug branding, the avian flu outbreak, one stock investors need to watch, and more.

In the following segment, health-care analyst David Williamson discusses the week's biggest movers and shakers, including a trio of stocks receiving the FDA's new "breakthrough" designation. Watch and find out what it means for investors.

What macro trend was Warren Buffett referring to when he said "this is the tapeworm that's eating at American competitiveness"? Find out in our free report: "What's Really Eating at America's Competitiveness." You'll also discover an idea to profit as companies work to eradicate this efficiency-sucking tapeworm. Just click here for free, immediate access.

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Health Care's Biggest Movers and Shakers

TN inmate health care deal raises conflict issue

Two companies are battling for a $200 million-plus contract to provide health care to Tennessee's prison inmates.

One came in almost $16 million cheaper and has a long but controversial history of providing those services. The second, more expensive company has struggled to explain how it has enough experience to do the job. It also happens to employ the wife of the head of the Tennessee Department of Correction.

The second company, called Centurion, won.

Department of Correction Commissioner Derrick Schofield's wife, Latrese, works for the company as an inmate re-entry coordinator in Georgia. But that fact was never disclosed in Centurion's bid, nor was it mentioned at a protest hearing by the losing bidder last week, whose executives were confused about losing out on a job they had already been doing for more than two years.

Only two companies submitted bids, Centurion and Corizon. Corizon's bid came in at about $226 million while Centurion came in at about $241 million.

The Department of Correction maintains that there is no conflict and that Derrick Schofield recused himself from having any say in the awarding of the contract.

"We're confident that the process was appropriate and fair and resulted in the selection of the best-qualified bidder," said TDOC spokeswoman Dorinda Carter. "Ms. Schofield is not in a position of making decisions regarding the contract and she's not an executive-level employee."

Derrick Schofield has disclosed his wife's employment on ethics disclosures for the past three years. He declined to respond for this story through the agency spokeswoman.

Centurion said it also did not see a conflict but declined to answer specific questions about its bid and the omission of her employment in bidding documents.

"She is not now or has ever been involved in our Tennessee work," said Steve Wheeler, president of Centurion. "As it is under protest, it is not appropriate for me to answer any questions about the procurement."

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TN inmate health care deal raises conflict issue

Health care economist: Obamacare the law of the land; adjust to it

Regarded as one of the world's foremost health care economists, Dr. Gail Wilensky had a clear message last week for a sellout crowd at Oak Hills Country Club: Obamacare is the law of the land now, so don't waste time focusing on overturning or repealing it. That opportunity has come and gone.

Instead, she strongly recommended the health care industry should now concentrate on the nitty gritty of the Affordable Care Act's implementation. Over the next few years, she said, the specifics of exactly how the law will be translated into everyday application will be written and codified in Washington. Those likely to be directly impacted by the new rules and regulations should engage with the rulemaking process soon to have any chance of affecting how the law will be applied.

It's an enormously large piece of legislation, but, despite that, many of the important details about how you actually make it operational haven't yet been written, Wilensky told a room full of many of San Antonio's highest-echelon health care executives. That means implementing legislation needs to get drafted. If you're really interested in affecting change, this is where you pay attention, right now, she added, urging vigilant monitoring of and participation in the development of detailed regulations under the law.

Wilensky is an economist and senior fellow at Project HOPE, an international health foundation. She directed Medicare and Medicaid from 1990 to 1992 and was a senior health and welfare advisor to President George H.W. Bush. She also advised presidents Bill Clinton and George W. Bush on healthcare issues and policy.

She spoke March 28 at the annual meeting of the San Antonio Medical Foundation, which manages the land and other assets of the South Texas Medical Center.

Besides the detailed regulatory language that must now be developed, Wilensky said, the usual pattern in Washington of clean up legislation will soon follow. Bills to fix unintended problems with the original legislation could start winding through Congress as soon as 2014 but certainly no later than 2015, she said.

And that's likely to happen every year for the rest of the decade, she said. This process, too, is an opportunity for the industry to weigh in with its desired changes.

Wilensky said she believes the Affordable Care Act has good and bad points. On the plus side, she noted, it provides health insurance to millions who do not currently have it. In many cases, these are people who might allow what should be manageable health problems to spiral into much more serious problems because they cannot afford care.

The uninsured will ultimately get care when their health problems get bad enough, she said, and society at large will end up paying for it anyway. That has been an expensive problem for hospital systems for years.

One big question regarding the law, Wilensky said, is whether some states will opt out of the expansion of Medicaid, the joint federal/state health care program for poor children and the disabled.

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Health care economist: Obamacare the law of the land; adjust to it

Brewer vetoes individual health care shopping bill

PHOENIX -- Saying there are technical problems with the proposal, Gov. Jan Brewer vetoed legislation Friday which would have allowed individuals to shop around for the best price on health care needs.

The legislation crafted by Sen. Nancy Barto, R-Phoenix, would essentially have put hospitals and doctors in the same position as retailers: They would have to give people an opportunity to learn what certain procedures will cost, before they show up in a waiting room.

That would have included both a requirement for online posting as well as making a price list available on site.

Barto promoted the legislation as a cost-containment measure, especially for patients without comprehensive health insurance who end up having to pay all or part of their medical bills.

In her veto, the third of the legislative session, Brewer said she supports the idea of transparency "which will provide useful information to help patients manage their health care needs." But the governor said there are "practical and potential legal implications of this bill."

Barto, however, called the veto "an incredible insult to consumers."

The senator said she had been in contact with the governor's office all along about her proposal and had not heard any objections -- until now. Barto said she would have made necessasry changes had the Brewer's staff raised issues before final approval -- and before this year's legislative session was so far along as to make it too late to start over.

And Barto said it may be that Brewer's veto has less to do with the text of the legislation than the fact she has been an outspoken foe of the governor's push to expand the state Medicaid program.

"It's not to her benefit to play those games," Barto said of the governor. "She's not going to gain votes by being petty."

Gubernatorial press aide Matthew Benson said the veto is totally unrelated to Barto's opposition to the Medicaid plan. He said there were "technical concerns."

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Brewer vetoes individual health care shopping bill

Health care roundtable May 8 at Hyatt hotel

The Wichita Business Coalition on Health Care and the Sedgwick County Health Care Roundtable will host an annual conference from 7:30 a.m. to 4:30 p.m. on May 8 at the Hyatt Regency Wichita.

This is the 35th year of the roundtable, which was established to provide a forum for employers, providers and health care insurance carriers to discuss at the local level changes affecting health care within our area, the premise being that having a dialogue among decision makers allows for problem solving, said Jon Rosell, executive director of the Medical Society of Sedgwick County.

Janet Hamous, executive director of the coalition, said this is the second year that the coalition has partnered with the roundtable.

The thrust of this years program is the Affordable Care Act and the next level, Hamous said. All of us are focused on the details around implementation but with this program, were wanting to take this to the next level when we look down the road a few years.

Were hoping to learn a lot about different perspectives and how the whole game will be changing in future. In many cases, its really a crystal ball viewpoint because nobody really knows for sure.

The keynote speaker is Susan Dentzer, editor-in-chief of Health Affairs magazine. She will speak about the reinvention and renewal of the countrys health care system.

Were really excited about having someone of her caliber with us, Hamous said. Its valuable to hear that global perspective, to not only sees things differently from being in a different part of the country and involved with different players.

Other speakers on the agenda include Stephene Moore, regional director of U.S. Department of Health & Human Services, Region 7; Steven Smith, an attorney at Hinkle Law Firm; Joaquin Santos, internal medicine physician at Via Christi Clinic; and Kendra Tinsley, Kansas Healthcare Collaborative director.

There will also be a health care provider panel discussion and a payer panel discussion.

Coalition members will elect new board members and officers at the conference.

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Health care roundtable May 8 at Hyatt hotel

Roundtable highlights local health care needs

FARMINGTON A community roundtable held recently in Farmington gave participants an opportunity to learn what the Mercy health care system will bring to its new partnership with Mercy Hospital Jefferson in Crystal City.

More importantly, said Lynn Britton, Mercy president and CEO, this event is allowing community leaders a chance to provide input on the regions health care needs.

The event, held April 4 at Alexanders, was attended by approximately 50 people who were treated to a meal and special presentation given by Mercy.

Mercy is the sixth largest Catholic health care system in the United States and serves more than 3 million people annually. The highly integrated organization includes 32 hospitals, 300 outpatient locations, 39,000 co-workers and 1,700 integrated physicians in Arkansas, Kansas, Missouri and Oklahoma.

Jefferson Regional Medical Center became a part of Mercy two months ago and was renamed Mercy Hospital Jefferson. Established as Jefferson Memorial Hospital in 1957, it is a 251-bed private, not-for-profit hospital managed by a local board of directors.

During the presentation, Britton expressed his pride in Mercys humble beginnings and its continued commitment to ministry.

Mercy has always been about caring for those who need it most, Britton said. From the beginning, the Sisters who began our ministry often used methods that were considered unconventional. That pioneering spirit and desire to change things for the better has always been part of Mercy.

According to the health systems website, Mercy traces its U.S. roots to New York in 1846. In 1856 the Sisters of Mercy came to St. Louis and founded the Religious Sisters of Mercy of the St. Louis Province. Fifteen years later in 1871 they opened a 25-bed infirmary for women and children. Over the years, the Sisters of Mercy expanded their health ministry in the Regional Communitys seven-state area: Arkansas, Kansas, Louisiana, Mississippi, Missouri, Oklahoma and Texas. While the hospitals and other health care facilities sponsored by the Sisters of Mercy were not formally linked, as early as the 1960s they shared management and consulting staff resources.

In 1986, to position the individual hospitals for coming changes in health care, the Sisters of Mercy created the Sisters of Mercy Health System, Britton explained. Today, Mercy carries a simplified name and a focus on providing the best care in our hospitals, physician clinics, outpatient facilities, outreach ministries and other health and human services. We are sponsored by Mercy Health Ministry, which was established by the Catholic Church to oversee the healing ministry and Catholic identity of Mercy Health.

Britton explained that, when the Sisters of Mercy came to the decision to turn their ministry over to the health care system, the agreement had to receive approval from the Vatican. They also made the requests: 1) Never let Mercy become a relic; 2) Love it and nurture it; and 3) Please dont forget us.

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Roundtable highlights local health care needs

Spread of Catholic health care raises barriers to care choices

Commentary: When it comes time for you to die, who should get to decide what medical services and options are available? Whether youre Catholic or not, the U.S. Bishops may have the biggest say.

Source: American Civil Liberties Union of Washington

Religiously affiliated hospitals in Washington state servce much of the population. Click to enlarge

Tue, Jul 5, 2 a.m.

Meeting in Bellevue, the bishops take a firmer line on physician-assisted aid-in-dying laws and make allegations about abuses that are not supported by the experience in Oregon and Washington.

The freedom to die in peace has been much in the news of late. When an 83-year-old manshotfirst his dying wife and then himself in a Pennsylvania hospice, distressed commenters speculated that local law left him with no better options. The wife was bedridden, in a unit for people who have less than six months to live, and Pennsylvania has noDeath with Dignityprovisions like those in Washington and Oregon.

Washingtons Dignity Act was championed by former Gov. Booth Gardner, who himselfdiedlast month after a protracted fight with Parkinsons disease. Several years ago, I hosted a small gathering in which the former governor battle, through the debilitating veil of his illness, to explain why the issue was so important to him. His effort said more than his words ever could.

The legal rights Gov. Gardner championed are in place in Olympia, and a new Seattle Cancer Care Alliance study shows that the state's Dignity Act is an option that can work well for patients and physicians. But recent events make it clear that the battle is far from over.

Early in March, when a California nurse refused to perform CPR on a dying 87-year-old, her decision created a nationalfirestorm. The Washington State Health Care Association hastened to assure us that nothing like that could happen here. Vice president Wendy Gardner at Merrill Gardens, which runs 24 care facilities across the state,told the Seattle Times, We always start CPR. I made a note to self: Tell the kids to ship me out of state when my time is getting close, to someplacenotcalled Merrill Gardens.

Two years ago, I scheduled a routine colonoscopy through Seattles Polyclinic and was horrified when the pre-operative paperwork informed me that the Polyclinic does not honor patients end of life directives. The staff explained that this is because they are an outpatient surgery facility. Are you saying that your statusobligatesyou to violate my wishes orallowsyou to violate my wishes? I asked. They couldnt say. Time was short, and I went through with the procedure but started transitioning my care away from the clinic. If there is one thing that is absolute for me it is this: my body is my own.

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Spread of Catholic health care raises barriers to care choices