politics

Is It True? Who Cares?

May 6, 2005

Regular readers of CJR Daily know we’ve been hard on the heels of the Associated Press of late for its propensity to cover the Social Security debate, among other things, with “he said/she said” journalism that leaves bewildered news consumers wondering whose version is closer to reality.

This week, the wire service went one better for its subscribers: “he said” journalism. Forget that bothersome other side.

On Monday, an AP story about a speech by Health and Human Services Secretary Mike Leavitt — to hospital administrators, no less — had this lede: “Encouraging new Medicare participants to write living wills could end up saving the government large amounts of money.”

As reported by the AP’s Kevin Freking, Leavitt said:

“It may be that we could build into Medicare a means by which there was a consultation as part of the Medicare physical where that decision could be discussed and potentially made and … it would not just save families anguish but would likely save the system a remarkable amount of money, allowing that money to be spent in other ways and in other places.”

Leavitt, responding to a question from the audience, did not specify how living wills would save the government money. But presumably, if such a proposal is put in place, the government would not spend money keeping alive terminal patients who had filled out living wills rejecting life-prolonging medical care.

Sign up for CJR's daily email

The AP story, which was picked up by a number of outlets, reported that Leavitt had been approached by an unidentified member of Congress who raised the idea of incorporating living wills into Medicare consultations. Next thing you know — thanks to AP’s coverage — we’ve got the HHS secretary touting living wills as a huge windfall for the government in papers around the country.

Uh-oh. We’re not sure who should have more egg on their faces — the AP’s Freking, or Secretary Leavitt.

After the speech, the Washington Post‘s Ceci Connolly came up with a novel idea that apparently had escaped both Freking and Leavitt: Check to see if the idea had any merit. According to Connolly’s legwork, it doesn’t. She writes:

[A] a large body of scientific data — including an article co-written by the Bush administration’s Medicare chief — offers little or no evidence that living wills or hospice care lower medical bills.

In a series of academic articles, the three researchers and others outlined several reasons why having an advance directive does not have a significant impact on medical spending. Many patients sign documents with limited or conflicting instructions; many do not include a do-not-resuscitate order; some physicians refuse to comply with the instructions; and, contrary to popular perception, not every living will calls for less aggressive or less costly treatment.

Memo to AP and the speechwriters at HHS: Last time we looked, Google was still free.

–Susan Q. Stranahan

Susan Q. Stranahan wrote for CJR.