This Saturday is National Healthcare Decisions Day, emphasizing the importance of planning ahead for your healthcare decisions.

Kim Callinan, president and CEO of Compassion & Choices, which works to improve patient rights and advocates for individual choice at the end of life, said a growing number of older Americans are being diagnosed with dementia, which which underlines the need to think about the future.

“One in two older people now die with or because of dementia and sadly most don’t foresee what the end might be like,” Callinan pointed out. “Without planning, you leave your loved ones and caregivers to make heartbreaking decisions about what care you receive or don’t receive at the end of life.”

According to a report by the Alzheimer’s Association, Washington State has the ninth highest death rate from Alzheimer’s disease in the nation.

Callinan noted that the rising rate of dementia is partly the result of advances in life-extending medicine, reducing deaths from diseases like pneumonia and influenza. However, she said end-of-life care can also include serious interventions — like CPR, which can break ribs, or intubation — that might only make sense for a healthy person.

“But for someone with advanced dementia or terminal illness, you’re subjecting yourself to aggressive interventions that probably won’t prolong your life, but will prolong your suffering,” Callinan argued.

Compassion & Choices has an online Dementia Values ​​and Priorities tool that allows people to identify when they would like to forgo treatments and allow a natural death.

Callinan added that it can be especially helpful for people who want to document their care preferences.

“On National Healthcare Decisions Day, I encourage everyone to have conversations with your loved ones about the care you would want at the end of life,” Callinan urged.

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This week is Black Maternal Health Week, highlighting disparities in health outcomes for pregnant women.

Black mothers are two to three times more likely to die from pregnancy-related complications than their white counterparts.

Dr. Jemma Nonog, Thriving Families Health Equity Director, Kaiser Permanente of Washington, who also practices midwifery, said there are similar death rates in Washington and the pandemic has exacerbated issues of structural racism within the health system. Nonog said racism shows up in the body.

“Added stress causes premature births and amplifies some of the things we see even before the pandemic,” Nonog explained.

In 2021, the White House began recognizing Black Maternal Health Week and issued a proclamation this year as well.

Nonog pointed out that there are important warning signs that pregnant women should watch out for. They should contact a healthcare professional if they have headaches that won’t go away, fainting, or unusual swelling.

Nonog noted that they should also be aware of thoughts of harming themselves or their baby, as this could be a sign of a mood disorder. Perhaps just as importantly, the doctor added, people know they deserve to be heard.

“As a BIPOC provider who is also a parent, it can be difficult to really speak up, given my own history of internalized racism,” Nonog acknowledged. “I had to work three to four times harder than my white counterparts just to be heard or valued.”

Nonog added that Kaiser Permanente also supports pregnant women in other ways, such as monthly cohort meetings with healthcare professionals. The doctor pointed out that the health organization was also trying to take a step back to understand its role in combating structural racism.

“We listen to the community, inviting them to tell us what they need,” Nonog said. “And we’re trying to look at the data. We’re trying to assess any implicit bias that we might have.”

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Advocates for older Americans are urging Congress to take action to reduce drug prices, particularly by allowing Medicare to negotiate with drug companies.

The Build Back Better Act would have done just that, while capping out-of-pocket spending for seniors and imposing tax penalties on pharmaceutical companies for excessive prices. The legislation stalled in the US Senate after the House passed it last year.

In New Hampshire, the average annual cost of prescription drug treatment increased by more than a quarter from 2015 to 2019, but residents’ annual income increased only 9%.

Jennifer Delaney, deputy director of state advocacy, AARP New Hampshire, said price inflation is hurting Granite Staters.

“A lot of people can’t afford their medications,” Delaney observed. “They have a choice between heating their house, putting food on the table, or taking their life-saving prescription drugs. And I’m talking about people who have cancer, Parkinson’s disease, diabetes.”

Delaney pointed out that when people ration their medications or skip doses, it can have negative health effects and even lead to hospitalization. She added that according to the Congressional Budget Office, drug pricing measures passed by the House would save the federal government hundreds of billions of dollars over the next two decades.

Megan O’Reilly, vice president of federal health and government family affairs for AARP, said the Senate Finance Committee recently held a hearing on the urgent need to reduce drug prices. Opponents argued it would hurt innovation, but O’Reilly noted that support for negotiating Medicare is high across the political spectrum.

“Taxpayers bear the burden of these increased prices, but they have also paid to help with the research and development of these,” O’Reilly argued. “And yet, there is no check on the pharmaceutical industry, as they continue to raise these rates, really, on the wallets of families in New Hampshire and across the country.”

More than 85% of respondents to an AARP survey said Congress needs to take action to lower drug prices. More than 75% of Democrats and more than 50% of Republicans said they would look more favorably on a political candidate who supports cutting drug costs.

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No news is good news for Ohioans who signed up for Medicaid coverage during the COVID-19 public health emergency.

State Medicaid agencies are prohibited from de-enrolling beneficiaries until the end of the month in which the emergency expires. Saturday is expected to be the termination date, but since the federal government has yet to notify the states, advocates expect that deadline to be pushed back to mid-July.

Elizabeth Thuranira, organizer for UHCAN Ohio, said it’s crucial that enrollees respond to all renewal forms sent out by Medicaid so they don’t lose coverage.

“The focus right now is on updating your contact information, whether it’s their mailing address, phone number or even their email address,” she said. “It’s imperative right now to get people to update them, so they don’t end up losing their coverage.”

When the public health emergency ends, more than 14 million Medicaid enrollees could lose coverage nationwide. In the meantime, Thuranira said, they should continue to use the preventive health services available under their coverage. In Ohio, Medicaid enrollment increased nearly 20% between March 2020 and last January.

If Medicaid beneficiaries are deemed ineligible for the redetermination process, Thuranira said the
Marketplace is a good option that often offers discounted premiums for individuals and families. She explained that health insurance navigators are available throughout Ohio to help with enrollment.

“These are the navigators who showed up at local events, churches, social service centers and even on campuses and simply let it be known that Ohioans had options when it came to coverage. “, she said.

The Centers for Medicare and Medicaid Services has a special enrollment period, open through the end of the year to help people earning up to 150% of the federal poverty level get health insurance coverage free. For a family of four, it’s $39,750.

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