Senator Warner believes one of the ways we can begin to reform our nation's health care system is by starting a national conversation about end-of-life issues.

He told a national meeting of hospital executives last week:

"We leave it to families to resolve these extraordinarily difficult decisions with little guidance.  Other industrialized nations have dealt with the end-of-life issue. It's time we did as well."

On Friday, the Virginian-Pilot started the discussion with a front-page article that debated the issue.  They spoke with Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania:

Caplan praised Warner for tackling a subject most political leaders try to avoid. When politicians talk about curtailing care in the context of controlling medical costs, he said, many Americans worry that "they're just trying to get me to die faster."

Laurens Sartoris, the president of the Virginia Hospital & Healthcare Association said that Senator Warner's "point is well-taken":

But the line between futile end-of-life treatments and care that can significantly extend life often is hard to discern, he said. Patients and doctors alike are understandably wary of deciding too soon to curtail treatment.

Patients and families also are often influenced by cultural factors, he added. Rural residents are more likely to expect to die at home, while those who live in urban areas routinely expect to go to a hospital and receive aggressive care to the end.

Not everyone agrees.  The Pilot story quotes Steffie Woolhandler, a Harvard Medical School professor and co-founder of Physicians for a National Health Program, as saying there is no evidence that end-of-life planning will reduce costs. 

Click here to read the Pilot article.

On Saturday, the Roanoke Times Editorial Board commended Senator Warner for starting the discussion in an effort to cut health care costs:

These are politically tricky waters, but Warner waded in.

He also acknowledged the public's trepidation about the cost of reforms. But given that health care costs are on a trajectory to hit $4.3 trillion a year over the next decade, he said, "The direction in which we are headed is simply not sustainable -- either for the public sector or for private industry. Failing to act will still mean cuts in health-care spending."

On that, he is standing on solid ground.

Click here to read the speech he gave to the Federation of American Hospitals.