Marty Rochester’s May 20 column accomplishes two things for Jewish Light readers. First, he points out the importance of “living — and dying — with dignity.” Second, he highlights the many cogent points made by Atul Gawande in his book, “Being Mortal.” I write this letter to clarify several points about the care of terminally ill patients.

The fact that a disproportionate amount of Medicare funds are now spent on care of those who are in the last two years of their life and even more dramatically in the last six months of life has been recognized for many years before the Affordable Care Act (ACA) and has nothing to do with this legislation. A proposal to fund a discussion of end-of-life preferences by a person’s own physician under the ACA was unfortunately derailed by political pressure when it was termed a “death panel.”

Medicare and the ACA are finding ways to circumvent the political rhetoric and improve communication with patients and their families to facilitate decision-making about end-of-life care for those with chronic illnesses. Health care funds are being triaged to primary care physicians to have the necessary patient-centric discussions that can lead to living and dying with dignity.

Gary A. Ratkin, M.D., Creve Coeur