RT Journal A1 Wald MS T1 DIchotomy in health care policy JF Archives of Internal Medicine JO Archives of Internal Medicine YR 1993 FD January 25 VO 153 IS 2 SP 259 OP 259 DO 10.1001/archinte.1993.00410020103010 UL http://dx.doi.org/10.1001/archinte.1993.00410020103010 AB I found the editorial by Singer and Lowy1 very thought provoking with many interesting facts as well as ideas. However, it has been my experience that patients and their families are unwilling to take the initiative despite careful discussion in choosing to address an advanced health care directive. It is now nationwide policy in the United States to provide every patient who enters the hospital with information concerning advanced life and health care directives. It has been my experience that these are not very helpful in the care of the patient should he/she reach a critical illness. It is also my thinking that the proposed 5 billion dollars saved, at the authors' low-end estimation, is still probably an overestimation of what it would, in fact, save us.2The patients who receive care in the intensive care units certainly comprise a large bulk of high technology, high expense medical