NEW YORK -- If you're looking for a unique gift for Valentine's Day, you might consider giving some peace of mind -- by deciding and sharing what type care you'd want in a health crisis.

The COVID pandemic has brought new urgency to the need for end-of-life planning. It may seem like an unlikely theme for a song, but the not-for-profit organization Compassion & Choices has put its advice to music to encourage people to prepare advance directives for end-of-life care.

Kim Callinan, the group's president and chief executive, said she hopes the song will help people find new ways to share messages of empowerment, gratitude and the importance of making plans aligned with their personal values and priorities.

"Valentine's Day is a time when you show your loved ones that you care about them," she said, "and one way to show that you care is to give the gift of clarity by documenting and discussing your end-of-life preferences."

The song, "This Is Your Show," features Broadway and film star Carmen Ruby Floyd. Callinan said the second verse captures the core message with the words, "You have the option to write your last chapter."

Brandi Alexander, national director of community engagement at Compassion & Choices, noted that surveys show African Americans are more likely to choose aggressive treatment to prolong life, but this group also is less likely than others to prepare advance directives, to let people know their wishes for end-of-life care.

"A lot of it has to do with a history of mistrust with the medical community, and really just not wanting to have the discussion," she said, "and therefore, we don't talk about it until it's almost too late or until we're in a time of crisis."

Alexander added that when her father died without making his own end-of-life wishes clear, it caused disagreement and tension in her family as they tried to decide what he would have wanted.

Callinan urged people to go through the process of deciding what level of care they want, and then communicating those wishes. The organization's website has a plan-your-care section that is free to use.

"That has a simple checklist that helps them to learn what priorities are most important to them and how to fill out an advance directive, how to make sure your doctor's aware of what you want; having conversations with your health care proxy and your loved one," she said.

She pointed out that end-of-life planning and discussions are about love, and how you or your family want to be cared for.

During National Health Center Week, health-care advocates are highlighting the work Community Health Centers are doing to improve access to care throughout the state.

More than 600,000 Missourians turn to Community Health Services for primary care and preventive services - as well as dental, mental-health and substance-abuse services.

Steve Douglas - director of marketing and public relations with ACCESS Family Medical and Dental Clinics in Neosho - said their focus is underserved populations, including people without health insurance or gaps in coverage.

"We're able to get them a lot of care they can't get any other place," said Douglas. "And if we can take care of a debilitating health issue, or a toothache, whatever it may be, they can get back into the workforce and provide for their family and keep them off of other government assistance programs."

Nearly 75% of Missourians served by CHCs have incomes at or below 100% of the federal poverty level. About one-in-four lack health insurance, and nearly half have Medicaid.

Douglas said state and federal funding are critical to their work, especially in rural communities where medical care is more scarce. He pointed to programs such as the National Health Service Corps, which helps connect medical professionals to jobs in underserved areas.

"We need incentives to get the very best providers that we can possibly have," said Douglas. "The people that are in our region deserve the same quality of health care they might see in Los Angeles. So support grants that help us to recruit and train great talent are just vital."

During National Health Center Week, the Missouri Primary Care Association and Community Health Centers are celebrating a $150 million investment in the 2023 state budget that will help expand services.

Health advocates are hailing the new Inflation Reduction Act, saying it would be the biggest health-care reform since the Affordable Care Act.

The House of Representatives is expected to vote tomorrow on the bill, which already has passed the Senate. Anthony Wright, executive director of the Health Access California, said it includes many proposals activists have pursued for years.

"It would allow the government to negotiate down prices for the most expensive drugs," said Wright. "It would cap Medicare costs for medications, and it would require rebates if prices rose greater than the rate of inflation. That would help millions of Californians."

The bill also would extend subsidies from the American Rescue Plan that help people afford health care. Without the extension, Wright said he predicts the average Covered California enrollee would see an 82% increase in premiums - a jump of about $1,000 per year.

Bianca Blomquist - California policy director and Northern California outreach director for Small Business Majority - said more than half of people enrolled in ACA-subsidized health plans work for or own a small business, or are self-employed.

"The provisions in this package are crucial for the equitable recovery of small businesses in California," said Blomquist. "And we urge Congress to advance a vote on this legislation quickly."

The American Rescue Plan capped CoveredCA premiums at 8.5% of income. That is set to expire at the end of the year unless the Inflation Reduction Act becomes law.

Backers of a bill now in the U.S. Senate contended it will address rising health care costs and could provide Americans with some relief.

Part of the Inflation Reduction Act would allow Medicare to negotiate directly on prescription drug prices in 2023, and cap out-of-pocket drug costs for Medicare patients at $2,000 a year. It comes a month after Gov. Ned Lamont expanded the state's Covered Connecticut program to adults without children.

Jim Manley, board member of Consumers for Quality Care, noted rising out-of-pocket costs are a chief concern.

"The issue comes down to caps on copays, rising deductibles and prescription drug copays," Manley explained. "Caps on copays are largely absent from the current health care bill that the Senate is going to take up this week. And so, that's been driving out-of-pocket costs higher and higher for more and more Americans."

In the group's new survey, 45% of Americans said their out-of-pocket costs are far too high, and more than 70% feel health care costs are increasing "much more than other things they need." The Urban Institute said one in 10 people in Connecticut, and 13% of Americans overall, have past-due medical debt.

Manley feels while the issue is important, it will not be a dominant factor in the November midterm elections. However, he believes a change is needed. In the survey, 60% of people said they skipped or delayed medical treatment because it is so expensive.

"Health insurers have shifted costs onto patients through higher deductibles and out-of-pocket costs," Manley pointed out. "That's proven to be a real problem for the American consumer. It is leading them to either skip the care and/or go into medical debt. Medical debt is increasingly rampant throughout this country."

For now, the Affordable Care Act outlines out-of-pocket caps, but Manley believes they should be updated. His group also is backing a cap on the price of insulin, which according to a 2020 study is much higher in the U.S. than in most countries.