Is End of Life the Most Expensive Period?

For John, BLUF:  Health care is getting more expensive, and bureaucracy doesn't help.  Nothing to see here; just move along.

Earlier in the week we had a discussion of end of life medical care, prompted by my Brother Lance, who has weighed in again, with this item from The New York Times.  The author, Dr Ezekiel J. Emanuel, writes that the bromide about spending more on your last year of life than for all the previous years is wrong:

IT is conventional wisdom that end-of-life care is an increasingly huge proportion of health care spending.  I’ve often heard it said that people spend more on health care in the year before they die than they do in the entire rest of their lives.  If we don’t address these costs, the story goes, we can never control health care inflation.

Wrong.  Here are the real numbers.  The roughly 6 percent of Medicare patients who die each year do make up a large proportion of Medicare costs: 27 to 30 percent.  But this figure has not changed significantly in decades.  And the total number of Americans, not just older people, who die every year — less than 1 percent of the population — account for much less of total health care spending, just 10 to 12 percent.

Mr Steve Reznick comments on the article:

Dr.Emanuel glosses over the extremely high cost of providing care the last few months of a person's life in light of the Medicare financial crisis.  Hospice and palliative care worked best when they were volunteer organizations staffed by volunteer staff including physicians, nurses, clergy and lay persons. The medical directors were unpaid volunteer physicians who all loved the time spent with the volunteer staff.  Now that it is a compensated by Medicare program it has become far more expensive because of all the rules and regs they now must comply with.  That is not to say that hospice employees are not angels of mercy and reason and compassion because they are.  In exchange for financial support from the government the costs have gone up dramatically.

Does Mr Reznick's comments remind you of higher education costs?  I would hope so since we see the same pattern in higher education.  The Federal Government steps in to help, but because it is the Federal Government, standardization is required and thus administrators are required and thus costs go up.  What started as a great idea has become part of another problem.

As Arthur Block would tell us:

Every solution breeds new problems.

Regards  —  Cliff