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The High Cost of Death

October 23rd, 2006

by Nick Jacobs

Julie Appleby of USA TODAY did a nice job on Thursday of this week in her summary report article entitled "Debate surrounds end-of-life costs.". For those of us who have been following the statistics surrounding this issue for the past twenty years, there were no major new findings or discoveries, just updated numbers. We have been aware of the phenomena that is surrounding this topic, but each time we read it, it forces us to deal with the sad reality of its thesis.

In areas of the country where there are more Intensive Care Units and more specialists, the cost of dying can be exponentially higher than in states like Oregon where the end of life discussion has been completely embraced in the open, with public discussion appropriately combined with private decision making.

She quotes researchers at the Dartmouth Atlas Project where Medicare data was analyzed to determine the exact cost of dying in the various states. Of course, showing the costs is the easy part. The real question becomes how much of the extra care actually resulted in either better care or a higher quality of life? The answer to this question will help to determine how long our current system of care can be sustained within the United States.

Depending upon your geography, costs for end of life care range from approximately $11,000 to nearly $36,000. So, do you want to spend the last few months of your life seeing specialists, having tests, trying new drugs with little or no chance of survival while being attached to respirators, or would you rather be with your family and other loved ones at home in relative comfort?

If I were more talented on the computer, this is where you would hear the sound cue, and that cue would be ka-ching.

According to Ms. Appleby's source, John Santa who is the medical director for the Center for Evidence Based Policy in Portland, "One of the things that frustrates us all is to see care being provided in an absolutely futile situation . .. and doctors and hospitals are not accountable but are also being rewarded (financially) for that (futile care).

My recommendation is that we keep the question front and center. We still have one of the most outrageous percentages of infant mortality in the industrialized world because we are allocating so much to end of life care and because we have NO National Healthcare Policy. This happens while our single, uninsured mothers are not even receiving prenatal care.

We, the senior voting members of our society are short changing the children who represent the future of our country by squandering their share of public healthcare dollars on meaningless treatments that do not add quality to the end of our lives.

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