by Nick Jacobs

The November 25th, Sunday, New York Times editorial provided an in depth analysis of "The High Cost of Health Care." Six possible solutions were identified that could possibly assist in ameliorating this accelerating problem: Geography, the wide variances that occur in pricing based upon location of the service; Stick to What Works, a demonstration that only those treatments that actually have proven merit should be utilized by the physicians; Managed Care, it worked for a while, but too heavy of a hand would cause passionate kickback by both the population and the physicians; Information Technology, knowledge is power and this will produce more efficient use of the system; Prevention, everyone knows that attention to prevention works; Disease Management through comprehensive management of chronically ill patients; and finally, Drug Prices, drugs are more expensive in the United States.

The seventh and probably most important means to reduce health care costs was omitted by the Times, and by what seems like 75 percent of physicians most days, and that is Hospice care. Approximately 30 percent of all health care dollars spent in the United States are spent on the last thirty days of life. If we are close to 2.2 trillion dollars in expenditures, then divide by three and see what an impact Hospice could have on our expenditures.