USA Today Series Examines End-of-Life Care

Main Category: Palliative Care / Hospice Care
Also Included In: Seniors / Aging;  Medicare / Medicaid / SCHIP
Article Date: 23 Oct 2006 - 17:00 PDT

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In the fourth-part of a week-long series titled "Prescription for Change," USA Today on Thursday examined whether costly end-of-life care that includes "additional hospitalizations, tests and doctor visits" is "best for elderly patients or the long-term financial future of programs such as Medicare." Estimates show that 27% of Medicare's annual $327 billion budget is used for end-of-life patient care. According to a survey by ABC News, the Kaiser Family Foundation and USA Today, 48% of U.S. residents believe costs should be considered in regards to end-of-life care, compared with 40% who said a person should be kept alive as long as possible, regardless of cost. Research has shown that end-of-life care costs vary by state, but "the real question remains" whether more costly care has "resulted in better care or better quality of life," USA Today reports. According to USA Today, "some patients may be pushed into more [treatment] than they want by a medical system that values doing something over doing nothing, even when futile." John Santa, medical director for the Center for Evidence-Based Policy, said, "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 the (futile care)." Joanne Lynn, a geriatrician who studied end-of-life care at RAND, said, "We are going to double the number of people who are sick, old and frail in about 15 years. It would be a good thing to try on some ways of thinking about how to live that well ... and at a cost the community can sustain." Lynn added, "None of us wants to bankrupt our community on desperate, long-shot treatments" (Appleby, USA Today, 10/19).

Editorial
"We would never argue that police and fire protection should be distributed based on income, so why should health care?" Timothy Johnson, medical editor for ABC News, writes in a USA Today opinion piece. Johnson notes that the U.S. will spend more than $2 trillion on health care this year, but the country ranks "last among 23 industrialized countries in infant mortality." A "major reason ... is the huge number of uninsured or underinsured in our country who do not get timely care," Johnson writes, adding, "So why not make health care a right so every American can potentially benefit from early intervention and better prevention?" According to Johnson, speculation that U.S. residents would "abuse" a universal health care system is "crazy." He concludes, "How long do we want to be known as the wealthiest country in the world -- and the only one that does not provide universal health insurance when we could and should" (Johnson, USA Today, 10/19).

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