60 Minutes took an rare unblinking look at the REAL 800 pound Gorilla in the cost of Health Care American style. The exploding costs of End of Life Care are increasing at an alarming rate that is not only unsustainable for our health care system, but unsustainable for our whole economy.
The Cost of Dying
"This is the way so many Americans die. Something like 18 to 20 percent of Americans spend their last days in an ICU," Byock told Kroft. "And, you know, it's extremely expensive. It's uncomfortable. Many times they have to be sedated so that they don't reflexively pull out a tube, or sometimes their hands are restrained. This is not the way most people would want to spend their last days of life. And yet this has become almost the medical last rites for people as they die."
Dr. Byock leads a team that treats and counsels patients with advanced illnesses.
So far advocates of Health Care Reform have shied away from this issue. Opponents have tried to demagogue the issue fabricating a specter of death panels to drum up fear. Its an issue we'll have to face up to as a country sooner or later or it will gobble up our very economy.
Patients' final 2 months of life cost Medicare $50 Billion in 2008. Our system creates incentives for doctors to deal with elderly patients by putting them into the hospital.
"How do so many people end up in the hospital?" Kroft asked Dr. Elliott Fisher, a researcher at the Dartmouth Institute for Health Policy.
"It's the path of least resistance," Fisher said.
Our system also creates an incentives for hospitals to provide more aggressive End of Life Care whether it is likely to be beneficial or not.
But if recent history is any guide, rationing has become the third rail of American politics, even though Elliot Fisher says we already limit health care based on income and whether people have insurance.
After analyzing Medicare records for end-of-life treatment, Fisher is convinced that there is so much waste in the present system that if it were eliminated there would be no need to ration beneficial care to anyone.
The opportunity costs are becoming unbearably burdensome for American Society.
This is also a deeply personal issue for tens of millions of American families including my own. The price Americans pay to cling to this medical/cultural custom of aggressive End of Life Care are exceedingly high in terms of human suffering and loss of dignity, as well as in macro economic terms.
Watch the 60 Minutes video