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Bob McMillanAn Opinion

By Bob McMillan
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End of Life Care

With all the debate over “Obamacare,” Medicare, the economics of healthcare and taxes, take a look with me at some of the issues, which will become front and center over the next five years.

First, examine some of the statistics with me. In the United States – Medicare and private insurance spend some $60 billion each year on hospital bills during the last two months of a dying patient’s life! For example, one day in an intensive care hospital bed costs around $10,000.

The challenge we face is that some of the medical procedures used in the end of life care may very well have no meaningful impact on the life of dying patients. At the same time, some modern day medical treatments do prolong life. Some people are now asking whether prolonging life is too expensive. And that turns into both a moral and economic question, just like whether every American is entitled to health insurance.

With the costs for medical treatment skyrocketing – healthcare expenditures are four times the size of the Department of Defense’s yearly budget. Last year healthcare expenditures in the United States were some $2.6 trillion. All of this reminds me of a comment made by the head of a Florida hospital a few months ago. The hospital administrator was in England and reviewing hospital administration there compared to the United States. As the tour of the English hospital was underway, they came to the intensive care unit. There were only 12 beds. The Florida administrator asked “Why, when you have twice as many regular beds as my hospital, do you have only 12 beds in intensive care?” The English administrator said, “Death is an option.”

With Medicare in deep financial difficulty, and the Administration looking for ways to trim Medicare spending, is “death an option” in the United States?

All of this leads to one area where the new healthcare law is gaining more scrutiny. That is the Payment Advisory Board. There is growing medical opposition to that board, because doctors feel medical decisions should be left to doctors and their patients. Doctors are concerned that government bureaucrats will determine a general standard of care when doctors feel each patient should be dealt with individually.

In the final analysis, as I said before, this all boils down to a moral vs. economic debate. We cannot stop caring for people as they begin to die; yet, the sums of money being spent on end of life care are growing to staggering amounts. Is there any moral middle ground between “dying is an option” and spending is growing out of sight?

Whatever happens in June when the Supreme Court decides Obamacare, we have not heard the end to the issues discussed in this piece. And as more of the nation ages and more spending is at the end of life, the debate could become very fierce.

Robert McMillan Website: www.bobmcmillan.net