Healthcare Spending & End of Life Care

In August, 60 Minutes did a segment on end of life care and how much it costs the U.S. health care system each year. Although the video is from August, the issue it covers is still relevant today. This is a huge issue that comes with a gigantic moral debate attached to it.



The segment presents some staggering stats:

• U.S. spends 55 billion dollars a year  on hospital bills in the last 2 months of patients lives. This 55 billion  trumps both the annual budget for The Department of Homeland Security and The Department of Education. It is estimated that 20-30 percent of these procedures have no meaningful impact on the patient.
• One day in an Intensive Care Unit (ICU) costs over 10,000 dollars. 18-20 percent of Americans spend their last days in an ICU
• While a majority of Americans prefer to die at home, 75 percent die in hospitals & nursing homes.
• The government or private insurance pays for 85 percent of these medical costs

What are the underlying issues?

1. Medical technology has become so good that if patients want to, they can be kept alive much longer with advanced procedures and machines. The problem is, this is very expensive.
2. The U.S. health care system is built so that supply drives demand. This means that doctors are in control of the kind of medical care you demand because they suggest it. If the doctor suggests a certain treatment chances are you will demand that treatment. Doctors get paid by the patients they see and the tests & procedures they do so their incentive is to provide as much care as possible. This is also expensive.
3. Patients often never even see the medical bills they rack up because the government & insurance pays them. If they aren't paying nobody really cares how much these procedures cost.

It was amazing to hear the word "bankruptcy" brought up several times throughout the video. But that's how big of an issue this is; it can eventually bankrupt the United States. The problem is the huge moral debate. We can't just stop caring for people when they begin to die but at the same time a huge amount of money is being spent on this. Is there a moral middle ground or a way around this issue? Should end of life care be rationed or capped at a certain amount? It's a really hard debate to have.