What portion of $60 billion do we want to re-allocate...

Some research on annual healthcare costs, and where the money goes...

This is part of my series to document that individuals actually have more control on national healthcare costs than the government, insurance companies or politicians. There is a lot of evidence of this…

For example, in a January 10th, 2013 article in Forbes Entrepreneurs, Michael Bell wrote his reaction to data from Dr. Susan Dale Block of Bringham and Women’s Hospital in Boston. He wrote “It seems that no matter how much money you use during that last year/month (of a person’s life), if the person is sick enough, the effort makes things worse”.

We know that 30% of all Medicare costs (equal to about $175 billion) are spent in the last year of Medicare patients’ lives… and about 1/3rd of that in the last month (about $60 billion).

It is a relatively simple algorithm to state that ‘if’ a patient is very sick with end stage cancer, 'then' keep the patient comfortable; do not treat to extend life. By doing this, the Medicare system either saves a large portion of $60 billion, or uses it to ‘save’ lives. I am not suggesting that the decision be made without the patient’s knowledge; the decision is the patient’s. The obligation here is for the medical profession to ensure the patient is knowledgeable of her situation, and be allowed to choose.

We are all going to die. If we internalize knowledge about treatment, outcome, costs and so on, it is a simple leap to a better end. Should the motivation be to save money… likely not… that’s too hot. But just the knowledge that when we spend more, we likely “make things worse” should be enough.

Generally, people who know they are going to die, don’t want to go through excessive pain to live an extra day(s). It is also important for loved ones to understand the facts, and not get in the way. Is it a moral and ethical issue… only for the individuals involved? Perhaps, the rest of us, and the medical profession c/should stand aside.

How do we start the discussion and make this happen. It is a financial ethics issue, too.


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