October 16, 2009

The Dangerous Fallacy of Seeking to Save Medical Costs in the Final Two Years of a Citizen’s Life

We've been hearing a great deal from the Obama administration about saving Medical costs by cutting money spent on patients who are in the last two years of their life. From the Washington Post, June, 2009:

But it is the findings of the Dartmouth Institute for Health Policy and Clinical Practice that have generated the most excitement in the Obama administration, all the way up to the Oval Office. For more than a decade, the New Hampshire researchers have documented and mapped wide variations in the cost and types of care given to American seniors through the Medicare program, concluding that spending more on health care has not resulted in better health.

In the final two years of a patient's life, for example, they found that Medicare spent an average of $46,412 per beneficiary nationwide, with the typical patient spending 19.6 days in the hospital, including 5.1 in the intensive-care unit. Green Bay patients cost $33,334 with 14.1 days in the hospital and just 2.1 days in the ICU, while in Miami and Los Angeles, the average cost of care exceeded $71,000, and total hospitalization was about 28 days with 12 in the ICU.

Here's the dangerous fallacy of pursuing this argument: there are many cases in which people whose doctors expected they had little time left to live, went on to enjoy years of life, in which they were able to bring joy to their friends and loved ones.

One of my very good friends was told many years ago that he had at most a year or two left.  He is still very much among us, a good father to his son, and contributing greatly through his work to many people's lives.

A quick Google search for "lived longer than doctors predicted" turns up numerous examples.

To sum up:

In many cases, possibly a majority of cases - particularly in cases of those who are elderly but not terminally ill - no one knows in advance when the last two years of anyone's life will be.

But Obama evidently seeks to have doctors make a decision about when the last two years of our lives have arrived, and then withhold medical care from that point forward, hastening an earlier death. 

Here's the famous video of Obama, relevant to the subject:

Obama: "Maybe you're better off, not having the surgery, but taking the pain killer."

Do you want a doctor, very possibly acting in a way enforced by federal guidelnes written by bureaucrats in Washington, telling you when they must withhold medical care from your parents?

If that's not a death panel, it's too close to one for comfort.

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Categories: Health

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