Year after year, health care reform continues to inspire discussion here, including a lengthy ongoing discussion in the middle of a thread on civility.
That discussion had progressed to the issue of heavy spending in the last two years of life, so let me try to continue it with a fresh thread by telling a recent, personal story.
In January, my 96-year-old mother fell ill, and the doctors at the western Mass. hospital near her home told us there was nothing they could do for her. She was simply too frail to survive any treatment they could give her. In keeping with her wishes, we suspended life-extending procedures and she was prescribed “comfort care.” After a few days, we prepared to send her home under the care of a hospice organization.
I was in her hospital room, ready for the hospice folks to come and get her, when an aide came in, telling me a resident had instructed him to come in and give her an EKG, to see how her heart was doing. I asked why, since she was going into hospice care. As soon as he heard that, he retreated, saying there’s no way she should be undergoing tests and promising to explain to the physician who had ordered it. I was pleased with his reaction – and glad I had been there, otherwise he would have gone ahead with an expensive and totally unnecessary test.
I’m willing to chalk it up to a misunderstanding, but I couldn’t help but wonder whether it was typical of the way hospitals pad Medicare bills.
By the way, I still haven’t read Steven Brill’s Time tome on overpaying for health care, but I just printed it out and will take it on my vacation next week. Time subscribers can read it here. I don’t pretend that confronting the costs of health care in the last year of life is easy, but a lot of other countries have managed to deal with it. There are huge problems with the American way of death; while most people say they’d rather die at home, something like 80 percent breath their last in a hospital ICU or a nursing home. For most, it’s not the passing they’d wish and for everyone, it’s really expensive.