Million Dollar Patients

Jul 8, 2012 | 2 comments

How much money would you spend to keep your elderly parents alive in the hospital? Because of Medicare, most families don’t have to ask themselves that tough end-of-life question.

Perhaps families should start to consider how they would respond.

This eye-opening story that originated in the St. Louis Post-Dispatch traced the six-month decline of an 89-year-old woman. She had Alzheimer’s, was placed on a feeding tube when she could no longer eat, then was placed on a respirator when she could no longer breathe on her own.

The day came that the doctor said to the woman’s three children that it was time to let Mom die. The two daughters agreed, but the son refused, wanted everything possible done to keep her alive, and bolted from the room.

As the article stated, such wrenching dilemmas test not only family bonds and the frontiers of medicine, but the nation’s tolerance for runaway health care costs. In the final six months of her life, this woman’s care totaled about $1.2 million, according to billing records provided by the family.

How many families would pay for this kind of life-extending medical care if they had to pay it themselves? This is when the death panel conversation becomes real – and the panel is comprised primarily of the offspring of that person in the hospital bed.

From the article:

As the debate over the Supreme Court’s ruling on the national health care overhaul law continues, many experts say that the ethical and financial dynamics of dying should be front and center. Yet few politicians, bureaucrats, insurers and doctors dare even to discuss it. And no one seems to have a clue as to how our society can afford to pay national health costs that approached $2.6 trillion in 2010 — a tenfold increase since 1980, according to the Centers for Medicaid and Medicare Services.

When the elderly can survive only with aggressive measures, the incentives for all involved tilt toward treatment, regardless of cost. Family members naturally want loved ones to live. Physicians and hospitals get paid well for providing extensive medical treatment — and face legal liability for denying care, even if the patient has scant survival prospects.

Insurance companies likewise fear being vilified and sued for denied care, and can preserve profit margins by passing along the costs to employers and their workers. And the Medicare program ultimately reports to Congress, which has shown no willingness to wade into the political deadly arena of near-death care — or curbing federal health entitlements at all.

The financial train wreck is coming and our current healthcare system only stokes the boilers. The Silver Tsunami of baby boomers is starting to build. We need to have these serious conversations with our partners, our siblings and our parents now, before illness and disability strike.

A Good Goodbye