End-Of- Life Medicine

Having lived through several very personal ends of life I feel qualified to comment. I have seen different life ends with vastly different medical costs. What the country needs is a thorough vetting of this, and related issues. Unfortunately as this article points out Americans don’t want to talk about it. Even if we pass some watered down health care “reform” the end of life issue will not be adequately addressed because we don’t talk about it as a nation. I have seen Medicade prolong the life of a dying woman and another just sit in a chair and die, with virtually no additional expenses. My wife and I have done almost all we can do to make those hard decisions and prepare wills with powers of attorney and yet if catastrophe hits us we are not prepared to pull the plug.

Much of this debate is left off the table. It is a reflection of our cultural mores. 150 years ago people died in their homes, with their families gathered around, when it was time it was just time. Today many people are in assisted living (joke) facilities or nursing homes and the system picks up the expense instead of family. That part is not political it is cultural. As long as we continue to deemphasize familial and personal responsibility and accountability as a culture the end of life issues will rage on.

Here are a few of the pertinent paragraphs from this article.

“Almost a third of the money spent by Medicare—about $66.8 billion a year—goes to chronically ill patients in the last two years of life”

“Studies show that about 70 percent of people want to die at home—but that about half die in hospitals.”

 “Our medical system does everything it can to encourage hope. And American health care has been near miraculous—the envy of the world—in its capacity to develop new lifesaving and life-enhancing treatments. But death can be delayed only so long, and sometimes the wait is grim and degrading. The hospice ideal recognized that for many people, quiet and dignity—and loving care and good painkillers—are really what’s called for.”