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January 04, 2013 11:29 AM Better, if not Cheaper

By Aaron Carroll

Ezeliel Emanuel has a great piece over at the NYT about end-of-life care. He starts off by correcting a few myths:

Here are the real numbers. The roughly 6 percent of Medicare patients who die each year do make up a large proportion of Medicare costs: 27 to 30 percent. But this figure has not changed significantly in decades. And the total number of Americans, not just older people, who die every year — less than 1 percent of the population — account for much less of total health care spending, just 10 to 12 percent.

While obviously higher than average, these numbers obviously aren’t driving the massive over-spending we do on health care. Plus, what can we do about it? It’s easy to identify the year before people die when we look back at data. It’s impossible to do so looking forward. We spend money on people when they get sick. Sometimes we save them, and sometimes we don’t. We can’t tell ahead of time which group is which in order to save spending by not bothering.

Besides, we’re never going to do that. Nor should we.

Emanuel spends the rest of the piece discussing how we could do a better job of end-of life care. But what pleases me most is that he spends his time discussing how we could make it better, not cheaper. Go read it. The stuff he recommends is somewhat common sense, but all-too-often ignored. Death panels even make an appearance.

If nothing else, it’s nice that one of the first things I read this year acknowledged that sometimes good things cost money.

[Cross-posted at The Incidental Economist]

Aaron Carroll ,MD, is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine.