Recent end-of-life stats bring compassion into question

Should Medicare spending be limited in the final months of life?

For years, industry researchers have bemoaned the state of Medicare spending. In particular, end-of-life ‘comfort care’ has been called into question, with statistics suggesting that as high as 25% of all funds are funneled into situations deemed futile. While these figures imply huge waste that could somehow be curbed, there’s clearly much more to the story. In fact, health policy pundits now say the idea of huge sums of money being squandered on end-of-life care is actually a misconception.

Howard Gleckman of Forbes, asks, “What if the entire premise of this argument is wrong? What if Medicare spends just a small fraction of its resources on those who are expected to die?” In fact, new research suggests exactly that.

The price of prediction

These new findings shiſt focus away from seemingly ‘wasted’ funds and back onto the real problem: as care providers, we have a pretty poor track record when it comes to predicting imminent death. Data shows that only 10% of patients with a 50% chance of perishing in a year actually do, while others pass unexpectedly – and for countless unforeseen reasons.

“Those who end up dying are not the same as those who were sure to die,” say researchers at the American Association for the Advancement of Science. “Thus, much of the care we provide in what turns out to be the last year of life may not be futile at all based on what doctors know at the time they are treating their patients.”

Because of these disparities, it’s impossible to determine if Medicare spending is truly in vain. Logical fallacies aside, the greater debate also inspires questions related to compassion and support for our sickest patients. As we strive to preserve their dignity, respect and quality of life in the face of devastating odds, a meager 5% of all Medicare costs seems beyond justifiable.

Experts remind us to concentrate on smart spending habits related to the sick in general, as opposed to those who will ‘probably’ die. If doctors and scientists ever acquire the tools to accurately predict end of life, revisiting Medicare costs in this context may be appropriate. But until then, it’s best to approach the high price of palliative, hospice and similar care with a grain of soul.