Monday, April 07, 2008
The Death of Health Care
In today's New York Times there's an article that addresses something I've argued for a long time: the way to control costs of health care is to look at how and why costs and practices differ, and to adopt the best practices.
Now this article in particular is about the costs of end-of-life care, which is tricky. Even better, though, as a point of discussion, because it's been shown that a huge amount of the health care dollar is spent in the last months of life. Were this area looked at -- really looked at -- we'd have a paradigm in which to figure out what we really want from our health care money. About 30% of Medicare money is spent in the last year of life. Of that, 40% is spent in the last month. It's not surprising, of course: you tend to be sick before you die. So one would hope. Still, it would seem that in the variations described in the NYT article, there's much to be learned. Is it the same care being delivered more efficiently? Is it philosophical?
I don't know the answer, and I've already posted once today, so I'll wax waningly. I'm just saying that it's about time to turn our attention to where the real money is and have a little candid politicking. Candidates propose ways to fund insurance. Scheduled to go into effect this year and next are major cuts in physician payments by Medicare. Politically popular. Easy. And looking exactly 180 degrees away from the heart of the matter.