Reining in End-of-Life Costs Won't Be Easy

Stella Fitzgibbons, a Houston physician, has an op-ed in the LA Times in which she complains about the cost of futile treatments at the end of life.  

“Consider the case of a man I’ll call Mr. A. At the age of 80, he is admitted to intensive care after a huge stroke. He also has pneumonia and kidney failure. He is too sick to tell us his views on aggressive care at the end of life, but his family is happy to fill the void. They insist we use every tool at our disposal to prolong his life, despite brain scans making it clear that he will never again be able to walk, talk or feed himself. The total bill for the last month of life? Many tens of thousands of dollars.”

“Americans have spent the last several decades hearing that all you have to do is be a little assertive to get top-of-the-line treatment. . . .  Some efforts are being made to control costs. Hospitals keep an eye on “unnecessary days,” and medical personnel are becoming experts on “cost-effective care.” But the savings of such efforts are insignificant compared with what we spend on futile care at the end of life . . . .”

“[W]e cannot afford to give every patient and family all they want, or to provide four-star medicine when the three-star version is almost as likely to succeed.”