- The Washington Times - Monday, July 20, 2009


Your article ” ‘Ration’ is GOP’s weapon in health care war” (Page 1, July 13) suggests that if health care reform reduces medical costs, it must be at the expense of good care and necessary treatment.

Recent research confirms what we have learned from decades of experience improving care and expanding end-of-life choices: More treatment does not mean better care. Futile and painful end-of-life procedures often yield nothing but needless suffering even as they add great expense. Ten percent of all Medicare costs occur in the final 30 days of life. Most of the money in those last 30 days pays for intensive care and invasive, unwanted treatments (such as feeding tubes and mechanical ventilators) intended to extend life .

Ironically, these exorbitantly expensive procedures do not even serve their goal. A study released in the March 9 issue of the Archives of Internal Medicine concluded that higher medical costs in the final week of life were associated with more physical distress and worse overall quality of death but made no difference in survival rates.

Patients who discuss end-of-life preferences with their doctors are more likely to forgo ineffective, burdensome interventions. Current fee-for-service payment encourages doing as many things to people near death as is medically possible.

We need a health care system that pays doctors to talk with patients about peaceful endings when death is imminent and pays for hospice care as readily as for intensive care. True reform will fashion this profit-centered industry into a patient-centered one to deliver the comfort care and supportive services people truly want and need at the end of life.



Compassion and Choices


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