KHN Morning Briefing

Summaries of health policy coverage from major news organizations

End-Of-Life Care: A Challenge In Terms Of Costs And Quality

The Medicare NewsGroup takes a long look at the issues surrounding end-of-life care within the American health care system with a series of stories, including these:

The Medicare NewsGroup: The Cost And Quality Conundrum Of American End-Of-Life Care
At first glance, America is making great strides toward a medical and cultural shift in its approach to end-of-life care: More and more providers are recognizing the benefits of hospice, more people are dying at home, and many health care organizations are institutionalizing the discussions between providers and patients that would help patients formalize their wishes for end-of-life care through an advance directive. But pull up the curtain on these statistics, and the drama that unfolds tells a very different story. End-of-life care continues to be characterized by aggressive medical intervention and runaway costs (Adamopoulos, 6/3).

The Medicare NewsGroup: End-Of Life Care Constitutes Third Rail Of U.S. Health Care Policy Debate
Any debate about health care policy isn’t complete without adequately addressing its third rail—end-of-life care—and the financial stress it puts on the Medicare budget. Total federal spending on health care eats up nearly 18 percent of the nation’s output, about double what most industrialized nations spend on health care. In 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients’ last six months of life (Pasternak, 6/3).

The Medicare NewsGroup: Advances In U.S. Medical Care Bring Too Much Of A Good Thing
Through a triumph of will, organization, medical technology, and ethics, frail elderly and chronically ill people in the United States are being kept alive far beyond the point at which they would have succumbed in earlier generations. Dialysis, intensive care units, organ transplantation, cardiovascular procedures, and medications are indefinitely extending the lives of very sick people who are never going to get well (Moore, 6/3).

The Medicare NewsGroup: Time To Address End-Of-Life Care In Medicare, Some Experts Say
End-of-life policymaking may be as inevitable as death itself -- an issue that lawmakers may fear and loathe, but one that is unlikely to ever go away. The “death panel” debate that circled an early provision of the Affordable Care Act that would have provided payment to physicians for advance planning and end-of-life consultations was like a vulture trying to kill its prey. But while it may have temporarily squashed the issue (the provision was stricken from the bill that became law), the costs, ethics and concerns about end-of-life care will not let the topic die (Taylor, 6/3).

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