sdWhy You Treat Me Like a Dog?: Saving Healthcare Dollars .comment-link {margin-left:.6em;}
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Tuesday, April 04, 2006
 
Saving Healthcare Dollars
Yesterday, Doctor Bean over at Kerckhoff Coffeehouse posted about the National Health Service in the United Kingdom and how it isn't working. An interesting discussion about health care delivery in the United States then ensued. I left a comment there that I am proud of, and think it deserves further discussion and perhaps further political action if someone has the energy to make it happen. I decided to repost it here in the hopes that this could happen, and in the off chance that there are people out there who read this blog and not Kerckhoff... The comment follows:

One of my ICU professors when I was a medical resident proposed a relatively quick fix to Medicare which I haven't heard too much discussion of since. It is a known fact that the vast majority of health care expenditures in the U.S. is at the end of life, or in the few months preceding the end of life. We go to great heroic measures to prolong the lives of people who by all rights should be dead, and in fact, if they had a choice in the matter probably would be.

Therein lies the point, as my prof pointed out. It should be a requirement that anyone who enrolls in Medicare have an advanced directive, as well as a health care proxy who will make decisions for them should they become incapicitated. These should be kept on a centralized database, easily accessible in any emergency room (and changeable if the subscriber so desires).

Doctor Bean and Psychotoddler can tell you about the endless and very expensive days elderly, chronically ill, demented, unresponsive people, with no quality of life whatsoever spend languishing in our hospitals, ICUs and yes, nursing homes. They are kept alive because they never made their end-of-life wishes known.

The current assumption is that as health care professionals, we should be prolonging life at all costs. The same assumption applies to Medicare/Medicaid and that as a society we should continue to prolong life at all costs. That assumption needs to change. There is nothing wrong with dying, at the appropriate time.

A mandatory advance directive would be relatively easy to enact, simply becoming an integral part of the application for Medicare/Medicaid. I firmly believe that this would result in substantial savings to the health care system and slow the runaway train of ballooning health care costs.

Do those of you reading this have an advanced directive? Do your loved ones know what you would want done if you were terminally ill? Have you designated a person to be your health care proxy in that event?

I'll get off my soapbox now.
- posted by wanderer @ 1:23 PM
Comments:
It's a good soapbox Wanderer, and one that most of us lay-people do not know about. I think it sounds like a reasonable goal, but how to actually make it happen is yet another story.
# posted by Blogger cruisin-mom : 4/04/2006 2:03 PM
 
You make a great point. I answer in detail in the original thread.
# posted by Blogger Doctor Bean : 4/05/2006 8:46 AM
 
I believe this is a fabulous idea.
# posted by Blogger Stacey : 4/06/2006 7:04 AM
 
Cruisin Mom & Stacey - thank you for your support.

Doc Bean - appreciate your points, I'm sure we'll discuss this further at some point.

goldstone - glad to hear you've got a directive, my wife and I do too. Now if you could only take care of our brethren rioting in Boro Park, I'd be impressed...
# posted by Blogger wanderer : 4/06/2006 3:29 PM
 
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