Wednesday.....Culture.....Health Care Reform In The Newspaper

The front page of Wednesday's New York Times delved into the world of end of life medical treatment. In a two page article titled Weighing The Medical Costs of End-of-Life Care, two academic analyses are compared. The first revolves around a group of hospitals in California that have earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient's life, and another called the Dartmouth end-of-life analysis. The former takes all statistics, including the patients that survived, into account and the latter considers only the costs of treating patients who have died. Quoting a doctor from the former If you come into this hospital we're not going to let you die. The Dartmouth analysis leads to criticism that these hospitals spend the most on end-of-life care but seem to have no better results than hospitals spending much less. U. C. L. A. doctors point to the fact that Dartmouth only considers the patients who have died, thus their conclusion. Two specific cases are given as examples. In the first, a 71 year old man was referred to U.C.L.A. for, other medical centers might have considered {him} too old for the surgery. The patient not only survived but is no longer considered in active need of a transplant. Quoting the article According to Dartmouth, Medicare pays about $50,000 during a patient's last six months of care by U. C. L. A. where patients may be seen by dozens of different specialists and spend weeks in the hospital before they die. By contrast, the figure is about $25,000 at the Mayo Clinic in Rochester, Minn., where doctors closely coordinate care, are slow to bring in specialists and aim to avoid expensive treatments that offer little or no benefits to a patient. Continuing... By some estimates, the country could save $700 billion a year if hospitals like U. C. L. A. behaved more like Mayo. In the current House bill the Institute of Medicine would determine either to reward or penalize hospitals along this line. The California hospitals call this rationing and caution against real harm that could be done. Another example was given of a 49 year old man who needed a heart transplant. He was initially a good candidate but was deteriorating. The doctors tried every means possible to stabilize him enough for a transplant. They were unable to do so and he died five weeks later at a cost of $300,000. How are doctors to determine in advance which patients will die after five weeks or more of treatment? They cannot, they can't even guess. The only thing they could do is to establish a set of qualifications that must be met to "insure" success. The bar on this criteria will be high. Many would die who could be kept alive for normal lives..but...much money would be saved! If we give the OK to this method, the argument will be given that you could use it in other areas concerning life and death and even quality of life. The health care bill in the Senate right now does not have everything that Progressives want, but it is a start for them...a foundation that most assuredly would be built upon. For this reason, along with the nefarious schemes used to get it passed, the bill should be stopped and serious, legitimate reform of health care started.