END OF LIFE

Two reports from the ACC News Digest, juxtaposed, nicely indicate the sickness pervading our health care system and the underlying mindset that permits it to continue:

NYTimes Highlights Poll Showing Popularity Of Massachusetts’ Healthcare Law.

The New York Times (6/10, Subscription Publication) editorializes, “Discount most of what you hear from Republican critics about the alleged failures of health care reform in Massachusetts, the template for the national reform law,” because according to “a poll by the Harvard School of Public Health and The Boston Globe” 63% of state residents “supported the state reforms, up 10 percentage points from 2009. Only 21 percent opposed it.” The Times concludes, “The most important takeaway from the poll is that after five years of real-life experience, support for reform in Massachusetts is strong and growing stronger. Support for the national reform is apt to follow the same trajectory.”

HHS Data Show Uninsured Typically Leave $49 Billion In Unpaid Health Bills Annually.

USA Today (5/10, Kennedy) reports, “Uninsured Americans — including those with incomes well above the poverty line — leave hospitals with unpaid tabs of up to $49 billion a year,” according to a study released by the Department of Health and Human Services. On average, the study found that uninsured families “pay only about 12% of their hospital bills in full.” Researchers also found that most “uninsured people have ‘virtually no’ savings and that about a third have no financial assets.”

As to the first, I think the “most important takeaway from the poll” is that people receiving much more in value from a system than they’ve paid in will, of course, favor a policy that supports this, regardless of its sustainability. The second is self-evident.

This past weekend I rounded on two patients in their nineties with end-stage heart disease (among other problems), snatched from the jaws of death at great expense. They are not very functional, and will live, at most, a short time longer, while the families continue to struggle even with the idea of giving them “do not resuscitate” status. In years past, such individuals would have died quickly, and peacefully.

Two questions come to mind: How long can the current bankrupt system continue to underwrite such extravagance? And would these same families be as quick to want “everything” to be done for their loved ones under such dire end-of-life circumstances if they were the ones footing the bill?

Things to think about.

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