HARD-HEARTED PRAGMATISTS SAY that the U.S. spends far too much on expensive and largely futile medical treatments for terminally ill patients. One number often cited in the media and elsewhere: 30% of health-care dollars are spent in the last six months of life. It follows that tens of billions of dollars could be saved by eliminating heroic measures for people who are bound to die in any case.
IN REALITY, patients in life's last year account for only about 10% to 12% of U.S. health-care outlays. That's a recent estimate in The New England Journal of Medicine by Dr. Ezekiel Emanuel and Dr. Linda Emanuel of Harvard Medical School. True, about 30% of Medicare spending goes for the last year of life--but Medicare covers only people over 65, who have a much higher death rate. Beyond that, it may be hard to reduce spending on dying patients, note the two doctors, because "humane care at the end of life is labor-intensive and therefore expensive."EDITED BY LARRY LIGHT AND JULIE TILSNER By Michael J. Mandel