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NYT: Too Much Money Is Wasted On Old

From the ‘death panel’ lobbyists at the New York Times:

Weighing Medical Costs of End-of-Life Care


December 22, 2009

LOS ANGELES — The Ronald Reagan U.C.L.A. Medical Center, one of the nation’s most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient’s life.

“If you come into this hospital, we’re not going to let you die,” said Dr. David T. Feinberg, the hospital system’s chief executive.

Yet that ethos has made the medical center a prime target for critics in the Obama administration and elsewhere who talk about how much money the nation wastes on needless tests and futile procedures. They like to note that U.C.L.A. is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less.

Listening to the critics, Dr. J. Thomas Rosenthal, the chief medical officer of the U.C.L.A. Health System, says his hospital has started re-examining its high-intensity approach to medicine. But the more U.C.L.A.’s doctors study the issue, the more they recognize a difficult truth: It can be hard, sometimes impossible, to know which critically ill patients will benefit and which will not.

That distinction tends to get lost in the Dartmouth end-of-life analysis, which considers only the costs of treating patients who have died. Remarkably, it pays no attention to the ones who survive.

Take the case of Salah Putrus, who at age 71 had a long history of heart failure.

After repeated visits to his local hospital near Burbank, Calif., Mr. Putrus was referred to U.C.L.A. this year to be evaluated for a heart transplant.

Some other medical centers might have considered Mr. Putrus too old for the surgery. But U.C.L.A.’s attitude was “let’s see what we can do for him,” said his physician there, Dr. Tamara Horwich.

Indeed, Mr. Putrus recalled, Dr. Horwich and her colleagues “did every test.” They changed his medicines to reduce the amount of water he was retaining. They even removed some teeth that could be a potential source of infection.

His condition improved so much that more than six months later, Mr. Putrus has remained out of the hospital and is no longer considered in active need of a transplant.

Because Dartmouth’s analysis focuses solely on patients who have died, a case like Mr. Putrus’s would not show up in its data. That is why critics say Dartmouth’s approach takes an overly pessimistic view of medicine: if you consider only the patients who die, there is really no way to know whether it makes sense to spend more on one case than another.

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 benefit to a patient.

“One of them costs twice as much as the other, and I can tell you that we have no idea what we’re getting in exchange for the extra $25,000 a year at U.C.L.A. Medical,” Peter R. Orszag, the White House budget director and a disciple of the Dartmouth data, has noted. “We can no longer afford an overall health care system in which the thought is more is always better, because it’s not.”

By some estimates, the country could save $700 billion a year if hospitals like U.C.L.A. behaved more like Mayo. High medical bills for Medicare patients’ final year of life account for about a quarter of the program’s total spending.

Under the House health care legislation pending in Congress, the Institute of Medicine would conduct a study of the regional variations in Medicare spending to try to determine how to reward hospitals like Mayo for providing more cost-effective care. Hospitals identified as high-cost centers might even be penalized, perhaps receiving lower payments from the government. The Senate bill calls only for studies of Medicare spending variations, so it will be up to House-Senate negotiators to resolve the matter in the final legislation.

That prospect worries Dr. Rosenthal and his U.C.L.A. colleagues, who say that unless the distinction can be clearly drawn between excellence and excess in medical care, efforts to cut wasteful spending could be little more than blunt rationing.

“There’s a real risk of doing harm here — real harm,” he said.

Indeed, U.C.L.A. and five other big California medical centers recently published their own research results with a striking conclusion: for heart failure patients, the hospitals that spend the most seem to save the most lives…

This is a typically overlong and meandering New York Times piece. But you get the point.

Somebody needs to decide who all this medical money gets spent on. And of course it should be liberal Democrat bureaucrats.

After all, who else can be counted on to consider the life of a decrepit New York Times employee to be more valuable than a productive member of society?

This article was posted by Steve on Wednesday, December 23rd, 2009. Comments are currently closed.

11 Responses to “NYT: Too Much Money Is Wasted On Old”

  1. Right of the People says:

    Here come the death panels, here come the death panels!

  2. pagar says:

    Never thought I would see “productive member of society” and ” New York Times Employee” used in the same sentence.

  3. proreason says:

    Too much money is wasted on pompous, stupid, lying Slimes reporters.

  4. Reality Bytes says:

    Tell ya what, get on a first name basis with these folks like I have & then let’s see who’s willing to pull their plug. I have! Obama doesn’t have the guts! He’s too busy impressing himself – such a sorry bastard (oops, did that hit too close to home?).


  5. 12 Gauge Rage says:

    What goes around comes around. One day these proponents of get rid of all the old people will be old themselves. And if they think that they’ll receive any partiality when they’re old because they pioneered the system of deciding who lives and dies, they’re in for a rude awakening. For the young people they train to take over will turn on them just as well.

  6. caligirl9 says:

    A great deal can be told about a society by the way it takes care of pets, children and old people. The United States sucks. We take better care of illegals and deadbeat career welfare recipients …and that’s nothing to be proud of!

    • Liberals Demise says:

      Well said!!

    • jobeth says:

      Caligirl…as usual…you hit the nail on the head.

      It’s those who have no usefulness to those in power.

      The old…and we can add the innocent unborn…Yet these same people will argue we shouldn’t put to death those who have killed and maimed others.

      Guess those people are able to be bought for their “talents” against the old and innocent. That’s always handy to have around (sarc)

      BTW…A special “Merry Christmas” to you and yours. Hope your family is all safe and healthy. I will drop you an email as soon as I can. Lots have been going on here…but it all turned out blessings in the end.

  7. Media_man says:

    It’s very true that we spend a huge amount on end of life care relative to other developed countries with socialized medicine, but I don’t consider that a bug, but a feature. If we can fund quadruple bypass operations for 90 year olds I think that’s a good thing. By all means lets continue this, but invest in the technology that would bring down the cost.

    How do the Democrats figure this will be a political winner? I don’t get it. They’ve been demagoging this for decades now and suddenly they discover healthcare for Senior citizens is expensive?

    Oh well. When your political enemy is committing suicide, just get out of the way.

    • proreason says:

      “How do the Democrats figure this will be a political winner?”

      It’s satanic calculus….here’s what they think.

      They plan to give amnesty to 20 million illegal aliens whose average age will be about 25 years. They will get 95% of that vote because it’s a huge giveaway.

      They know they will lose the votes of some of 50 million senior citizens…..say 40%.

      But do the math:
      – 20 million illegal aliens times 55 remaining years times 95% is about a billion votes.
      – 50 million seniors times 15 remaining years times 40% is 300 million votes.

      They gain 700 million votes over the next 55 years….enough to swing almost every election in that period.

      And that also explains why they have zero interest in keeping seniors alive. The faster seniors die off, the more power they acquire.

      Like I said….satanic calculus.

    • Liberals Demise says:

      WOW pro, that’s deep!!

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