Aging as a Medical Emergency

A good column in the NYT on the issue of expensive and intensive care for the elderly:

IN the 1980s, I worked as a respiratory therapist in intensive-care units
in the Midwest, taking care of elderly, dying patients on ventilators. I
remember marveling, along with the young doctors and nurses I worked with, over
how many millions of dollars were spent performing insanely expensive
procedures, scans and tests on patients who would never regain consciousness or
leave the hospital.

When the insurance ran out, or Medicare stopped paying, patients and their
families gave the hospital liens on their homes to pay for this care. Families
spent their entire savings so Grandma could make yet another trip to the
surgical suite on the slim-to-none chance that bypass surgery, a thoracotomy, an
endoscopy or kidney dialysis might get her off the ventilator and out of the
hospital in time for her 88th birthday.

That was back in the mid-’80s, when the nation was spending around 8
percent of its gross domestic product on health care. I and other health care
workers solemnly agreed that the spending spree could not continue. Taxpayers
and insurance companies would eventually revolt and refuse to pay for such
end-of-life care. Somebody would surely expose the ruse for what it was: an
enormous transfer of wealth based on the pretense that getting old and dying is
a medical emergency requiring high-tech intensive-care intervention and armies
of specialists, which could cost $10,000 or more per day. (Europeans have so far
resisted this delusion, one reason they spend much less than we do on health
care, with far better results.)

But we were wrong.