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Why Doctors Die Differently
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Ken Murray, a retired family medicine professor at the University of Southern California, describes how doctors address the option of prolonging life when the prospects of survival improve say from 5% to 15%. The choice is based on the human need to find closure in an atmosphere that gives comfort, a sense of peace and a sense of place with home and family, with hospitals not deisnged to and not able to perform that role. Murray gives the example of his cousin Torch, who he says was born at home by the light of a flashlight, who decides to not choose aggressive treatment, which would have prolonged his life for no more than 4 months. Instead he spent the next 8 months with family and did everything he could do with the 8 months that made for quality of life, rather than just choosing quantity in and out of hospitals. He died peacefully in his sleep. The heroics in and out of hospitals would actually have deprived the patient of the opportunity to reach a sense of closure that comes from the comfort of home, family, and arriving at a sense of peace.
Developing new solutions to the problem of escalating health care costs in the U.S.
01/31/2008
New solutions are being developed and new ideas being tried to bring down health care costs. In many case quality can improve at lower cost or the similiar results delivered for lower cost with some other advantages inpatient focussed healthcare that improve outcomes. Pricing of pharmaceutical products and healthcare services as the major unsolved problem in the U.S.
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The need to find closure to life in an atmosphere of comfort, peace and home, and how hospitals cannot provide this. The better choice of doctors who choose quality over quantity of life- when the odds of surviving move up dramatically, say from 5% to 15% by using technological advances, but are still very low. The issue is also one of spiralling costs for an aging populaton in the U.S., when one of the options being considered is dismantling of Medicare as it was known in the years since 1950, or cutting Medicare services when they are most needed.
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The cost to Medicare of prolonging life when there is little or no hope and quality of life has deteriorated upto a point where the patient gains little from extending life for a few months. Estimates show a large part of Medicare, as much as third takes place in the last year of life, and a large part of that in the last month. With the option of cutting Medicare services or dismantling Medicare as it was known in the years since 1950 because of spiralling costs, this is an issue that needs to be addressed for Medicare solutions.
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