The Cost of Dying

    • November 22, 2009

The Cost of Dying,” which aired Nov. 22 on CBS News’ 60 Minutes, explores the extraordinary amount of money spent on medical care at the very end of people’s lives, citing research funded in part by the Robert Wood Johnson Foundation

In 2008, Medicare paid $50 billion for doctor and hospital bills during the last two months of patients' lives—with as much as 20 to 30 percent deemed to have had no meaningful impact, Steve Kroft reported.

Dr. Elliot Fisher of Dartmouth's Institute for Health Policy and Clinical Practice explained how as many as one-fifth of Americans end up dying costly deaths in intensive care units because "it's the path of least resistance" - the easiest way for doctors to manage them.

Because of the way the system is set up, he said, “primary care physicians don't have time to spend an hour with you, see how you respond if they wanted to adjust your medication. So the easiest thing for everybody up the stream is to admit you to the hospital. I think 30 percent of hospital stays in the United States are probably unnecessary given what our research looks like.

The report explored the human as well as financial costs of such a system. "Families cannot imagine there could be anything worse than their loved one dying," said Dr. Ira Byock, who heads the palliative care program at Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, NH. "But in fact, there are things worse. Most generally, it's having someone you love die badly - dying, suffering, dying connected to machines."

Many people are not aware there are alternatives to such expensive and prolonged death, he said.