Tuesday, December 20, 2011

Medical Expenditures - Life v. Death

In a recent essay in the New York Times, Dr. Peter Bach discusses the "worth" of medical care, even if the end result is death.  He cites an example from his medical background of a "middle-aged man" with no reported chronic medical history who appeared in the emergency room with a life-threatening acute illness.  Though close to death, with a grave prognosis, proper treatment was instituted and three weeks later the man left the hospital in apparent good health.  Bach speculates that, had the patient in fact died, many "policy analysts" would have called the expense of those three weeks a "waste of health care dollars."

Bach confuses terminal patients with non-terminal patients is this discussion of costly treatments.  This "middle-aged" man is hardly the same as a very elderly man with a known terminal disease who happens to come to the emergency room with a similar clinical picture.  We all accept the fact that caring for the sick many mean caring for people who may die, but such patients represent a very broad and varying landscape.  The distinguishing factor should not be "people who may die," but "people who may live!"

I have heard no arguments regarding expenditure for saving a life.  The ongoing valid argument concerns expenditure in situations where this probability is, in fact, virtually non-existant.

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