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Life Health > Long-Term Care Planning

One-quarter of Medicare funds spent on the dying

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Each year, Medicare spends about a quarter of its budget on the treatment of terminally ill patients. Last year, Medicare consumed some $528 billion in total or 13.3 percent of the federal budget, which is why the program figures so prominently in federal budget negotiations. If changes to the program aren’t made, that figure is projected to increase 7 percent per year for 10 years as baby boomers pour into the system, according to the Centers for Medicare & Medicaid Services.

In a study of Medicare records spanning the years 2003 to 2007, researchers at Dartmouth College found that while there is a trend toward providing end-of-life care in hospice settings, those who do live out their days in intensive care do so for longer periods than in previous years. Some of these patients receive care that they either do not need or that will provide no benefit.

Caught in the middle of the partisan debate over what to do with out-of-control spending on Medicare are issues such as the availability of hospice care in any given region and the demands of patients’ family members for costly treatments regardless of the outcome. Complicating matters is the public’s stance against cutting Medicare; a recent Washington Post-ABC News poll found 78 percent opposed to cutting the program to help balance the federal budget.

While it may be understandable that family members of dying patients want doctors to do everything possible to save their loved ones, the entire health care system would benefit from a more honest and practical approach to the treatment of terminal seniors. As the Dartmouth study authors put it, “in addition to its effects on patients’ quality of life, unnecessarily aggressive care carries a high financial cost.”


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