A few excerpts from his piece:
As 25-30% of Medicare spending occurs in the last year of life, end of life care has become a rising issue in health care policy debates. End of life scenarios often place the ICU physician in the position of persuading designated surrogates of the patient to—after consulting the patient’s living will and stated wishes—withdraw care and allow the patient to succumb to their illness...But you should read the full text.
The growing fiscal burden of the program, not surprisingly, raises concerns regarding the costs and efficacy of the treatments paid for by Medicare. End of life care often takes place in ICUs and employs expensive state-of-the-art technology. Yet, in certain contexts, these advanced therapies are unable to alter the course of illness. Family members of gravely ill patients may have religious, financial, or other reasons to continue care and when an unseen 3rd party is responsible for the bill, costs of care are not a factor...
It is the increasingly socialized atmosphere of medicine that has created this scenario that puts physicians in a financial stewardship position creating a conflict with their role as an advocate for their patients. In any system where government pays for end-of-life health care, it will inevitably have to decide who receives it or not. In a free market, in which individuals control their own health care spending, individuals make these decisions for themselves...
