End-of-Life Care Not to Blame for Increased Costs

In this information age, there certainly seems to be a large amount of misinformation.  One of the more persistent myths, is that the high cost of end-of-life care for the elderly represents a financial threat to the health care system.  According to a recently released study by the International Longevity Center-USA, "Myths of the High Medical Cost of Old Age and Dying," it is simply not true that the aging of Americans and over aggressive care at the end of life are major causes of increasing health care costs in the United States.

According to the report, studies that have looked at the causes of increased health care spending conclude that as little a 5 percent of the increase may be attributed to the aging of the population, the other 90 to 95 percent resulting from other causes.

Many have predicted that the already high cost of caring for seniors will skyrocket in the next tewenty years as the oldest baby boomers start reaching age 85. The new report suggests that this is not necessarily true, particularly if better health care can reduce the prevalence of chronic disability as it has in the past. For example, the incidence of chronic disability among seniors decreased  by 6.5 points over the period between 1982 and 1999.  The mere fact that full recovery from stroke and heart failure is now so prevalent, suggests that mere extrapolation from the past regarding disability or related health care cost is likely to lead to wrong conclusions.

While studies do show a high percentage of Medicare costs going to care during beneficiaries' last year of life, further examination shows that this is not necessarily due to over-aggressive care.  Moreover these costs as a percentage of overall Medicare spending have remained remarkably stable over the years. 

Finally, any estimate of actual costs is without regard to the financial contribution the elderly have made directly and indirectly over their lives, which contributions serve to stabilize and moderate costs for others.  Through premiums, taxes, charitable contributions, and direct payment for medical care, the elderly have supported the health care system for an entire life, contributing to a system that benefits everyone, whatever their age.  

Of course, the elderly, and advocates for the elderly, are sensitive to any suggestion that it is the elderly who over-burden the health care system, because they appropriately fear that health care will not be available when they most need it.  Particularly given that it is their financial contribution over a lifetime that supports the health care system, any suggestion which hints at rationing care for the elderly seems fundamentally unfair.  Perhaps a healthy dose of truth will put the myth, and the fear, to rest. 

To download or purchase the entire report, go here; for more information about (or from) the International Longevity Center- USA go to http://www.ilcusa.org/.