My friends in medicine tell me that a large portion of the health-care dollars that a person consumes over the course of his or her life is consumed in the last six months of life. Part of the problem is that people with insurance are insulated from the costs of their decision whether to continue treatment even when there is little hope of recovery. While an economist might propose bribes to the patients (or their families) to encourage them not to undergo costly treatments that have a low probability of success, much of society would be morally uncomfortable with the idea of paying people to forgo potentially lifesaving treatment. Why not have a different type of side payment whereby a terminally ill patient who chose to forgo treatment would be given an allowance equal to some percentage of the cost of the forgone treatment that he or she could donate to some charitable cause? The trade off could be characterized as life for life instead of life for money. The terminally ill person might lose his or her life some months earlier than he or she would have had he or she continued to receive treatment, but the reallocation of resources to the charitable cause could save several lives (literally or figuratively). The terminally ill person would be better off because he or she would have an opportunity to have some good come from giving up the fight; society would be better off because scarce resources would be allocated to more efficiently help people and even the insurers would be better off because they could keep the remaining amount that is not included in the allowance that otherwise would have been spent on treatment.
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The theory is there, but even if society accepted the trade off, the drug companies wouldn't, if people were using less drugs then they would just increase the price of them, so in the end the cost would remain the same.
The problem is real. There is already a substantial inducement in the form of hospice services. When medical judgement determines that a person is within 6 months of death, a person may agree to accept palliative and comforting care in the place of efforts to prolong life. This makes the person eligible for stronger narcotics and provides extra coverage of the costs. It has been available from Medicare for many years. Probably it would benefit from more publicity.
I doubt that the economic interpretation is adequate in this case. It ignores non-economic costs to the dying patient. Most of the expensive methods to prolong life are also quite unpleasant. They may be worth enduring if the result will be a greatly improved quality of life. If they only add a few months of lying in bed with attached tubes, they may not be worth it, no matter who pays.
It is an interesting piece of black humor that the value of a life to a person is calculated in money by people with bean counter minds. Of course money is involved but the values of an extra week or day or even minute to a patient who understands the true value of being alive, of sensing light and sound and touch and the love of people close cannot be calculated in money. It is one of the unfortunately disgusting elements of a culture that tries to tie the essential values of being alive to what can be held in a wallet that makes me despair over humanity.