NCPA - National Center for Policy Analysis

Panel Urges Overhauling Health Care at End of Life

September 23, 2014

The country's system for handling end-of-life care is largely broken and should be overhauled at almost every level, a national panel concluded in a report released on Wednesday, according to the New York Times.

According to some, the system is geared toward towards simply doing more toward the end of life which can be costly and not consistent with what the patients actually want. A report by a nonpartisan committee that was appointed by the Institute of Medicine has some recommendations for dealing with end of life care:

  • First, Reimburse health care providers for conversations on advanced care planning.

  • Restructuring Medicare, Medicaid, and other health care delivery programs.

  • Eliminate perverse financial incentives that encourage expensive hospital procedures when low-tech services like pain management and home health care are available.

  • Finally, accredited medical schools and groups as well as health providers should greatly increase training in palliative care.

Some recommendations, like changing the reimbursement structure so that Medicare would pay for home health services would require congressional action. In all, however ,the 507-page report, titled "Dying in America," said its recommendations would improve the overall quality of care and save a significant amount of money for our health care system.

Some critics argue that end-of-life choices that stem from the standpoint of economic savings would prompt the medical establishment to pressure people into rejecting life-sustaining treatment. However, in a survey of doctors about their own end-of-life care, many wish to be at home and simply free from pain. The conclusion of the study would not necessarily prompt premature deaths, but instead provide more choices for an increasingly diverse set of wants from a growing American population.

To accommodate this shift to more end-of-life planning, higher health education needs to be completely revolutionized to teach more palliative care skills and teaching. As it stands, many doctors are uncomfortable or ill-equipped to deal with the subject.

Source: New York Times, "Panel Urges Overhauling Health Care at End of Life," September 17, 2014.


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