Weighing Medical Costs of End-of-Life Care

http://www.nytimes.com/2009/12/23/health/23ucla.html?_r=1&hp

---------- Forwarded message ----------
From: barry levine 
Date: Wed, Dec 23, 2009 at 10:29 AM
Subject: re: Weighing Medical Costs of End-of-Life Care
To: letters@nytimes.com


To the Editor:

    Half a year into the debate on health insurance, we still pretend that that debate is about healthcare. Now when we talk about end-of-life decisions, you characterize that as a discussion of "costs" as if that were different. Dr. Patrick T. Dowling gets to to the heart of the matter: "The more tubes you put in, the more you get paid".  The American healthcare system is therefore geared to do ever more and more, and charge ever more and more, quite independent of what's best for the patient.  Adam Smith taught us 200yrs ago that the incentives are the system. As long as the U.S. keeps a fee-for-service model for our physicians, our healthcare costs will continue to rise, until they consume our entire economy.

Barry Levine