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What can we do about death? Reinventing the American medical system
Date:5/31/2011

fordable Care Act might ease the financial burden of this system, but not eliminate it. It reports, for example, that the cost of Alzheimer's disease is projected to rise from $91 billion in 2005 to $189 billion in 2015, and to $1 trillion in 2025 twice the cost of Medicare expenditures for all diseases now.

"We need to change our priorities for the elderly. Death is not the only bad thing that can happen to an elderly person," the authors write. "An old age marked by disability, economic insecurity, and social isolation are also great evils." They endorse a culture of care, not cure, for the elderly, with a stronger Social Security program and a Medicare program weighted toward primary care that supports preventative measures and independent living.

Callahan and Nuland point the way to a more sustainable path that reprioritizes the entire system. Among their recommendations:

  • improve medicine at the level of public health and primary care, while reducing its use for expensive high-tech end-of-life care;

  • shift resources for the elderly to greater economic and social security and away from more medical care;

  • subsidize the education of physicians, particularly those who go into primary care, and decrease medical subspecialization;

  • train physicians better to tell the truth to patients about the way excessively aggressive medicine can increase the likelihood of a poor death;

  • shift the emphasis in chronic disease to care rather than cure;

  • conduct a top-down, bottom-up, long-range study of the entire American system of health care, including the training of physicians, with a view toward reconstituting it along systematic lines that take science, humanistic concerns, economics, and social issues into account.


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Contact: Michael Turton
turtonm@thehastingscenter.org
845-424-4040 x242
The Hastings Center
Source:Eurekalert

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