the policy conceit that spending money on patients who die is a waste overlooks the core purpose of health care — to prevent or forestall illness, disability and death among patients at risk of those outcomes.
It also overlooks a key correlation in health care. When people get sicker, they need more intensive — and expensive — health care services. But when they get sicker, they are also more likely to die. When I met my patient, I took him to the intensive care unit, the second-most-expensive place per minute in any hospital. The other place he went, twice, was the operating room — the most expensive place.
Healthy people, who are unlikely to die, are also very unlikely to find themselves in those settings. Thank goodness.
Thus, spending will always be concentrated on people who are the sickest. When one examines spending on patients who die, dollars will be concentrated there, too.
I am not saying that every health care dollar is well spent. But five carefully done studies have now shown that hospitals that spend more on caring for sick patients have better outcomes than those that spend less. So some of the spending is improving health.
via www.nytimes.com
