This blog is the combined effort of four senior pastors of different churches. Their desire is to point you toward living a God-centered, gospel-focused, Christian life.

Tuesday, June 12, 2012

The High Cost of Health Care is Worth It

Last week, Newsweek published an article by Amanda Bennett in which she told the heartbreaking story of her husband Terrence’s battle with kidney cancer and his death in 2007.  It was entitled, “Why Did Her Husband’s End-of-Life Care Cost So Much,” and emphasized the high financial cost of his final days of life.

I agree with many of Bennett's concerns throughout the piece, but the underlying assumption of the article is that at some point the cost of trying to keep a person alive becomes too excessive and is even perhaps morally wrong.  Bennett muses:

Would Terence and I have picked hospice sooner had we had someone—or something like a panel—waiting there to help us work through our choices?  I don’t know.  But even knowing the price tag on the care he was getting might have helped him make choices that were consistent with the life he had lived.  The seven-year bill for his care was $618,616.   I believe he would have liked the chance to play a more active role in how we spent enough money to vaccinate 600,000 children in the developing world.  That’s how he would have seen it.

There are a host important things to consider when discussing end-of-life care and it’s emotional and financial cost.  Sometimes our herculean efforts to keep a person alive simply lead to the greater suffering of someone who is certain to die.  Medical care in this instance leads not to continued life but simply a longer death. 

We must also acknowledge there is rampant waste in our medical system that raises the cost of dying.  Tests that are unnecessary are conducted anyway, due to fear of unscrupulous attorneys who prey on grieving families.  The arbitrary nature of our medical costs are highlighted by Dr. Renee Hsia who found that the cost of an appendectomy in California “ranged from $1,500 to an extraordinary $183,000, with the midpoint at $33,000—and no obvious medical reason for the difference.”

My purpose isn’t to wade into the deep waters of a subject I know little about.  Many of you could speak more knowledgeably regarding the cost of health care.  I simply want to highlight this point: the cost we spend to care for a dying person is worth it. 

Yes, it’s expensive.  Yes, we should not unnecessarily prolong someone’s suffering.  But the way we treat those who are dying says something about what we believe about the theology of life.  The care we show those who bear the image of God even in their decaying bodies says something about what we believe about God.

As we consider the cost of caring for the aged or terminally ill, it is important to remember a few things.  First, remember that for most people the cost of dying is distributed among a large group of people through medical insurance.  Not all of us are going to die "expensively," so we share the cost of those who will.  Second, even though the last few months of a person’s life may be incredibly expensive, when you spread the cost of their health care over their entire life, the cost makes more sense.  Third, it is hard to know when we're dealing with end-of-life costs.  It's a case of 20/20 hindsight to say sometimes that a particular treatment was excessive or unnecessary.

Those who criticize the cost of dying like to throw out dramatic statistics that make it seem like a waste of money.  Some researchers estimate that the cost to add a year of quality life is about $145,000.  That means that for a person to go from age 80 to age 81 would cost $1,800 a year over the course of their life.  

If in a family of three, one person developed a life-threatening illness and the family extended that person's life by a year, the cost spent by their insurance company would be about equal to what the family had spent on household cleaning products over the course of that person’s life.  That seems worth it to me.  

But even if this were not the case, I’d still argue that the amount we currently spend to care for the dying is worth every penny.  After all, we’re a people that spend $43 billion on our pets! 

I don't know how to make all the decisions regarding what care to give and when.  I understand that our resources are limited.  We sometimes have to make hard economic choices, such as choosing where to spend research dollars.  The mentality that devalues human life or views high health care costs of the elderly as excessive, however, does not reflect biblical values in my opinion.  The human life at all stages has a unique value that we as believers must champion.  


  1. Thanks for your blog, Daniel. Whenever I've had occasion (infrequent thus far, thankfully) to be hospitalized, there is always the question of a "living will" (it seems to be the second question after, "Do you have insurance?"). To this point, my answer has always been, "No, I don't have a living will, and I want all measures taken to spare my life." I get the strangest looks when I say that. However, my view is that while I or my family can always back off of the high ground, you can never move "up" once you've abandoned such decision making to others.

    This is not to say that there are not good reasons to have a living will. I'm just saying that our culture is moving, it seems to me, at a rapid pace toward the devaluing of life that is deemed, by no absolute or objective measure, "lacking quality of life." The medical world, as good as they are, cannot but be affected by this shift in worldview. I cannot expect that my worldview will be treated with as much care as my body will.

    There are, of course, good reasons when and why heroic and extraordinary measures should not be taken. It tougher to decide this than one imagines, when one is actually in the decision making (as I have been on a few occasions). But my default is always to go for life and find reasons why not rather than default to death and find reasons why not.

    As for costs, I think that the costs of medical care due to liability, government filing requirements, environmental laws, etc. would be stunning, were we to know the true cost. This is a big reason why medical tourism is on the rise. See: to learn more about the phenomenon.

  2. Great thoughts, Scott. The way worldview shapes our care of the ill is very interesting. When I visited nursing homes with Ritch, he would point out the way that theology (or lack thereof) impacted the care shown to residents.

  3. Scott's comment about defaulting or "going for life" is a good general principle, I think, and it can be applied to many circumstances. It should take some pretty strong reasons to land on the side of death when it comes to health care, voting, contributing funds, research, or any number of related topics.

  4. Daniel, thank you for a very thoughtful article on a difficult subject. I applaud loudly your willingness to tackle this subject in the weekly blog. And I applaud more loudly your love for God and the sanctity of human life that drives your thinking.

  5. I greatly agree with your heart for valuing life. I think it should apply to the embryo in it's mother all the way to the death of the elderly as well as everything in the middle including the mentally &/or physically handicapped, but I do have some questions. I feel one of the big reasons for spending money no matter to the cost to keep someone alive is often not based on a theology of life, but rather fear of death. To this end I feel the opposite side of the coin should be addressed. Your main statement of determining life or death was not based on critical life support issues but rather "quality of life." This statement in itself is rather subjective both to the person determining it as well as the state of the individual in need of care as to their mental & physical abilities before & after whatever occurrences brought them to needing health care. I couldn't help but think of Paul in Phil 1:20-26 & was wondering if we could use that as a model. Paul values & longs for death & in it Christ. Yet his "quality of life" was determined by 2 things... 1) fruitfulness in his labor for Christ & 2) the benefit & spiritual growth of others by his help (these 2 may really even be 1). That being said, if we value Heaven & Christ, should we really want to live from "80 to 81" if we cannot use that time to benefit Christ's kingdom & others? (I realize that in your post you were probably referring to someone with a "quality of life" so maybe this question does not apply. However, it was not clear & I feel could lead to great guilt on the part of families who have chosen to terminate life support of loved ones who had no "quality of life" whatsoever or any hope of recovering one in any way.) Just wanted your thoughts on all of this.