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.