Kurt Ullman wrote in
:

Ran across this article, Han,
http://www.thirteen.org/bid/sb-howmuch.html

Among the highlights:
Medicare did a major analysis of end-of-life spending trends in 1993,
looking at data for 1975, 1980, 1985, and 1988. Gerald Riley, Medicare
actuary, conducted the analysis with colleague James Lubitz and
published it in the 1993 New England Journal of Medicine. They found
no evidence that elderly persons in the last year of life account for
a larger share of Medicare expenditures today than before the
onslaught of technology. In fact, Medicare paid the exact same
percentage for patients in the last two months of life in 1976 as in
1988.
€ 27 to 30 percent of Medicare payments cover the cost of care
for
people in the last year of life.
€ 40 percent of Medicare dollars cover care for people in the
last
month.
€ 12 percent of Medicare spending covers people who are in the
last
two months.
€ 10 percent of Medicare beneficiaries account for 70 percent
of
program spending.


Dr. Riley reappeared last year in Health Services Research. Using the
Continuous Medicare History Sample, containing annual summaries of
claims data on a 5 percent sample from 1978 to 2006, he found the
share of Medicare payments going to persons in their last year of life
declined slightly from 28.3 percent in 1978 to 25.1 percent in 2006.
After adjustment for age, sex, and death rates, there was no
significant trend.

Health Serv Res. 2010 Apr;45(2):565-76. Epub 2010 Feb 9.
Long-term trends in Medicare payments in the last year of life.
Riley GF, Lubitz JD.

Thanks for the references, and the data! Seems to confirm that it is
expensive to be sick, and that afterwards you still die ... So the
question needs to be restated - and it is definitely a selfish question -
should people be encouraged to limit their use of the most expensive
forms of care in their last moments? Something everyone needs to
consider, IMO.

--
Best regards
Han
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