Dr. Albert Woo, a professor at the Johns Hopkins University's Bloomberg School of Public Health, says it's not that easy. In the mid-1990s, he and other researchers tracked thousands of patients at several hospitals who had been given six months to live.
While on average the group did indeed survive six months, "for any individual person, the results were very hard to predict," Woo says. "Is care futile? It's very difficult to figure out. The person could live for six months, or the person could live for a year and a half."
Or longer. At some point, after all, we're all terminal.
Woo thinks doctors can save taxpayers money and show more compassion at the same time by communicating better. Some critically ill patients don't want heroic, expensive measures, but the doctors provide it anyway. In the 1990s study, only 47 percent of the physicians knew when their patients didn't want cardiopulmonary resuscitation, or CPR.
The larger solution is to stop paying for ineffective or unneeded procedures among all patients, not just the dying, Woo says. Woodlawn's Centers for Medicare and Medicaid Services are chock-full of underused data on what works and what doesn't for operations such as tonsillectomies, hysterectomies and prostatectomies.
"Is it time to start rationing care?" Woo says. "I think we should ration care by whether or not treatments are effective."
Easy to say. Madelyn Dunham's hip operation, one could argue, was effective. The new hip worked two weeks and then, Obama told The Times, "things fell apart" and his grandmother veered toward death.
One person's ineffective medical treatment is another person's inalienable right. The dollars spent on end-of-life care are about to balloon as baby boomers start dying in greater numbers. The first boomers become eligible for Medicare in two years.
Things can't go on as they are, and only one thing is for sure.
"When it comes to Medicare and Medicaid, where taxpayers are footing the bill," Obama said, "we have an obligation to get those costs under control."
