End-of-Life: Rationed Care or Rational Care (part I of a 5 part series) To make money, we lose our health, Then to restore our health we lose the money. We live as if we are never going to die, And we die as if we have never lived. Anonymous Politicians have returned to Washingtonafter their summer recess. The time for slogan-slinging is over. Now the hard work begins for politicians as well as those in the health-insurance and health-delivery systems. One of the clichés in the healthcare debate which peaked during the recess, related to the sensitive issues of end-of-life care and the rationing of medical-care. These issues converge sharply for patients terminally ill with cancer, the second most common cause of death in the U.S. This is, by no means, a new issue. It has merely been brought to the forefront by the current debate. We would all be remiss if we do not use this opportunity to educate ourselves about the issues involved. While the following discussion provides a factual grounding of the issues as related to cancer, the conditions also apply to the over-all issue of end-of-life care. In the USA, cancer afflicts one in three individuals, and three of four families will be affected by the disease. A quarter of all cancer victims deplete their savings during treatment of the disease. The direct cost of treating cancer is about $90 billion annually. Yet 25% of all treatment costs are incurred in the last month of life. It is common knowledge that the vast majority of cancer patients have little quality of life in their final months. They are generally confined to bed, their main physical activity being limited to visits to the doctors' office or to the hospital for blood or X-ray tests or to be admitted. Need for a different mind-set is vital -- part 2 of 5 next
