The New York Times reports in ni “Building a Better Valve”.
“With his smooth, fleshy face and twinkly eyes, Herbert Auspitz, 93, had an air of vigor, but he was fading fast. He had a fatal disease with a prognosis worse than that of most cancers: severe aortic valve stenosis. It is a narrowing of the valve that controls blood flow from the heart. There is no way to prevent it, and there are no drugs to treat it.
“Until recently, his fate would have been sealed. His doctors thought he was too likely to die if they cracked open his ribs and stopped his heart while they cut out his old valve and sewed in a new one.
“This time, they had a new option. They were able to replace his valve using a method recently approved by federal regulators for people who are inoperable or at high risk from open-heart surgery. His cardiologists, led by Dr. Howard C. Herrmann, inserted a new valve made from the lining of a cow’s heart through a catheter, then opened it like an umbrella.”
Later the article notes:
“And the procedure is costly. Dr. Reginald Blaber, who runs the cardiovascular disease program at Our Lady of Lourdes Medical Center in Camden, N.J., said the hospital lost money when it used the valves, although it offers the procedure so it can give patients the best treatment.
“ ‘It’s a hard proposition when $32,500 goes right out the door to Edwards,’ the valve manufacturer, he said. The hospital gets about $40,000 fromMedicare, which is fine if there are no complications. But older patients, in their late 80s and 90s, often end up with four-, five- or even seven-day hospital stays. ‘We could lose $25,000,’ he said.”
If the hospital lost money, it was small beans compared to the cost to Medicare and the nation’s health system. The entire procedure likely cost well over a $100,000. Is this the type of intervention for the extreme elderly that our nation can afford?
People 80 and over already consume 33% of Medicare expenditures in 2011.
And what about the cost effects on Social Security and other elderly support systems?
We are not suggesting that the USA follow the ancient course of some Native American tribes of expelling elderly widows to cope for themselves, but there has got to be a point in life whereby when extraordinary medical expenditures will not be provided at the expense of tax payers.
As it is now, 18% of Gross National Product goes to health care, as compared to an average of 10% in other advanced nations which, incidentally, have higher rated health care systems. It is predicted that the 18% will increase in future years to well over 19%.
The difference of 8% reflects why we can not afford to build high speed transportation, today’s equivalent of the Interstate Highway System. Hell, we can hardly afford to maintain our roads!
Infrastructure built decades ago is now crumbling for want of repair and replacement. When driving, look down at the pot holes and rough surfaces and look up at the rusting bridge structures.
Some schools can’t even afford books, let alone lap tops!
Nor do we provide pre-school education for youngsters from two to kindergarten age as do other advanced nations, a far better use of that $100,000 than prolonging the life of an octogenarian.
It is wonderful that people have an opportunity to live longer. But as we all benefit from society throughout our lives, we must also accept that the time will come when society will no longer intervene with Herculean efforts on our behalf.
There is a time to come. But there also is a time to go. We all must come to understand that.
I can’t believe I’ m even reading this question – ” How much should our nation’s health care system spend on a 93 year old?”
Assuming the old guy wants to live (which is often not the case), why would we ever deny a taxpayer their right to life-saving healthcare? We have no problem providing healthcare and even sex-change operations for people convicted of murder, rape, arson, and other horrible crimes. If we’re going to cut off life support, let’s put their pictures on TV and vote who gets the money.
I can hardly believe you’re worried about lap tops for schools over healthcare. Do you really think Johnny can’t read because words are on paper instead of an LCD screen?
Here’s a thought for the U.S. (if we’re going to start deciding who gets life-saving healthcare) – why don’t we take a page from the Chinese and harvest a kidney from all our lifers in prison?
The $100,000 procedure is in my opinion money well spent as long as his prognosis was good and he had some type of meaningful life after the procedure. If he just ended up a vegetable with a good heart again like I have seen happen to so many elderly heart patients undergoing bypass surgeries then it was the typical heart surgeon “good outcome’ with no consideration of post-op quality of life.
Perhaps a better way to look for savings would be the Republican giveaway of Medicare D, a government handout to the pharmaceutical industry, the people behind the outcomes of elderly being placed on literally dozens of medicines they don’t need and some doing more harm than good. An example, the off-the-box prescribing of anti-psychotics en masse to elderly nursing home patients when it is well known one of the adverse outcomes is increases in falls and fractures costing millions of dollars in emergency procedures to frail elderly who generally don’t recover well from these traumas.
I also seriously doubt the hospital lost money on the procedure, they inflate so much of their billing to compensate.