Death can’t be prevented, only delayed.
I would say EOL care is for making your last days as pleasant as possible for you and (a bit less so) those who care about you.
As an example, “overtreated to the max” may mean replacing “a few days to talk with family, sitting in the sun” by “a few weeks being sedated undergoing various invasive procedures”. I think that, if the choice were that clear, few people would choose the latter.
Watching my grandparents’ experiences (and our dog’s) gave me great perspective on the topic. One of four grandparents “got it roughly right”; the other three suffered extensively.
And sure, I think most people would argue it's not worth spending another $500,000 treating a terminally ill patient with a 0% chance of survival.
But often the chance isn't 0%, it might be 15%. So if it's your loved one who has stage 4 cancer and the doctor says "it's going to cost a lot of money and only a 15% chance we'll cure the cancer", not many people will say "meh... those odds aren't good enough, so lets just put grandpa in a hospice and let him go"
Here is an example: https://www.tecentriq-hcp.com/urothelial-carcinoma/clinical-...
For people with cisplatin (chemo) resistant metastatic (spread through the body) bladder cancer, if you treat with immunotherapy only 6% achieve complete response (cure). The other 94% has a partial response (which means they progressed) or no response at all. So they would likely die of their cancer relatively soon.
Lots of cancer drugs are like that.
Immunotherapy is expensive. Is it worth spending $250,000+ on cancer drugs for a 6% chance of a cure?
Why bother? That's a good question. I think the answer is "because 5% will be cured and another 20% will have some response which means they may live another few years."
But the problem is, you won't know who benefits and who doesn't. So do you deny everyone a chance at a 5% cure of 20% chance of a longer life? No, you treat everyone and see what happens.
The UK government put a price of ~25,000GBP per year of life (quality adjusted). So even if people are cured there is value in extending years of life.
This is a resource allocation problem. People (whether individually or collectively) work to create things of value and direct some percentage of that to medical treatment. If that is wasted in rare cases, that’s unfortunate but we accept some amount of imperfection. If it’s wasted in a lot of cases, many other people will go without needed care who didn’t have to if we allocated that spend more effectively.
How could not money pay part in this? If the continued care costs, let's say $10,000/month (not unusual for the US) and you have 1:1000 chance to live that month, it means this month has cost $10 million dollars. Who is going to pay for that? In fact, taking all this money for yourself, the healthcare for other people will need to be reduced which can lead to shortened life expectation for those people.
That remark sounds odd to me. "EOL care" is provided to people who are at end-of-life, by definition. And neither EOL care nor anything else can "prevent" death.