Comment by kelseyfrog | Hacker News Reader

Comment by kelseyfrog | Hacker News Reader

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End of life counseling became a political third rail when it was rebranded as "death panels" by Sarah Palin in order to delegitimate the ACA. Since then, it has been avoided as a topic of public discourse by the media.

Discourse around death in general makes people queasy. We tend to avoid the cognitive dissonance between the idea that supplying less end of life care would dramatically reduce medical expenses and the idea that all people deserve the best chance at life[1]. We are similar avoidance when MAID is discussed specifically because we know incentives and values clash.

1. this could probably be phrased better. sanctity of human life and dignity if human life don't quite fit because those are meager at EoL and value of human life sounds a but off.

> supplying less end of life care would dramatically reduce medical expenses

This is a myth.

  [Those] with a high chance of dying accounted for only 5 percent of total Medicare spending, and among them about half survived in any case

  total spending on end-of-life care is only 9 percent of the total cost of health care.

9% of $4.3 trillion is $387 billion. That’s a pretty dramatic reduction.

Unfortunately that figure contains selection bias - it is measured for those who die, but the figure for those who survive is missing.

That reduction is simply not achievable unless you can accurately predict who is going to die, which turns out to be very difficult to do.

The most significant health costs are for chronic conditions, and their ongoing consequent costs.

Your point is as non-sensical as saying we could save millions of dollars by killing 10% of the population at random.

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