Why do we spend twice as much on futility than prevention?


North America spends at least 20% of its global healthcare budget on patients that are in their last month of life, yet less than 5% is spent on disease prevention. Much of this late-stage treatment represents clearly futile interventions and micromanagement that is usually not within the best interests of the patient, nor significantly life-prolonging or enhancing of comfort/dignity/QOL. The only benefactors of such futility are those who perform such interventions. Clearly, there are flagrant vested interests that drive such activity. Moreover, it is easier to deliver “false hope” to patients rather than having a fulsome conversation in which the natural history of disease(s) and associated prognosis is outlined. Ironically, most patients with incurable illnesses and limited life expectancy, if involved in the decision making process, would actually elect to forego late-stage/futile AAMM in favour of CPM. Therefore, the simple process of promoting PCC/PE through asking the patient “what they want” could reduce spending on futility, and the savings achieved could be reinvested into disease prevention programs.

Advertisements

About drvincentmaida

Consultant in Palliative Medicine & Wound Management, Assistant Professor, University of Toronto & McMaster University, Researcher & Author.
This entry was posted in Distributive Justice and tagged , , , , , . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s