Should cost be a factor in a case like Emilio's, which exceeded $1.6 million?
Medical ethicists expect cost to be an issue more and more as boomers age and health care resources become scarcer.
By Mary Ann Roser
AMERICAN-STATESMAN STAFF
Monday, May 28, 2007
Doctors who wanted to end life support for 18-month-old Emilio Gonzales at Children's Hospital of Austin said their concerns were about stopping his suffering ? not about the cost.
But by the time he died May 19, after 142 days in the intensive care unit, Emilio's hospital bill had reached $1.68 million. Some callers to a hot line the hospital established to handle a flood of Emilio-related calls and bloggers wondered about the cost of treating a patient who had no hope of recovery.
Because there was no hope for Emilio, "why don't we spend our money for children who can get better?" Vera Preston-Jaeger, a retired math professor who lives in Bastrop, asked in an interview.
Medical ethicists around the country said that even though physicians and politicians are squeamish about mingling discussions of money and end-of-life care, they expect those debates to only intensify as baby boomers age, health care resources become more scarce and cases like Emilio's capture headlines.
"Emilio Gonzales would be a very, very good example" in the ongoing debate, said Dr. Robert Fine, director of the Office of Clinical Ethics at the Baylor Health Care System. "He spent almost six months on a mechanical ventilator. Did he recover? No. Did it do him any better? No."...
...Medicare, which insures about 80 percent of Americans at the end of life, spends 28 percent of its dollars on the last year of life and 14 percent of its dollars on the last two months, Fine said. Medicare also sets the pace for what services private insurers will cover.
To some extent, Medicare and other insurers already ration care, he and others said. Some costly procedures are branded "experimental" and refused for coverage. Some health plans won't cover transplants, and most set lifetime dollar limits on how much they will pay out, ending coverage once a person hits the limit....
...When doctors wanted to stop treating Emilio, who was born blind and deaf and was later diagnosed with a terminal illness that destroyed his central nervous system, the ethics committee at Children's Hospital initially decided to continue treating him.
But in February, the committee agreed with doctors that it was time to stop and gave Catarina Gonzales, his 23-year-old mother, 10 days to find another hospital for Emilio. The committee, and later a judge, extended the time as Gonzales fought to keep him on a respirator and looked
unsuccessfully for another facility that would treat him. The hospital and doctors said the cost of Emilio's treatment was never part of the discussion.
Emilio's care was covered by Medicaid and Supplemental Security Income, and the hospital expects to collect $389,000 of what it billed because of low reimbursements under the program, said Michael Regier, general counsel for the Seton Family of Hospitals, which runs Children's Hospital....
http://www.statesman.com/news/...al/05/28/28emilio.html
Facebook
Twitter