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Final Word: Better health care from Day One influences last days

On Day One of the implementation of the health care exchanges under the Affordable Health Care Act, or, Obamacare, I was in San Francisco as a guest at a board meeting for one of the biggest health care plans in the nation.

Most of the conversations were about the private insurance side, not the health care exchanges, but what I found most fascinating was the cost of health care in America compared with other nations. I spent a lot of time talking to a doctor who was born and raised in India. He came from relative wealth in a poor country, but he said despite his and other families’ means, people in his country don’t spend so much money at the end of life trying to prolong it.

He told the time he was working in an emergency room on the East Coast. He got a call about an incoming patient in cardiac arrest. The hospital was technologically advanced, so he had a detailed copy of the man’s file before the patient arrived. Before the man was wheeled in, this doc knew that the man was 93, in frail health, and had been treated for a decade for a life-threatening illness.

The man was basically nonresponsive upon arrival. Yet, when the doctor reached the man’s a son, living in another state, the son said, “Do everything you can to save him. I haven’t seen my dad in 10 years.”

This is one story, but I have to believe it gets played out more than once in hospitals across the country day after day.

We spend so much money trying to extend that life at the end, instead of making informed decisions ahead of old age or the onset of chronic illness. Almost 30 percent of Medicare’s budget goes to care for patients in their last year of life.

Granted, with the advances that have been made in areas such as cancer treatment in the last 10 years, it’s possible to cure a lot more people than ever before. But the costs can be astronomically high and the odds of long- term survival are exceedingly slim.

Let’s make better decisions for the end of life by making better choices earlier.