Re: Medical expenses on elderly (was: Vaccine efficacy)

From: Robin Hanson (
Date: Wed Feb 16 2000 - 08:40:29 MST

Robert J. Bradbury wrote:
>... regarding the issue of health care costs, its generally
>known that the elderly are the ones that are sucking up the $$$.
>Some huge fraction of our health care dollars (20-30%???) goes
>to support people in the last year of the lives.

Actually, the people who die in a given year spend ~11% of all
health care in that year (and ~27% of Medicare). 3 randomized
trials comparing hospice vs. regular high tech treatment for end
of life find no savings from using hospices. A survey of the
non-randomized trials concluded that using hospices would save
0% to 10% on care in the last year of life [JAMA, 275(24):1907-1914,
6/26/96]. (Btw, JAMA will devote its Nov 2000 issue to this topic.)
So forgoing high tech medicine at the end of life might save 0-1%
on health care, and so up to 0.14% of GDP. Forgoing all treatment
entirely (send them out to die in the snow?) would save 1.5% of GDP.

Robin Hanson
Asst. Prof. Economics, George Mason University
MSN 1D3, Carow Hall, Fairfax VA 22030
703-993-2326 FAX: 703-993-2323

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