Matthew Holt writes that the last year (or at least 6 months) of Gerald Ford’s life was a poor use of resources , and an example of what’s wrong with the health care system today. He thinks the money could have been better spent providing prenatal care to an uninsured woman.

So consider Ford’s last few months of life. He was admitted to hospital last January for pneumonia. Then spent much of July in hospital in Vail; then went to the Mayo Clinic for not one but two angioplasties in August. Then went back into hospital in California in October, and now has died in December. All that time he was obviously going to die within a year or so, and all that time he was at least 92 years old.

My guess is that over the last 12 months of his life well in excess of $100,000 was spent on his health care. And that money probably extended his life by three months at most.

Do we often perform “heroic measures” on people who might not want it, or don’t receive any quality of life benefit from it? Absolutely. Now maybe Holt has an in with the Ford family, or was following his health very closely, but there’s no way for me to know that he was “obviously going to die within a year or so.” Yes, he was 93, yes, he had had several hospital admissions. These are not Good Signs. But still–ask any doctor: internist, geriatrician, palliative care specialist–and they’ll all tell you we’re shitty at predicting when someone’s going to die . Because there’s definitely 93 year-olds out there that get a pneumonia, get really sick, but then recover and end up living 10 more years.

I’m all in favor of having people have these discussions with their family members–living wills, durable powers of attorney–but how can we tell if Ford was gonna kick it until 103?

4 Comments »