April 22--TAMPA -- Every year, Medicare pays Tampa Bay-area hospitals hundreds of
millions of dollars to treat critically ill seniors.
The care those patients receive -- and the amount taxpayers spend --
hinges on where they are treated, according to a recent study comparing
end-of-life care at hospitals nationwide.
Those patients absorb about a quarter of Medicare spending nationally,
making their care an important part of the debate about reining in Medicare
spending, which makes up a significant chunk of the federal budget.
Medicare is projected to have cost the federal government about $528
billion in the 2010 fiscal year -- 13.3 percent of the federal budget.
Spending is expected to grow 7 percent a year over the next decade, as baby
boomers join the ranks of Medicare recipients, according to the Center for
Medicare and Medicaid Services.
The Republican plan for controlling Medicare costs, proposed by Wisconsin
Rep. Paul Ryan, who chairs the House Budget Committee, would privatize health
care by giving seniors vouchers they could use to buy their own health
insurance. Democrats want to keep the system intact but cut costs by weeding
out unnecessary spending with the help of medical experts.
Tangled in the policy debate are the practices of doctors and hospitals;
the availability of specialists, intensive and hospice care in given areas;
and the demands of patients' families for costly treatments, regardless of the
outcome.
Researchers at Dartmouth College studied Medicare records from 2003 to
2007. The study, published this month, found that chronically ill Medicare
patients are spending more time in hospice care and less time in the hospital.
But those who are hospitalized see more doctors and spend more time in
intensive care than in the past, sometimes receiving care they don't need or
won't benefit from.
"In addition to its effects on patients' quality of life, unnecessarily
aggressive care carries a high financial cost," the study's authors reported.
Complicating the national debate over Medicare is the lack of public
support for cutting a popular program that's working for a lot of people. A
Washington Post-ABC News poll this week found that 78 percent of people oppose
cutting Medicare as a way of dealing with the national debt.
Ultimately, doctors, patients and taxpayers could benefit from frank
discussions about how best to care for the dying, said David McGrew, medical
director of HPH Hospice, which provides hospice care in Pasco and Hernando
counties.
"It's always a balancing act of gray issues," McGrew said. "But when you
get people looking at the things that are truly of value to them, who wouldn't
want their loved ones to live forever? But the reality is: That's not going to
happen."
Learn more in The Tampa Tribune on Sunday about how much Medicare spends
to treat critically ill patients at Tampa Bay area hospitals and what's been
doing to control costs.
Reporter Kevin Wiatrowski can be reached at kwiatrowski@tampatrib.com or
(813) 259-7871.
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