We've gone around on this one before, and we will again. All of the major sticking points have been hit on above, one way or another. It's true: the only true way to contain costs is to limit something. What will it be?
Personally, I have an idea for dealing with end-life costs that I've never seen anywhere else: Basically, we all get an "end life insurance policy" at a young age, that accrues to a certain dollar value. When we get a terminal illness diagnosis, we get a check for (say) $2M. We are free to do whatever we want with it. If we want to spend it on medical treatment--that is an option. If we want to forego everything but palliative care and pass the balance on to our families--that's ok too. Or, palliative care plus spending it all on living large--go for it. Get the idea? Now, if we die in an accident, it pays off to our heirs as a life insurance policy.
End-life care is a disaster, I agree. I saw it myself a little over a year ago with my mother. Surgery to correct a bowel blockage, led to weeks on a feeding tube in Crit Care, followed by aspiration pneumonia and more interventions to deal with the pneumonia, and then hospice. What did the surgery accomplish? In my mind, nothing. She lived, if you can call it that, another 6 weeks, almost all of it in Crit Care, unable to speak, and barely able to communicate at all. I question whether it was really worth it. (My brother argues that the surgery was successful because, after all, her intestinal blockage did clear and her gut did start functioning) I have no idea what her final bill was.
Part of the end-life solution was shouted down politically as 'death panels' a few years ago: basically it called for actual real consultations with all the medical and family involved to look at what was happening and decide earlier and hopefully more sanely when interventions are just piling up to no positive gain. Why can't we have this conversation?
Age at Diagnosis: 56
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA Non-Detect since April, 2015
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024