From the Editors’ Desk: Confronting Costs of Care at the End of Life

Abstract

Most experts agree that the current rate of rise of health care costs is unsustainable. The good news, however, is that there is an emerging consensus among policymakers over what needs to be done: realign financial incentives; reinvigorate primary care; support more informed, patient-centered decision making; develop a more robust evidence base of comparative effectiveness; create standards for electronic health records; invest in public health. In addition, many feel that excessive tests, consultations, and procedures in the last year of life contribute not only to higher costs but to diminished quality of care. However, these concerns were caricatured by conservative pundits and politicians, who portrayed hospital ethics boards as “death panels” and ultimately ensured that end-of life care was exiled from the health care reform agenda.