Discourse around death in general makes people queasy. We tend to avoid the cognitive dissonance between the idea that supplying less end of life care would dramatically reduce medical expenses and the idea that all people deserve the best chance at life[1]. We are similar avoidance when MAID is discussed specifically because we know incentives and values clash.
1. this could probably be phrased better. sanctity of human life and dignity if human life don't quite fit because those are meager at EoL and value of human life sounds a but off.
This is a myth.
[Those] with a high chance of dying accounted for only 5 percent of total Medicare spending, and among them about half survived in any case
total spending on end-of-life care is only 9 percent of the total cost of health care.That reduction is simply not achievable unless you can accurately predict who is going to die, which turns out to be very difficult to do.
The most significant health costs are for chronic conditions, and their ongoing consequent costs.
Your point is as non-sensical as saying we could save millions of dollars by killing 10% of the population at random.
It seems like the hard part is making sure people have had the conversation. If I'm over 80 years old and can't communicate or feed myself, I'm not expecting much of a recovery. I think a lot of people would acknowledge that if they were asked to think about it.
(of course there are lots of situations where a good recovery is pretty likely, but hopefully the doctors aren't waffling about what to do in those situations)
I recently went through a situation where my family member was the 95 year old. The immediate family had no basis to judge whether the care being given was futile or not. The doctors, the "palliative care" specialists, completely s** the bed there. We would have been open to good, quantitative, rational medical arguments -- the type of data-driven conclusions that guide the rest of the medical world -- but instead the palliative team (external consultants actually) seemed capable only of the basest emotional and social manipulations. We concluded from the lack of rational arguments that there was in fact no well-reasoned basis to discontinue care, and that the palliative team was really just a crew of hired guns brought in to lower hospital costs.
If you do in fact see this inefficient rationing of precious care as a major source of burnout, it seems to me that there is an enormous, wide-open opportunity to conduct studies on predicting outcomes for ICU patients & other patients with advanced conditions. It really made my spine tingle when every single doctor I asked about this simply had no reply.