The Cost of Dying

It’s not a subject many want to think about: death. How will you die? Will it be slow and painful or short and painless?

Then there are the thoughts that don’t even occur to some. If you spend your last days in the intensive care unit, how much will it cost? Are you willing to go to any cost to save your life?

According to the 60 minutes segment “The Cost of Dying,” Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients’ lives.

The story begins by saying, “every medical study ever conducted has concluded that 100 percent of all Americans will eventually die.” I don’t feel this was the best to start because personally I sat thinking “duh!” There could have been a more engaging way to draw viewers in.

But as the story goes on, 60 minutes tries to prove how the system of the government paying for those in the ICU could bankrupt our country.

One of the doctors, Ira Byock, tells reporter Steve Kroft 18 to 20 percent of Americans spend their last days in the ICU. Byock feels technology has become so advanced that some Americans are being kept alive longer than they probably should, costing the federal government an enormous amount of money.

Making money matters worse, Kroft explains doctors get paid based on how many patients they are seeing and treating, and hospitals are paid for the amount of patients they admit. Another doctor, Dr. Elliott Fisher, said 30 percent of hospital stays in the US are probably unnecessary.

Statistics show many Americans say they prefer to die at home, but more than 75 percent actually pass away in a hospital or a nursing home.

The story goes in-depth on how doctors test people, and how healthcare is different than any other business where customers and consumers must be cost-conscious. With the government or private insurers paying for 85 percent of the health care bills, some patients prefer to be kept alive any way possible because most of the time they don’t even have to see the bills.

With all the talk about the current healthcare reform bill, I do feel this was a fascinating story. It was a new and interesting way to look at healthcare. It is an example of how from just one subject many story ideas can form.

In terms of video, I think the editors did a good job of using nat sound in the story, but I didn’t like that they used the same shot numerous times. I would think in a hospital there could be a variety of shots if thought out creatively. They didn’t seem to get enough broll of the doctors and had to use the same video over. I also noticed, even though many doctors were interviewed, only one butted heads with others on screen. I feel it could have been more fluent if each doctor was facing opposite directions when they came on screen.

While there were shots I thought could have been done better, I commend 60 minutes on an array of shots that were alluring. As heartwrenching as it may have been, viewers got to be with patients in their last few days. Cameras captured their last moments in life.

The segment intertwined the life of three patients in the ICU. Each person’s story humanizes the facts and brings the segment to life.

Marcia Klish is suffering from complications of colon surgery and a hospital-acquired infection. She is brought into the story right away, but later passes away as a tie up to the story.

Charlie Haggart is another compelling story 60 minutes used. Viewers get a chance to sit through an awkward conversation between the doctor and Charlie about kept alive through CPR if his lungs were to give out. Editors left the moment of silence in between Charlie and the doctor to give the sense we are sitting with them. Many other times they use nat sound on video to keep viewers in the story, such as the doctor entering a patient’s room saying “hello there.”

This story made me feel sad, but at the same time I also felt I got a good amount of facts that made the story informational.

But the question at the end is still apparent: are people left in ICU’s way too long and costing the government way too much money, or is it only sensible that people are left on machines to live until they want to die?

Kroft might say the latter, but Byock disagrees.

“To say we’re gonna pull Grandma off the machine by not offering her liver transplant or her fourth cardiac bypass surgery or something is really just scurrilous,” Byock said. “And it’s certainly scurrilous when we have 46 million Americans who are uninsured.”

And so from this argument I learn. A good story like this has the viewer at the end questioning each side. Someday I hope to be able to do the same thing with my stories.

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*photos courtesy of South East Wales Critical Care Network, University of Iowa Carver College of Medicine