The Price Tag of a Slow Death

It's usually easy for me to walk by BusinessWeek on the newsstand. More Wall Street news? No thanks. But this week I stopped, picked it up and couldn't put it down. The cover story, by Amanda Bennett, is titled "Lessons of a $618,616 Death." The death is her husband's.

The story is online, and well worth a read, but I'll provide the CliffsNotes. Bennett recounts the illness and death of her husband, Terence Bryan Foley, a 67-year-old PhD in Chinese history who played 15 instruments and spoke six languages. His kidney cancer was not impressed. His years-long battle between diagnosis and death was exhausting and expensive. Two years after his death, his wife examines the expensive part. She gets some answers, but more questions. On the one hand, thanks to experimental drugs, Terence lived longer than most with similar diagnoses. On the other, he is the sort of person referenced by all the hoopla over "death panels," leaving his widow to wonder, how much should be paid to keep a man alive an extra month? An extra week? An extra day?

"Backed by robust medical insurance provided by a succession of my corporate employers ... we didn't have to think about money, allocation of medical resources, the struggles of roughly 46 million uninsured Americans or the impact on corporate bottom lines," Bennett writes.

The total bill for seven years of care was $618,616. The family was responsible for just $9,468. Insurance covered more than $250,000. Who paid the rest? Bennett points to built-in discounts and uncovered costs that disappeared into thin air.

Bennett and her colleagues went through almost 5,000-pages of documents, which revealed, she writes, "an economic system in which the sellers don't set the prices and the buyers don't know what they are. Prices bear little relation to demand or how well goods and services work."

The first bill, for a $25,000 kidney surgery, cost them just $209.87. Bennett's employer ended up paying about $14,000 of it -- something to remember when we gripe about our insurance rates increasing and then contribute to the flower fund for a sick colleague.

The rest of the money, for that surgery and countless other treatments, came from the insurance pool. This is a point that perhaps could have been made more clearly by President Obama and his allies in the fight for health care reform. Bennett writes: "The health insurance system depends on healthy people bearing the cost for sick ones like Terence. For all its incredible treatment benefits, the system is untenable. Should you have had a voice in Terence's final days? Would I make the same decision with my money for your loved ones? These are things I think about now but can't answer." In other words, should you be required to contribute to the insurance pool so a dying man can take a daily $200 pill? The smart answer in my mind is yes, because you or a family member might one day need a daily $300 pill.

Photo credit: sylvar