Last six months of life biggest cost factor in health care - Health - Brief Article

Community Action, March 18, 2002

OTTAWA -- The high cost of dying has more to do with soaring health care costs than the aging population does, according to the Canadian Institute of Actuaries.

In its submission to the Romanow commission on the future of health care, the institute said that 30 to 50 per cent of total lifetime health care expenditures occur in the last six months of life. Noting the sensitivity of the subject, the group suggested greater use of less expensive palliative care and living wills.

The debate on health care cannot move forward without a recognition that about 30 per cent of spending currently comes from the private sector, the institute said. That sector includes doctors, who are private entrepreneurs, and hospitals, which are generally private, non-profit corporations.

Standard insurance principles, including deductibles and co-payments, should be applied to medicare, the institute said.

Where an analysis of medical efficacy results in a service being dropped from provincial health plans, it should still be available to consumers who can pay directly or through private insurance, CIA said.

It also called for prescription drug coverage for all Canadians, noting that costs could be controlled through a national drug formulary that uses cost-benefit analysis. A British Columbia study showed that one-third of the 147% increase in drug costs for seniors over 15 years was the result of a shift to new, more expensive drugs with no improvement in therapeutic outcomes, CIA said. 416-504-8464