This guy for President:
Arnold Epstein: [Spending too much on care at the end of life] is a big problem. The numbers I've seen put it at something like $130 billion a year. The quip is that the U.S. is the one country in the world where they think death is optional. And we act that way. I think we have to start to deal with that. And the time to deal with it is not at the bedside. It's with a broader group trying to think about standards and piecemeal efforts where we can put things out of bounds. I don't know if that means we say that people don't get dialyzed when they're 97, or bring it back to 95 or 92. Or that certain medications when the cost per adjusted life-year is $500,000, we say that we're really not going to cover them. And we try and change the culture.
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