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There is even more fun aspect.

'Survival' for cancer tends to be defined as surviving 5 years. The earlier you catch, the more patient had left to live anyway.




Probably hyperbole but a colleague told me about a 80/20 distribution, that a decreasing amounts are spent on substantial life extension or quality of life improvement in the west as the pop ages.

The basic good old medical care invented 100 years ago, while dizzying amounts are spent on prolonging lives for very, very few years, often very late in life - efforts that are very close to - in effect to have done nothing, ie. almost performative.

Is this true?


I don’t know about that, speaking to oncology as I work in a NCI designated cancer center (i.e. somewhere that spends dizzying amounts) and it skews younger than you might think these days.

I’m not sure what you mean by “very, very few years”. As a hypothetical would prolonging life for ~3-7 years in a 40-50 year old be considered “almost performative” to you?

“Good old medical care” often means 3-6 month survival for these patients.


yes. the amount we spend to keep people alive who have little to no hope of ever recovering is immense. of course it is cruel and leads to myriad bad outcomes if you were to even attempt to have a discussion about trying to change that (it is the slippery-est of slippery slopes)

there's probably no way to actually do anything concerted about it without turning society into Logan's Run but having gone through it with a grandparent and a parent, it is clear something is broken at the end of life


Spending on Medicare beneficiaries in their last year of life accounts for about 25% of total Medicare spending on beneficiaries age 65 or older.

So yes, it's true (although that includes the cost of hospital stays which is where a lot of people end their life).


Probably. Look at the people in the hospital - they’re old. Inpatient costs are astronomical, and seniors with poor social supports end up hospitalized at great expense with issues where root cause are easily prevented… like dehydration.


Being old is a fairly long part of life nowadays. Old is not the same as hopeless or almost dying.

My grandma had a melanoma at the age of 74, which is "old" by most human standards. It was located on her earlobe and an operation helped her get rid of it.

She then lived to be 90, most of that extra time either fully or partially self-sufficient. Only in the last months in her life she really deteriorated.

Basically, she gained almost a fifth of her life by that single operation performed when she was already old.


That’s awesome. I’m not suggesting that older folks not get care.

But because of way our system works, we’ll happily pay $300k to hospitalize an otherwise healthy 70 year old who is dehydrated and develops serious problems that could be solved by an aide or helper that would cost $20-30k.




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