HealthWatch: The Cost of Care

As Terri Schiavo lies dying in a hospice in Florida, Barbara Howe is kept alive in a Massachusetts hospital thanks to ventilator and feeding tube.

The cost of such health care is staggering. Howe's health insurance maxed out and stopped covering her care two years ago. Schiavo's hospice costs $80,000 a year, and a fund for needy patients helps foot the bill.

One of the hardest and least-discussed issues at the end of life is the cost of care. Twenty percent of a person's lifetime healthcare spending occurs in their final year of life. Of that, two-thirds is taxpayer money -- roughly $120 billion paid by Medicare and Medi-Cal. One third of Americans who took care of a dying loved one at home lost their entire savings.

"Families often have to make up the difference in taking time off from work to care for sick loved ones," said Dr. Steve Pantilat, an end-of-life care specialist at UCSF.

Pantilat says many patients worry about becoming a financial burden to their families. About half of all personal bankruptcies filed in America are due to crushing medical bills.

"Understanding health care can be so expensive should be a reason to talk about it -- not avoid it," said Pantilat.

Experts say you should know your health insurance policy before you need to use it. Many policies have annual maximum benefits you can easily exhaust in a year. Look at your policies short-term and long-term care, home nursing, and hospice provisions. Look for hidden services. Case managers can coordinate your benefits and maximize your care, and may be your best ally.

"The health care system can be hard to navigate," said Pantilat. "Having someone who is savvy about the system is of great use."

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