What's wrong with our healthcare system

Yeah, so that's a big can of worms. I am not an expert just because I work in the medical field. The only thing prompting me to write this is that there are several things on my nerves this week. Here's the big one:

Why spend so much money prolonging a life we know we can't save?

For those who don't know, my specialty (if you can consider me specialized after only one year) is burn. One of the first things we learn is that your odds of surviving a burn are based on your age and your percentage of burn. It's easy. Add 'em up. If you are 40 and you are a 20% third degree burn, you're 60% likely to die. It's quick and dirty, and far from perfect, but generally the older the patient, the worse they do. SO when we get a 76 year old with 70% burns... well... I'm sure you see where I'm going here.

The thing is that we can't give up. The families don't want us to. And so we don't, or we'd get sued and loose our licenses and other awful things. So we have patients that linger for days, and sometimes weeks in an ICU bed that costs upwards of $5,000 a day - just for the space, not for the monitoring, the nurses, the therapists, the ventilators and oxygen therapy, the drugs. One drug that we use, albumin costs $500-$600 per bottle, and we go through 5 bottles a day for new patients. Also we give blood and blood products to these patients, which not only costs but also can possibly keep some more viable patient from getting the blood they need.

The hospital I work for accepts all patients, regardless of their ability to pay. One can hardly wonder why it's been running to bankruptcy like an Olympic sprinter towards the finish line.

This happens all the time: Grandpa was smoking a cigarette with his oxygen tank nearby, fell asleep, an BOOM - we've got a 76 year old male with a history of COPD, heart attack, and vascular insufficiency with 30% third degree burns to his face, neck chest, and arms. Now we're tasked with trying to keep this man, who realistically had another 4 years left in him anyway, alive. We intubate him because his neck will swell from the burns and he won't be able to breath on his own much longer. (Again, you may not know this - but once someone with COPD is intubated it's incredibly hard - very unlikely in fact - to get them back off the vent). We start IV therapy, fluids, tube feeding and a Foley catheter - all invasive and likely to increase the already compromised patient's chances of getting an infection. We give them IV pain and sedation medications all to keep them from feeling the pain that they wouldn't be feeling anyway if we'd just let them die.

Why? Why do we do all this?

We do it because it's our job, because we'd want everything done if it were our grandfather, because we can. We do it because the doctor's ego says "I want to show off to my collegues just how brilliant I am." And the patient suffers, lingers in an amazingly expensive room, and then dies despite all we do. This happens over and over, dozens of time in my unit alone, thousands of times a year across the country. ICU care eats up almost 20% of the nation's health care costs, according to this article. It's sad, because so much of this cost could really be eliminated by simply letting people die when it's their time to die.

I know some people argue that by deciding who lives and dies we are trying to 'be God'. But we already do that everyday. We treat people who would have died 20, maybe even 5 years ago, and we 'bring them back'. Good for us. But when we decide to let someone die, someone that we don't have the knowledge or technology to save - then we're playing God? Can't have it both ways... either we're always playing God - every time we treat an infection with antibiotics, or suture a wound, or perform CPR - or we aren't. Either way, I argue that the best way to reduce the patient's suffering and the family's (and society's costs) is to let people go on with their business of dying without resorting to heroics when we know that we can't save them.