The Economics of Death
The Cost of Dying: End-of-Life Healthcare
Why a large share of lifetime healthcare spending happens in the last months of life, the financial burden on Indian families, and the role of palliative care.
Much healthcare spending happens near the end of life.
The pattern
- In the US, around a quarter of Medicare spending goes to patients in their last year of life, according to studies.
- Intensive care and hospital stays are costly.
India
- Out-of-pocket spending on terminal illness can push families into poverty or debt.
- Many families sell assets or borrow.
Palliative care
- Palliative care focuses on comfort and pain relief rather than aggressive treatment.
- It can improve quality of life and reduce costs.
- India’s access to palliative care is limited, though Kerala has a strong community palliative care network.
Morphine access
Restrictions made morphine hard to access; the NDPS amendment in 2014 eased rules for pain relief.
Ethics
Decisions balance hope, dignity and cost; economics can inform but not decide them.
The Kerala network
In Kerala, volunteers and nurses visit terminally ill patients at home, providing pain relief and support at low cost.
Thinking more treatment always means better end-of-life care
Palliative care can improve quality of life.
Key takeaways
- Much healthcare spending occurs near the end of life.
- Terminal illness can push Indian families into poverty.
- Palliative care focuses on comfort.
- Kerala has a strong palliative care network.
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