Out-of-Pocket Spending in the Last Five Years of Life

Growth in Medicare Expenditures for Patients With Acute Myocardial Infarction

“…20 Finally, we did not include patients' out-of-pocket expenditures or care billed to supplemental insurance policies. 21 …”

The Growth of Palliative Care in the United States

“…Patients are incurring more out-of-pocket expenditures in their last five years of life (52). Family members are being called on to provide more informal caregiving to both young and elderly loved ones with chronic illness or debility (11,12).…”

Health Analytics, Economics and Medicine toward a 21<sup>st</sup> Century Health Care System

“…In their 2015 commentary on the Swiss health care system, Biller-Andorno and Zeltner [31] point out several features of the public-private partnership that has both an egalitarian and well-functioning public component and a very profitable private component. Although the system seems to have worked well in combining respect for individual choice and responsibility with communal solidarity that provides basic health care to fellow citizens who lack financial resource, it is "confronting a number of challenges": an aging society, possible overtreatment, and patchy records of the quality and equity of health care delivery.…”

“…According to WHO, the US spent more on health care, both per capita as a percentage of its GDP (17.2%), than any other nation in 2011, and yet lagged behind other industrialized nations in such measures as infant mortality and life expectancy. An analysis by Kelley et al [31] using a nationally representative Health and Retirement Study cohort found that despite Medicare coverage, about 25% of the senior citizens' out-of-pocket healthcare expenses exceeded baseline total household assets in the last 5 years of life. After the enactment of the Patient Protection and Affordable Care Act (PPACA) in 2010, the US has been undergoing changes in the uninsured rate, insurance coverage and financing, but there has also been ongoing debate about the constitutionality of the law, prescription drug prices, health care quality and equity and other political issues, with increasing polarity along party lines.…”