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A fully funded palliative plan saves money, report says

By Michael Swan
The Catholic Register

03/01/2017

TORONTO (CCN) — Timely, fully funded and widely available palliative care could save Canada’s health care system between $7,000 and $8,000 per patient, claims a new paper from the Canadian Society of Palliative Care Physicians.

“The savings in direct health care system costs are consistently reported to be around 30 per cent,” said the report, which summarizes recent peer-reviewed literature on palliative care economics.

“Palliative Care: A Vital Service With Clear Economic, Health and Social Benefits” has come out just three weeks after a paper in the Canadian Medical Association Journal claimed assisted suicide could reduce costs to public health care by between $34.7 million and $138.8 million annually.

The Canadian Society of Palliative Care Physicians hopes its paper will spur action in Ottawa.

“We know, financially, health care is terribly expensive in Canada,” said society president Dr. David Henderson. “We thought it was really important to show that not only better care can be provided, but it can be done in a very cost-effective way.”

Though the studies completed so far can’t answer the question definitively, savings from universal access to fully funded palliative care probably stack up against any savings that might come from assisted suicide, Henderson said.

The report says savings would come from, among other things, reducing hospital stays, moving patients from hospital to home or hospice care, and reducing unnecessary diagnostic testing.

“You’re talking about a lot longer period of time for those savings to occur,” said Henderson. “Even people who would choose MAID (Medical Assistance In Dying), generally they’re going to choose it pretty far down the line.”

The palliative economics study points out that “U.S. Medicare data shows that a quarter of total health care costs are spent in the last year of life, with about 40 per cent — or 10 per cent of the total Medicare budget — spent in the last four weeks.”

Given the cost of the legally mandated assessment by two physicians before euthanizing any patient, and the few doctors willing to offer the service, assisted suicide costs could be significant.

The fact palliative care could save money is already known, said Sarnia-Lambton Conservative MP Marilyn Gladu, the sponsor of a private members’ bill calling for a national framework and national standards for palliative care.

Gladu’s Bill 277 has passed first and second reading in Parliament with the unanimous support of the House. It’s due for committee study in March. Gladu believes the bill will pass this year.

Timmins-James Bay NDP MP Charlie Angus supports Gladu’s bill, but worries the government won’t keep its promise to spend $3 billion on home care and palliative care.

“What concerns me is it (Bill 277) will see all-party support and then the government will continue to take no action,” Angus said. “The issue of palliative care seems to have completely dropped off the map.”

Angus wants to see money spent on palliative care in areas where it actually delivers health care outside of provincial systems — the armed forces, veterans and First Nations. 

“I can tell you, in the First Nations communities the services are almost non-existent,” he said.

The economic argument in favour of more and better palliative care should be persuasive to all politicians, according to Angus.

“Canadians deserve top-quality health care, especially at end of life. And there is a real simple economic argument to make for why that’s a smart investment.”

“It should be a no-brainer to make these investments and move forward,” said Henderson.

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