In order to contend with ever-escalating health care costs, Americans will need to come to grips with the cost of end-of-life care. Right now, it’s my reality. I am seeing first-hand rampant and seemingly uncontrollable costs of sustaining life in a system which lacks any semblance of common sense.

My mother is 90 and other than being blessed with five healthy sons, has expended very limited health care dollars in her lifetime. That is, until now. Suffering mild dementia, she is a resident in a very pleasant assisted living facility in Long Island. They take good care of her creature comforts, however, medically she appears to be a case study in why we are all facing a crisis in cost escalation. I might add that two of my brothers are medical professionals and we have a concerned, but also knowledgeable, family that oversees her care. However, we are not with her all the time to manage treatment and that’s where it breaks down.

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At the first sign of an issue, the facility phones an ambulance and ships her off to the nearest ER; three times in the past few months. The first was due to the flu. She weathered the illness, but because of scarcity of resources, was bedridden for a week. As a result, she needed over a month of inpatient rehabilitation in order to restore her ambulatory skills. I am guessing that this episode cost in excess of $50,000. The doctor believes that the next two episodes — which occurred in the past 10 days — relate to an allergic reaction, and he has been trying to rule out possible culprits. He took her off Prilosec and soon thereafter she complained of chest pains, which turned out to be indigestion. So they sent her home. She burned through about $3,000 in costs to figure that one out. And then, tinkering with her medication, her blood pressure spiked to 200/113. This has resulted in another in-patient stay. We are planning to keep her moving to avoid another costly rehabilitation; so for this one, Medicare and her supplemental insurance will probably spend less than $20,000.

The medical expenses she has experienced were easily mitigated for a fraction of the cost. The problem is that our Medicare system pays for services rendered and not for care management. Care management would have resulted in a much better outcome for my mother, for our family and for U.S. taxpayers. I am convinced that the Affordable Care Act is not the answer to solve the health care crisis which can only be fixed if we change the way we deliver care at the end of life. And those that lobby for Medicare for all can consider my mother’s experiences. That’s certainly not the answer.

Hasday is president of Frenkel Benefits, LLC, one of the largest privately held independent employee benefits brokers in the United States. Reach him at or (212) 488-0200, and read more from Hasday at

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