I now know part of what makes healthcare/health insurance cost as much as it does

[usmbguest5318]

Last evening, I visited my closest friend's father (for this thread, call him Bob) who's squarely and unalterably in the terminal months of his dotage. My arrival coincided with a FedEx's delivery of some medicines Bob's doctor prescribed. My friend opened the package and reviewed the meds. After doing so, he wondered aloud, "What is all this stuff for?"

What he was getting at is that the doctor had prescribed a bunch of "when the time comes" medications. For instance, suppository pain killers were among the meds. Bob has no difficulty swallowing. A medicine that reduces swelling of the prostate was prescribed, yet Bob is on a Foley catheter that it's expected he'll have for the remainder of his days. There was also included an anti-anxiety medication, yet Bob has no anxiety issues; he's not at all the person who's anxious about his terminal diagnosis or anything else.

That the doctor had sent, and Bob's insurance paid for, the medications now struck my friend and me as wasteful because Bob's meds get delivered on the day or morning following their being prescribed and called in to the pharmacy. Accordingly, I and my friend are wondering why the unnecessary meds were prescribed. My friend called the doctor and the answer given was "so they'd be there if/when they were needed."

That may make sense for someone receiving at-home care and of whom it's relatively certain that they'll live long enough to use at some of them. That just isn't the case with Bob, who, along with being terminally ill, is nearly 100 years old. I went to see him because I knew that, quite literally and plausibly, he could pass at any minute. If Bob must urgently have a given medicine, either the scrip delivery service can deliver it, or someone will go to CVS and get it. That said, aside from pain abatements meds, there aren't any that the doctor prescribed and that fall into the "urgently needed" category.

Let me be clear. I have no idea of what the meds' prices. From my friend's discussion of what the doctor told him, it seems that this "just in case it's needed" prescribing protocol is just that, SOP for old, ill people. Is such an SOP's extancy a major factor militating for higher than necessary healthcare/health insurance costs? I don't know, and not knowing the specific prices, I can't speculate on whether it is or is not. What I can say is that insofar as it appears that there is the noted SOP, costs must, to some extent, necessarily be higher than they otherwise would need to be.

 

[OldLady]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

 

[usmbguest5318]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

Bob, prior to yesterday's delivery, had morphine, tramadol and oxcy. When the man feels pain, he's given one or the other, perhaps supplemented with an OTC Tylenol, depending on how bad he claims the pain is.

 

[Wyatt earp]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

I was amazed at a child hood friend of mine posted it on FB a picture of all the pill bottles that she has to take at only 50.. I don't get this.i personally refuse to even take asprin at 52 ..but I am a guy..

I guessed I got blessed by God or something... but there is no way in hell I will take a bunch of drugs to keep me alive...it won't happen.

.

 

[deanrd]

Last evening, I visited my closest friend's father (for this thread, call him Bob) who's squarely and unalterably in the terminal months of his dotage. My arrival coincided with a FedEx's delivery of some medicines Bob's doctor prescribed. My friend opened the package and reviewed the meds. After doing so, he wondered aloud, "What is all this stuff for?"

What he was getting at is that the doctor had prescribed a bunch of "when the time comes" medications. For instance, suppository pain killers were among the meds. Bob has no difficulty swallowing. A medicine that reduces swelling of the prostate was prescribed, yet Bob is on a Foley catheter that it's expected he'll have for the remainder of his days. There was also included an anti-anxiety medication, yet Bob has no anxiety issues; he's not at all the person who's anxious about his terminal diagnosis or anything else.

That the doctor had sent, and Bob's insurance paid for, the medications now struck my friend and me as wasteful because Bob's meds get delivered on the day or morning following their being prescribed and called in to the pharmacy. Accordingly, I and my friend are wondering why the unnecessary meds were prescribed. My friend called the doctor and the answer given was "so they'd be there if/when they were needed."

That may make sense for someone receiving at-home care and of whom it's relatively certain that they'll live long enough to use at some of them. That just isn't the case with Bob, who, along with being terminally ill, is nearly 100 years old. I went to see him because I knew that, quite literally and plausibly, he could pass at any minute. If Bob must urgently have a given medicine, either the scrip delivery service can deliver it, or someone will go to CVS and get it. That said, aside from pain abatements meds, there aren't any that the doctor prescribed and that fall into the "urgently needed" category.

Let me be clear. I have no idea of what the meds' prices. From my friend's discussion of what the doctor told him, it seems that this "just in case it's needed" prescribing protocol is just that, SOP for old, ill people. Is such an SOP's extancy a major factor militating for higher than necessary healthcare/health insurance costs? I don't know, and not knowing the specific prices, I can't speculate on whether it is or is not. What I can say is that insofar as it appears that there is the noted SOP, costs must, to some extent, necessarily be higher than they otherwise would need to be.

You aren't saying "kill him", are you?

 

[OldLady]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

I was amazed at a child hood friend of mine posted it on FB a picture of all the pill bottles that she has to take at only 50.. I don't get this.i personally refuse to even take asprin at 52 ..but I am a guy..

I guessed I got blessed by God or something... but there is no way in hell I will take a bunch of drugs to keep me alive...it won't happen.

.

This is last moments care. I've seen the struggle it can be to finally die, and I would spare anyone that.
I've been lucky, too, but I have older friends who are on a dozen or more.

 

[OldLady]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

Bob, prior to yesterday's delivery, had morphine, tramadol and oxcy. When the man feels pain, he's given one or the other, perhaps supplemented with an OTC Tylenol, depending on how bad he claims the pain is.

Well, why didn't you say so? But the suppositories are still a good idea, as are the tranqs, in case things go that way.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used, they've already been paid for so the hospital can't take them back and charge someone else for them, so they toss them.
A woman goes around to a handful of hospitals and collects this stuff and when she has the money, she sends shipping containers full of the stuff to struggling health clinics in places like Africa where even clean bandages are hard to come by. Her shipments are worth hundreds of thousands, even a million dollars or more. That is all just thrown away by hospitals everyday. And she only goes to a few that are local to her. Billions thrown out in hospitals across the country.

So that is another small but real example of waste in our healthcare system.

 

[usmbguest5318]

Last evening, I visited my closest friend's father (for this thread, call him Bob) who's squarely and unalterably in the terminal months of his dotage. My arrival coincided with a FedEx's delivery of some medicines Bob's doctor prescribed. My friend opened the package and reviewed the meds. After doing so, he wondered aloud, "What is all this stuff for?"

What he was getting at is that the doctor had prescribed a bunch of "when the time comes" medications. For instance, suppository pain killers were among the meds. Bob has no difficulty swallowing. A medicine that reduces swelling of the prostate was prescribed, yet Bob is on a Foley catheter that it's expected he'll have for the remainder of his days. There was also included an anti-anxiety medication, yet Bob has no anxiety issues; he's not at all the person who's anxious about his terminal diagnosis or anything else.

That the doctor had sent, and Bob's insurance paid for, the medications now struck my friend and me as wasteful because Bob's meds get delivered on the day or morning following their being prescribed and called in to the pharmacy. Accordingly, I and my friend are wondering why the unnecessary meds were prescribed. My friend called the doctor and the answer given was "so they'd be there if/when they were needed."

That may make sense for someone receiving at-home care and of whom it's relatively certain that they'll live long enough to use at some of them. That just isn't the case with Bob, who, along with being terminally ill, is nearly 100 years old. I went to see him because I knew that, quite literally and plausibly, he could pass at any minute. If Bob must urgently have a given medicine, either the scrip delivery service can deliver it, or someone will go to CVS and get it. That said, aside from pain abatements meds, there aren't any that the doctor prescribed and that fall into the "urgently needed" category.

Let me be clear. I have no idea of what the meds' prices. From my friend's discussion of what the doctor told him, it seems that this "just in case it's needed" prescribing protocol is just that, SOP for old, ill people. Is such an SOP's extancy a major factor militating for higher than necessary healthcare/health insurance costs? I don't know, and not knowing the specific prices, I can't speculate on whether it is or is not. What I can say is that insofar as it appears that there is the noted SOP, costs must, to some extent, necessarily be higher than they otherwise would need to be.

You aren't saying "kill him", are you?

??? No! I am not saying "kill him." Were I of that mindset, that's what I'd have written, but I didn't write. I'm saying neither more nor less than what I wrote.

How, from what I wrote, you managed to conjure that I might be advocating for an act of murder -- "kill him" is a murderous instruction -- I do not know.

 

[Jarlaxle]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

So, you didn't read the post.

 

[OldLady]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

So, you didn't read the post.

Speak to the topic and stop nipping at my ankles.

 

[usmbguest5318]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

Bob, prior to yesterday's delivery, had morphine, tramadol and oxcy. When the man feels pain, he's given one or the other, perhaps supplemented with an OTC Tylenol, depending on how bad he claims the pain is.

Well, why didn't you say so? But the suppositories are still a good idea, as are the tranqs, in case things go that way.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used, they've already been paid for so the hospital can't take them back and charge someone else for them, so they toss them.
A woman goes around to a handful of hospitals and collects this stuff and when she has the money, she sends shipping containers full of the stuff to struggling health clinics in places like Africa where even clean bandages are hard to come by. Her shipments are worth hundreds of thousands, even a million dollars or more. That is all just thrown away by hospitals everyday. And she only goes to a few that are local to her. Billions thrown out in hospitals across the country.

So that is another small but real example of waste in our healthcare system.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used [...] That is all just thrown away by hospitals everyday. [...] So that is another small but real example of waste in our healthcare system.

Yes, it is. That wasteful use of supplies is manifest in Bob's situation too. His nurse had delivered 500 bed pads, 500 adult diapers and 500 padded/absorbent pull-on underwear for him. Generally, Bob's bed pads and diapers/pull-ons need to be changed once a day. (Remember, he's on a Foley catheter, so he doesn't soil them with urine.) Maybe that will change (I suspect it will), but, again, it's not clear Bob will live for 30 days, let alone for months, though we don't know how long he will live. I would think ordering 30 days' worth of supplies at a time is reasonable and sufficient given the situation.

 

[Wyatt earp]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

I was amazed at a child hood friend of mine posted it on FB a picture of all the pill bottles that she has to take at only 50.. I don't get this.i personally refuse to even take asprin at 52 ..but I am a guy..

I guessed I got blessed by God or something... but there is no way in hell I will take a bunch of drugs to keep me alive...it won't happen.

.

This is last moments care. I've seen the struggle it can be to finally die, and I would spare anyone that.
I've been lucky, too, but I have older friends who are on a dozen or more.

That's what I don't get, I think people are becoming (what's that word I am searching for?) Hypercondriac..?


I mean I don't know why they need all these pills and all, is doctors over prescribing? I know I am a guy and all and women my age have different problems.. but I think it's ridiculous about all these medication people need to take.

.

 

[OldLady]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

I was amazed at a child hood friend of mine posted it on FB a picture of all the pill bottles that she has to take at only 50.. I don't get this.i personally refuse to even take asprin at 52 ..but I am a guy..

I guessed I got blessed by God or something... but there is no way in hell I will take a bunch of drugs to keep me alive...it won't happen.

.

This is last moments care. I've seen the struggle it can be to finally die, and I would spare anyone that.
I've been lucky, too, but I have older friends who are on a dozen or more.

That's what I don't get, I think people are becoming (what's that word I am searching for?) Hypercondriac..?


I mean I don't know why they need all these pills and all, is doctors over prescribing? I know I am a guy and all and women my age have different problems.. but I think it's ridiculous about all these medication people need to take.

.

Doctors will tell you that when patients come to them with a complaint, they expect some kind of "fix." And probably a lot of those meds do the job they are meant to do. People are certainly living longer more active lives because of them. But I agree when you are carrying your pills around by the sack load, you should at least take a look at that. Particularly if you see more than one doctor, like specialists for this or that. They can definitely be over prescribing if they don't see the whole picture.

 

[Wyatt earp]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

I was amazed at a child hood friend of mine posted it on FB a picture of all the pill bottles that she has to take at only 50.. I don't get this.i personally refuse to even take asprin at 52 ..but I am a guy..

I guessed I got blessed by God or something... but there is no way in hell I will take a bunch of drugs to keep me alive...it won't happen.

.

This is last moments care. I've seen the struggle it can be to finally die, and I would spare anyone that.
I've been lucky, too, but I have older friends who are on a dozen or more.

That's what I don't get, I think people are becoming (what's that word I am searching for?) Hypercondriac..?


I mean I don't know why they need all these pills and all, is doctors over prescribing? I know I am a guy and all and women my age have different problems.. but I think it's ridiculous about all these medication people need to take.

.

Doctors will tell you that when patients come to them with a complaint, they expect some kind of "fix." And probably a lot of those meds do the job they are meant to do. People are certainly living longer more active lives because of them. But I agree when you are carrying your pills around by the sack load, you should at least take a look at that. Particularly if you see more than one doctor, like specialists for this or that. They can definitely be over prescribing if they don't see the whole picture.

You might be right, I have a couple of old ladies that comes by once and a while to check on me why am I not walking my dog early in the morning and all..one is like 95 years old the other is in her late 80s ..I really don't know their situations but they still have a lot of life to them driving on their golf cart and all...


But as an old drug addict I am so amuened to pills my tolerance is way to high..that's why I stay away from it, I know first hand how addicted you can get and it becomes part of your life that I don't want no part of no more..

.

 

[OldLady]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

Bob, prior to yesterday's delivery, had morphine, tramadol and oxcy. When the man feels pain, he's given one or the other, perhaps supplemented with an OTC Tylenol, depending on how bad he claims the pain is.

Well, why didn't you say so? But the suppositories are still a good idea, as are the tranqs, in case things go that way.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used, they've already been paid for so the hospital can't take them back and charge someone else for them, so they toss them.
A woman goes around to a handful of hospitals and collects this stuff and when she has the money, she sends shipping containers full of the stuff to struggling health clinics in places like Africa where even clean bandages are hard to come by. Her shipments are worth hundreds of thousands, even a million dollars or more. That is all just thrown away by hospitals everyday. And she only goes to a few that are local to her. Billions thrown out in hospitals across the country.

So that is another small but real example of waste in our healthcare system.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used [...] That is all just thrown away by hospitals everyday. [...] So that is another small but real example of waste in our healthcare system.

Yes, it is. That wasteful use of supplies is manifest in Bob's situation too. His nurse had delivered 500 bed pads, 500 adult diapers and 500 padded/absorbent pull-on underwear for him. Generally, Bob's bed pads and diapers/pull-ons need to be changed once a day. (Remember, he's on a Foley catheter, so he doesn't soil them with urine.) Maybe that will change (I suspect it will), but, again, it's not clear Bob will live for 30 days, let alone for months, though we don't know how long he will live. I would think ordering 30 days' worth of supplies at a time is reasonable and sufficient given the situation.

I agree. It's possible the supplier doesn't have smaller orders available or the agency always orders the "family size" because it's cheapest. I'm sure part of the problem with ALL of this -- both your story and mine -- is that people aren't actually paying out of their own pocket. An insurance company or Medicare or both are picking up the tab and they don't know one thing about Bob or his situation. They just pay it.
There are ways Bob's son can gift any left overs to individuals who would appreciate them by talking to the nurse who is in charge of his care. She'll know of someone and probably happily take them off his hands.

 

[usmbguest5318]

I'd prefer my father went with no pain and no fear, when that time came. And you are second guessing if those are really needed. When "the time comes," you want the man to suffer for hours and hours while you reach a doctor, get a script called in and delivered or picked up? To save a buck?

Bob, prior to yesterday's delivery, had morphine, tramadol and oxcy. When the man feels pain, he's given one or the other, perhaps supplemented with an OTC Tylenol, depending on how bad he claims the pain is.

Well, why didn't you say so? But the suppositories are still a good idea, as are the tranqs, in case things go that way.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used, they've already been paid for so the hospital can't take them back and charge someone else for them, so they toss them.
A woman goes around to a handful of hospitals and collects this stuff and when she has the money, she sends shipping containers full of the stuff to struggling health clinics in places like Africa where even clean bandages are hard to come by. Her shipments are worth hundreds of thousands, even a million dollars or more. That is all just thrown away by hospitals everyday. And she only goes to a few that are local to her. Billions thrown out in hospitals across the country.

So that is another small but real example of waste in our healthcare system.

I saw a show on ... somewhere .... a while back about the enormous amount of waste in hospitals. Perfectly good medical supplies, still sterile and in their original wrappings, are thrown away every day. Catheters, bandages, even surgical supplies, are charged to a patient and when the patient is discharged and the supplies aren't used [...] That is all just thrown away by hospitals everyday. [...] So that is another small but real example of waste in our healthcare system.

Yes, it is. That wasteful use of supplies is manifest in Bob's situation too. His nurse had delivered 500 bed pads, 500 adult diapers and 500 padded/absorbent pull-on underwear for him. Generally, Bob's bed pads and diapers/pull-ons need to be changed once a day. (Remember, he's on a Foley catheter, so he doesn't soil them with urine.) Maybe that will change (I suspect it will), but, again, it's not clear Bob will live for 30 days, let alone for months, though we don't know how long he will live. I would think ordering 30 days' worth of supplies at a time is reasonable and sufficient given the situation.

I agree. It's possible the supplier doesn't have smaller orders available or the agency always orders the "family size" because it's cheapest. I'm sure part of the problem with ALL of this -- both your story and mine -- is that people aren't actually paying out of their own pocket. An insurance company or Medicare or both are picking up the tab and they don't know one thing about Bob or his situation. They just pay it.
There are ways Bob's son can gift any left overs to individuals who would appreciate them by talking to the nurse who is in charge of his care. She'll know of someone and probably happily take them off his hands.

I'm sure part of the problem with ALL of this -- both your story and mine -- is that people aren't actually paying out of their own pocket.

That's highly plausible and highly probable, at least IMO it is.

I know my friend thinks about the matter from at least two points of view:

• That of the family member/caregiver who, because it's his father, is somewhat indifferent about the abundance of supplies, and
• That of an individual who is well aware that excess such as he's observing contributes to increasing the cost of care and health insurance.

It's possible the supplier doesn't have smaller orders available or the agency always orders the "family size" because it's cheapest.

That's possible. I haven't queried the nurse or supplier about whether that's the case.

There are ways Bob's son can gift any left overs to individuals who would appreciate them by talking to the nurse who is in charge of his care. She'll know of someone and probably happily take them off his hands.

True. I'm sure the family will either deal with that or delegate doing so to me or one of the other close family friends or to a relative.

 

[PredFan]

Last evening, I visited my closest friend's father (for this thread, call him Bob) who's squarely and unalterably in the terminal months of his dotage. My arrival coincided with a FedEx's delivery of some medicines Bob's doctor prescribed. My friend opened the package and reviewed the meds. After doing so, he wondered aloud, "What is all this stuff for?"

What he was getting at is that the doctor had prescribed a bunch of "when the time comes" medications. For instance, suppository pain killers were among the meds. Bob has no difficulty swallowing. A medicine that reduces swelling of the prostate was prescribed, yet Bob is on a Foley catheter that it's expected he'll have for the remainder of his days. There was also included an anti-anxiety medication, yet Bob has no anxiety issues; he's not at all the person who's anxious about his terminal diagnosis or anything else.

That the doctor had sent, and Bob's insurance paid for, the medications now struck my friend and me as wasteful because Bob's meds get delivered on the day or morning following their being prescribed and called in to the pharmacy. Accordingly, I and my friend are wondering why the unnecessary meds were prescribed. My friend called the doctor and the answer given was "so they'd be there if/when they were needed."

That may make sense for someone receiving at-home care and of whom it's relatively certain that they'll live long enough to use at some of them. That just isn't the case with Bob, who, along with being terminally ill, is nearly 100 years old. I went to see him because I knew that, quite literally and plausibly, he could pass at any minute. If Bob must urgently have a given medicine, either the scrip delivery service can deliver it, or someone will go to CVS and get it. That said, aside from pain abatements meds, there aren't any that the doctor prescribed and that fall into the "urgently needed" category.

Let me be clear. I have no idea of what the meds' prices. From my friend's discussion of what the doctor told him, it seems that this "just in case it's needed" prescribing protocol is just that, SOP for old, ill people. Is such an SOP's extancy a major factor militating for higher than necessary healthcare/health insurance costs? I don't know, and not knowing the specific prices, I can't speculate on whether it is or is not. What I can say is that insofar as it appears that there is the noted SOP, costs must, to some extent, necessarily be higher than they otherwise would need to be.

Yeah maybe, but the suppositories are likely to be needed toward the end. In the hours before passing, he may not be able to swallow.

There are many other reasons that healthcare costs are high, but waste, unfortunately, is one of them.

 

[usmbguest5318]

Last evening, I visited my closest friend's father (for this thread, call him Bob) who's squarely and unalterably in the terminal months of his dotage. My arrival coincided with a FedEx's delivery of some medicines Bob's doctor prescribed. My friend opened the package and reviewed the meds. After doing so, he wondered aloud, "What is all this stuff for?"

What he was getting at is that the doctor had prescribed a bunch of "when the time comes" medications. For instance, suppository pain killers were among the meds. Bob has no difficulty swallowing. A medicine that reduces swelling of the prostate was prescribed, yet Bob is on a Foley catheter that it's expected he'll have for the remainder of his days. There was also included an anti-anxiety medication, yet Bob has no anxiety issues; he's not at all the person who's anxious about his terminal diagnosis or anything else.

That the doctor had sent, and Bob's insurance paid for, the medications now struck my friend and me as wasteful because Bob's meds get delivered on the day or morning following their being prescribed and called in to the pharmacy. Accordingly, I and my friend are wondering why the unnecessary meds were prescribed. My friend called the doctor and the answer given was "so they'd be there if/when they were needed."

That may make sense for someone receiving at-home care and of whom it's relatively certain that they'll live long enough to use at some of them. That just isn't the case with Bob, who, along with being terminally ill, is nearly 100 years old. I went to see him because I knew that, quite literally and plausibly, he could pass at any minute. If Bob must urgently have a given medicine, either the scrip delivery service can deliver it, or someone will go to CVS and get it. That said, aside from pain abatements meds, there aren't any that the doctor prescribed and that fall into the "urgently needed" category.

Let me be clear. I have no idea of what the meds' prices. From my friend's discussion of what the doctor told him, it seems that this "just in case it's needed" prescribing protocol is just that, SOP for old, ill people. Is such an SOP's extancy a major factor militating for higher than necessary healthcare/health insurance costs? I don't know, and not knowing the specific prices, I can't speculate on whether it is or is not. What I can say is that insofar as it appears that there is the noted SOP, costs must, to some extent, necessarily be higher than they otherwise would need to be.

Yeah maybe, but the suppositories are likely to be needed toward the end. In the hours before passing, he may not be able to swallow.

There are many other reasons that healthcare costs are high, but waste, unfortunately, is one of them.

Yeah maybe, but the suppositories are likely to be needed toward the end. In the hours before passing, he may not be able to swallow.

I think I understand the crux of what you've written.

Considering the matter in the abstract, I have to wonder just how much it matters, hours before the end, whether one swallows anything or doesn't. If it's a matter of weeks or days that one might persist and not be able to swallow, the suppositories may be necessary in some instances, of course.

Bob's is not one of those instances. He has liquid morphine that is placed under his tongue and absorbed through the tissue there. Occasionally something less powerful than morphine effectively abates his pain, but not usually, and never is just a couple Tylenol doses enough to do so. Just as I know that, so do the doctor and nurse who order the meds and supplies.

There are many other reasons that healthcare costs are high, but waste, unfortunately, is one of them.

It is. Furthermore, it's an comparatively easy ones to control and curtail. I'd think caregivers and clinicians would exercise due restraint, but clearly they don't.

"Just in case" reasoning occasionally has it's place; however, it seems that in Bob's case, the quantity of supplies and meds ordered for him appear to be just in case he lives for the longest span of time his doctors think is, in the abstract, possible. In Bob's case, that's been stated as ranging from a few weeks to a year.

Given the rate at which Bob's using the supplies, and the supplier's quick turnaround time (24-48 hours; it's 24 hours or less for meds) from order to delivery, it seems the shipment quantities are excessive. Were a variety of other factors in play -- winter storms preventing/impeding deliveries, Bob going through pads and incontinence-management items "like water," etc. -- I wouldn't arrive at the same conclusion. Starting Bob off with a one month supply of "everything" and then reordering when he's down to a five or so days worth remaining is just fine, especially seeing as it's summertime.