The Crushing Cost of Care

A small percentage of challenging cases, often at the end of life, make up the great bulk of Medicare spending on hospital care. Are we anywhere close to containing the costs? July 6, 2012, 7:13 p.m.

On Valentine’s Day 2009, Scott Crawford, 41 years old, received the break that he thought would save his life. A surgeon at Johns Hopkins Hospital in Baltimore removed his ailing heart and put in a healthy one. The transplant was a success.

But complications put the former tire-warehouse worker in intensive care for almost a year. Surgeons removed his gall bladder, his left leg and part of a lung. And Mr. Crawford soon became one of the most expensive Americans on Medicare.

As his condition turned grave, one of his doctors questioned whether to keep treating him. Nurses reported feeling “moral distress” over his unrelenting pain. Still, medical opinion was split, and Mr. Crawford’s family, with the backing of his transplant surgeon, pushed forward. Read more