16 April 2020

Egregious waste of medical resources in the U.S.

An op-ed in Bloomberg cites one example of the waste of medical supplies:
A few weeks before my husband died on March 7 at the age of 55, the oxygen arrived: a concentrator for everyday use and a backup tank in case of an emergency. That Barry had never struggled to breathe in the 10 months since being diagnosed with cancer didn’t seem to matter. Once he went into hospice, our living room was stuffed with pieces of equipment, a cornucopia of drugs, diapers, wipes, gloves, masks and whatever else the agency felt he needed to die comfortably at home...

But caring for my dying husband also drove home the system’s inefficiency and waste. Among the unwanted possessions that were bequeathed to me after Barry’s hospice stay were an unused commode chair, a shower chair he’d used twice, a bedside table, packages of ventilator tubing, unopened cartons of fentanyl patches and painkillers, boxes of nitrile gloves, masks and numerous other products that hadn’t been touched. Other than the bed, wheelchair, oxygen tank and concentrator, I was told to throw everything out. The hospice wouldn’t — couldn’t — take any of it back. I now understand how waste costs the health care system up to $935 billion a year, according to research by Humana Inc. chief medical officer William Shrank and colleagues that was published in October in the Journal of the American Medical Association...

Just as fighting the coronavirus has cleared the air in New York and the canals in Venice, perhaps it can help us see more clearly the cost of other choices we’ve made.
I can cite a relevant example from personal experience several years ago, as no doubt can many readers.  After my mother died, I tried to donate her wheelchair, walker, commode etc to the senior living facility - they couldn't accept them.  Nor could the university hospital.  Or the local hospice service.

I finally took those items to a local community senior center, which was grateful to get them.  Her medications - still safely sealed in bubble packs - had to be incinerated at the local police station.

Why can't most organizations accept such material?  Because the next person who needs such an item will simply be given new ones and billed for such through their insurance.  We have such a ridiculous excuse for a health-care system that it's beyond mockery.


  1. I think an important questions is if the organization that uses these donated supplies is legally liable if said supplies are faulty and result in death?

  2. There is a reason for not accepting the equipment back, and it's a fairly good one. Here is the best example, what if the sick person had COVID-19? They don't take the equipment back, because even if has not been used, the packages themselves, are no longer sterile. The medical establishments have no idea what the original owner had, cannot verify, and if they had accepted the donations, are now libel for any disease the next person who received the items might get. Now I fully acknowledge that it's the last reason that is probably the primary motivator, but there is a reason for the wastage. And I acknowledge that if someone died of a heart attack, there is no way that is transmittable, but the medical establishments have no way to track the equipment after it has left their hands, so they cant verify what the equipment has been exposed to. It's like keeping the chain of evidence in a court case. Could it be handled better? God Yes. And there are companies you can donate used medical equipment to, you just have to find them. No-kill pet shelters will take a lot of the metal generic tools, because they can sterilize them.

  3. My wife had a project in college that collected old wheel chairs (and other mobility devices) and shipped them to Africa. It is a shame to hear that equipment/supplies are discarded or incinerated when a need exists. By now, our society should know better than to waste frivolously.

  4. And. what is worse, compared to the incredible waste of resources involved in so-called "heroic measures" to extend the last days of patients near the end of life these wasted hospice supplies are a huge savings.

  5. If you read the full letter that was published in the link, the woman makes the greater point (IMO) that her husband was provided with a lot of supplies he did not use nor need. She points that in this time of dwindling medical supplies that are needed to treat people with COVID 19. This statement summarizes her concerns very well:

    "Even as he approached death, my husband was bombarded with stuff. Amid this unprecedented pandemic, though, U.S. doctors and health care officials now face tough choices in doling out treatment. As they seek more resources and equipment, we need to take a hard look at how the current inventory is being deployed."

    I understand why most facilities will not take equipment that has been in the possession of a consumer, even when no issues of a spreading is virus. A means needs to be developed where people do not simply receive medical goods just because they are available.

  6. I am very surprised they left the fentanyl. When my FIL died, hospice came and cut up all the leftover patches and flushed them down the toilet.

    1. Now that is also disturbing. Drugs should never be flushed, they eventually end up in the ocean or the aquifer. They should be disposed of properly as hazardous material.

  7. I'm the mother of a medically complex child with special needs. During my son's first 18 months of life, he had a gastrostomy feeding tube and was on a specialized medical formula that isn't something you can just pick up in 99% of the local stores. We spent obscene amounts of time fighting with insurance to cover the formula in an amount adequate to meet his nutritional needs, and to cover one feeding bag for the pump per day. The bags clearly states all over each individual bag and the outer case that they are not to be used for more than 24 hours, but insurance only wanted to cover 5 per month. The same for the sterile 60ml syringes we could use in place of the feeding pump if, for the example, the pump malfunctioned, the power was out, or we were feeding my son on the road due to doctor's or therapist's appointments. But they insisted on having our DME (durable medical equipment) supplier send us 4 boxes of sterile gauze drain squares and 4 rolls of medical tape each month. We needed perhaps half of that on a bad month. There were other items we only needed occasionally, but were forced to accept monthly deliveries for because the doctors were not allowed to write prescriptions on an as-needed basis for things like sterile lubricant for example, and insurance companies would not approve them unless it was written as a monthly delivery. We quickly became a part of multiple Facebook groups for parents of special needs children set up specifically to swap out surplus medical supplies and equipment for what was actually needed. In some cases the items were sold, but since this is actually illegal in most states (you can't resell items paid for by insurance or Medicaid- it's considered fraud) they were usually billed as "free for shipping" (you paid the cost of getting the items shipped to you, usually in flat-rate postal boxes).
    A lot of what was on offer on those sites was supplies left after the death of a child or parent after multiple attempts to donate them to various groups. I cannot even imagine how frustrating it must be to lose al one, have to clean out those stockpiles of supplies, and be told that it cannot be donated and then have to list it online piecemeal in hopes that some good could still come from that loss. It was certainly frustrating for me trying to get what we actually needed instead of what some low-level flunkies at the insurance company had been told was "standard care" with no actual input from a qualified medical professional who knew the equipment or supplies! And when my son no longer needed his feeding tube, it was definitely a pain in the butt to clean out and find homes for all those supplies that we didn't need. Every time I would open his closet to get something out, the waste of the whole system always hit home again.


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