In this country, people make demands and have immediate gratification expectations. It is no different in healthcare. Examples:
My brother severely injured/fractured his foot in a farming accident about 15y ago. His doc was able to fix all the bones and skin graft his foot. 4 trips to the OR. 5d in the hospital. Brother was furious the final bill was $40k. I said "well, you have your foot and all that surgery and care and anesthesia and medications cost money. They could have cut it off and sent you home for about $7k." You don't get Mercedes healthcare for a Volkswagen price.
I had a knee replacement in June and was home 14h after I left. People think they should be at the hospital for several nights. For what? You can take pain pills at home. AND the bonus is you get to sleep! Why not go home? Savings? About $5k.
My Mom's end of life care noted above was under $3k for 7wks. Hubby's Grandma was 5d in the hospital for over $50k (their age difference was 2y). Cat scan after cat scan to monitor changing conditions from a stroke until she died.
Do I believe in restricting care as we approach end of life? Yes I do. And I mean at ANY age. TONS of money is spent attempting to save preemies, trauma victims as well as that 99yo Grandma I spoke of earlier.
80% of healthcare dollars are spent in the final 30d of life-regardless of age.
Medical Ethics committees are faced with this every day in hospitals. But then we have the USA overpopulation of ambulance-chasing Lawyers who are constantly advertising to "victiims". TORT reform is badly needed in this country. You have no idea how big legal teams have become in hospitals in this country. It doesn't matter if there was no wrongdoing...we spend a ton of $ defending ourselves.
It's all going to get much worse before it gets better. People want what they want. They want it now. They want it perfect. They don't care if it's safe or not.
Another example: high blood glucose seriously inhibits tissue healing. A patient with a 385 glucose gets cancelled. He is outraged. He demands to have this elective surgery because it is inconvenient to wait. He yells at everyone. Stupid nurses. Stupid doctors. And NO, we did not do his procedure. Now you know he has told 10 of his friends what a crappy place we are and how stupid we are.
Can't win for losing. I could go on and on about what I've seen in my 38y career....but I'll stop for now.