TY - JOUR AU - Becker,Gary AU - Murphy,Kevin AU - Philipson,Tomas TI - The Value of Life Near its End and Terminal Care JF - National Bureau of Economic Research Working Paper Series VL - No. 13333 PY - 2007 Y2 - August 2007 UR - http://www.nber.org/papers/w13333 L1 - http://www.nber.org/papers/w13333.pdf N1 - Author contact info: Gary Becker Department of Economics University of Chicago 1126 East 59th Street Chicago, IL 60637 Tel: 312/702-8254 E-Mail: gbecker@uchicago.edu Kevin M. Murphy Booth School of Business The University of Chicago 5807 S. Woodlawn Ave. Chicago, IL 60637 Tel: 773/702-7280 Fax: 773/834-3554 E-Mail: murphy@chicagoBooth.edu Tomas Philipson Irving B. Harris Graduate School of Public Policy Studies University of Chicago 1155 E. 60th Street Chicago, IL 60637 Tel: 773/502-7773 E-Mail: t-philipson@uchicago.edu AB - Medical care at the end of life, which is often is estimated to contribute up to a quarter of US health care spending, often encounters skepticism from payers and policy makers who question its high cost and often minimal health benefits. It seems generally agreed upon that medical resources are being wasted on excessive care for end-of-life treatments that often only prolong minimally an already frail life. However, though many observers have claimed that such spending is often irrational and wasteful, little explicit and systematic analysis exists on the incentives that determine end of life health care spending. There exists no positive theory that attempts to explain the high degree of end-of life spending and why differences across individuals, populations, or time occur in such spending. This paper attempts to provide the first rational and systematic analysis of the incentives behind end of life care. The main argument we make is that existing estimates of the value of a life year do not apply to the valuation of life at the end of life. We stress the low opportunity cost of medical spending near ones death, the importance of keeping hope alive in a terminal care setting, the larger social value of a life than estimated in private demand settings, as well as the insignificance in quality of life in lowering its value. We derive how an ex-ante perspective in terms of insurance and R&D alters some of these conclusions. ER -