Sixty Minutes aired an excellent special last night dealing with the difficult issue of end of life treatment costs. As Congress debates health care and the future of Medicare, this is an important ethical component to debate.

http://www.cbsnews.com/video/watch/?id=5737138n&tag=api

While we deal primarily with issues concerning the Medicare Secondary Payer Act and CMS' efforts to enforce the law, it seems like a tiny sliver of the pie when you examine the staggering end of life costs paid by Medicare. Last year it was estimated that Medicare paid $50 billion for expenses incurred for beneficiaries during the last two months of life.

The white elephant in the room is right in front of us yet there is precious little leadership willing to take on the issue. Medicare can have a blank check policy or fiscal solvency. I don't see how it can have both.

CMS is going to have to hustle down a lot of $50,000 workers' compensation settlements to balance that checkbook.

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