To the Editor: In their analysis of proposals to control costs at the end of life, such as the use of advance directives and hospice care, Emanuel and Emanuel (Feb. 24 issue)1 somehow conclude that an annual saving of $29.7 billion is less than substantial. In most people's view, $30 billion in savings is anything but unsubstantial. For example, $30 billion is enough to provide health insurance to uninsured Americans as part of a plan of universal coverage. These savings can also be critical for people already in the system. On the basis of the Emanuels' estimate, the total savings.
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