Bloomberg News has a detailed and gripping account by the wife of a cancer patient about the costs of end-of-life care. Among the key facts: "Some insurers drove harder bargains than others. In December 2006, for example, UnitedHealthcare, a unit of UnitedHealth Group Inc., paid $2,586 to the University of Pennsylvania hospital for a chest scan; in March 2007, after I switched employers, WellPoint Inc.'s Empire Blue Cross & Blue Shield paid $776 for the same $3,232 bill." More: "The entire medical bill for seven years, in fact, was steeply discounted. The $618,616 became $254,176 when the insurers paid their share and imposed their discounts. Of that, Terence and I were responsible for $9,468 -- less than 4 percent." The $254,000 could have paid to vaccinate "almost a quarter-million children in developing countries," says the article's author, Amanda Bennett. Sad story, excellent journalism. One policy point to take away seems to be that insurance companies do provide some value. On the other hand, looking at the difference between the $618,616 and the $254,176 as a savings is like the wife who comes home from a shopping trip and announces, "Honey, you'll be so happy, I saved the family $50,000! I bought a fur coat for $20,000 that was on sale, reduced from $70,000." It's hard to know the value being provided by the insurance companies without knowing how inflated the original bills are in reaction to the inevitable bargaining-down of them by the insurance companies.