A growing body of research suggests wide overuse of tubes in other patients, such as those with some types of stroke, muscular dystrophy, and some cancers.

The Cost of Dying: Simple act of feeding poses painful choices - SGVTribune.com:

'via Blog this'"It is amazing how long you can keep someone alive," said Dr. Leslie Foote, medical director of the Salinas-based nursing home Windsor Gardens Rehabilitation Center. "But we sure aren't doing them any great favors."

Some manufacturers lease the feeding apparatus at low cost to hospitals and nursing homes in exchange for a commitment to use only the manufacturers' food and supplies.

Almost all dying patients, even those who are hand-fed, lose their interest in eating and drinking; this is the body's signal that death is coming, according to palliative care providers. If food is not artificially provided, patients typically die within two weeks, although exceptions are common. Lack of food triggers a biochemical process called ketosis, which actually blunts hunger and eases discomfort due to the release of natural morphine-like agents.

..."With this technique, it became easier -- you avoided the (operating room), you could do it in the endoscopic suite, and it was much faster. You didn't have to do deep anesthesia or face surgical complications," said Dr. Timothy O. Lipman, chief of the GI-Hepatology-Nutrition Section of the Veterans Affairs Medical Center in Washington, D.C.

The surgery was also lucrative: Medicare pays doctors $225 to $1,047 to place the tube and pays hospitals $591 to $3,361.

For nursing homes, it eased the workload of hand feeding.

As the market expanded, so did innovations in device design, materials, pumps and placement techniques. Each improvement boosted PEG popularity.

Initially, no companies were interested in manufacturing the tube, predicting little demand. Ponsky finally persuaded a company, American Endoscopy, to produce it. Now a dozen large corporations, such as Abbott and Nestle, dominate the market.