The current September 2008 edition of Critical Care Medicine includes an interesting article entitled "Growth of intensive care unit resource use and its estimated cost in Medicare." It presents work completed at the CRISMA Laboratory of our CCM Department. The co-authors are Drs. Kersten, Rahim, Dremsizov, Clermont, Cooper, Angus and Linde-Zwirble. The study examines changes in ICU resource use among Medicare hospitalizations (n = 121,747,260) from 1994-2004, finding that by 2004, fully one third of Medicare hospitalizations had either ICU or CCU care. The authors note that while Medicare ICU use rose rapidly over the period, adjusted daily critical care costs remained stable and care outside the ICU became more expensive. By 2004, daily ICU costs were only 1.7x that of floor costs, a relative bargain considering the additional care, monitoring, and expertise that comes with ICU care.