Newsweek, in all of its wisdom, is still arguing that Sarah Palin lied about the death panel provisions in ObamaCare, but we really should have a death panel anyways. The author of the below piece, Evan Thomas, writes that his 79 year old mother wanted to die but the doctors wouldn’t let her because the assisted living facility she was staying at was sustained by Medicare. He didn’t like this and muses on how we can fix health care in this country by, you guessed it, getting people into hospice care and out of hospitals. People need to die and just get it over with you see:
The idea that we might ration health care to seniors (or anyone else) is political anathema. Politicians do not dare breathe the R word, lest they be accused—however wrongly—of trying to pull the plug on Grandma. But the need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate. Everyone sees it but no one wants to talk about it. At a more basic level, Americans are afraid not just of dying, but of talking and thinking about death. Until Americans learn to contemplate death as more than a scientific challenge to be overcome, our health-care system will remain unfixable.
Compared with other Western countries, the United States has more health care—but, generally speaking, not better health care. There is no way we can get control of costs, which have grown by nearly 50 percent in the past decade, without finding a way to stop overtreating patients.
~~~But how do you decide which treatments to cut out? How do you choose between the necessary and the unnecessary? There has been talk among experts and lawmakers of giving more power to a panel of government experts to decide—Britain has one, called the National Institute for Health and Clinical Excellence (known by the somewhat ironic acronym NICE). But no one wants the horror stories of denied care and long waits that are said to plague state-run national health-care systems. (The criticism is unfair: patients wait longer to see primary-care physicians in the United States than in Britain.) After the summer of angry town halls, no politician is going to get anywhere near something that could be called a “death panel.”
There’s no question that reining in the lawyers would help cut costs. Fearing medical-malpractice suits, doctors engage in defensive medicine, ordering procedures that may not be strictly necessary—but why take the risk? According to various studies, defensive medicine adds perhaps 2 percent to the overall bill—a not-insignificant number when more than $2 trillion is at stake. A number of states have managed to institute some kind of so-called tort reform, limiting the size of damage awards by juries in medical-malpractice cases. But the trial lawyers—big donors to the Democratic Party—have stopped Congress from even considering reforms. That’s why it was significant that President Obama even raised the subject in his speech last week, even if he was vague about just what he’d do. (Best idea: create medical courts run by experts to rule on malpractice claims, with no punitive damages.)
But the biggest cost booster is the way doctors are paid under most insurance systems, including Medicare. It’s called fee-for-service, and it means just that. So why not just put doctors on salary? Some medical groups that do, like the Mayo Clinic, have reduced costs while producing better results. Unfortunately, putting doctors on salary requires that they work for someone, and most American physicians are self-employed or work in small group practices. The alternative—paying them a flat rate for each patient they care for—turned out to be at least a partial bust. HMOs that paid doctors a flat fee in the 1990s faced a backlash as patients bridled at long waits and denied service.
~~~One place to start is to consider the psychological aspect of health care. Most people are at least minor hypochondriacs (I know I am). They use doctors to make themselves feel better, even if the doctor is not doing much to physically heal what ails them. (In ancient times, doctors often made people sicker with quack cures like bleeding.) The desire to see a physician is often pronounced in assisted-living facilities. Old people, far from their families in our mobile, atomized society, depend on their doctors for care and reassurance. I noticed that in my mother’s retirement home, the talk in the dining room was often about illness; people built their day around doctor’s visits, partly, it seemed to me, to combat loneliness.
~~~Other initiatives ensure that the elderly get counseling about end-of-life issues. Although demagogued as a “death panel,” a program in Wisconsin to get patients to talk to their doctors about how they want to deal with death was actually a resounding success. A study by the Archives of Internal Medicine shows that such conversations between doctors and patients can decrease costs by about 35 percent—while improving the quality of life at the end. Patients should be encouraged to draft living wills to make their end-of-life desires known. Unfortunately, such paper can be useless if there is a family member at the bedside demanding heroic measures. “A lot of the time guilt is playing a role,” says Dr. David Torchiana, a surgeon and CEO of the Massachusetts General Physicians Organization. Doctors can feel guilty, too—about overtreating patients. Torchiana recalls his unease over operating to treat a severe heart infection in a woman with two forms of metastatic cancer who was already comatose. The family insisted.
~~~Our medical system does everything it can to encourage hope. And American health care has been near miraculous—the envy of the world—in its capacity to develop new lifesaving and life-enhancing treatments. But death can be delayed only so long, and sometimes the wait is grim and degrading. The hospice ideal recognized that for many people, quiet and dignity—and loving care and good painkillers—are really what’s called for.
Conservatives have said for a long time that we need tort reform, as the author agrees. We also agree that many times there are way too many tests run, a byproduct of the malpractice suits against doctors. Fix one and the other will fix itself.
But then the author ventures into the real meat of his story. People just need to learn to die and get out of the way.
But the thing is we DO NOT want the government making that decision. If a person wants to die and stop treatment that should be up to them, no outside entity or bureaucrat should make that decision and NO encouragement to end their life should be given.
What should we expect with a kind of system the Newsweek author wants?
I want you to say a prayer for Jayden this morning. Who is Jayden you ask? He is the son of Sarah Capewell, a mother in Britain whose baby boy was born too early. Jayden, born 21 weeks and 5 days into Sarah’s pregnancy, was denied life-saving care by a government system which decided arbitrarily he was unsustainable; decided it was not in his ‘best interests’ to survive.
Had Jayden been born just two days later, doctors would have given him the care he deserved. Instead, based on statistics and numbers, Sarah was told there would be no oxygen administered, no treatment rendered. Doctors did not care his tiny heart was beating strong or that he was breathing on his own. It didn’t matter, because a board somewhere who had never met Sarah or Jayden decided that her baby was not worth saving, nor could the costs be justified in an already burdened public medical system. Jayden is a beautiful baby boy and his mother loved him so.
I know his mother loved him. I also know the torture and horror and hope she had. I know exactly how she felt the instant her son was born. I know the screams and begging in her head as she wondered his fate over the first few hours of his life. But there is a part of her story I don’t know: I don’t know what it would have felt like to have to doctors refuse my child care. I don’t know the heartbreak of holding my baby while no one would help, until he struggled for and took his last breath.
Michelle Moore, the writer of the above post, gives an example of a baby who was born just as prematurely as Jayden….her own.
It didn’t take long for her to become the darling of the NICU. All the nurses loved her. 18 years ago it was unbelievable a baby this early and this tiny would survive. They cared for her gently. They held her hand; they soothed her when she cried. They all pulled for her to make it thru the first 72 hours; later, the first week.
Her eyes were fused shut; she was like a puppy. She didn’t open them until more than two weeks after she was born. Thankfully the wonderful nurses documented it for me. She just couldn’t open her eyes while I was there, but during one of the few times I went home to steal a nap or a shower. I will never forget sitting there for 15-18 hours every single day … just willing her to live with my mind.
My mom always encouraged strength in me; my will is as unbending as Kelsey’s. She lived because she was born strong and willful and because I wanted it so badly.
The truth is she lived because she got the care every baby deserves. Like Jayden, Kelsey’s saving grace was her strong heartbeat and lack of any serious defects, tested for and rejected over and over in the first several hours after her birth. Like Kelsey, it is very likely Jayden only needed the opportunity to grow, to get stronger. He probably would have required oxygen for a while, but more than anything he just needed the opportunity to “finish.” I have no doubt Kelsey would not have lived for two hours, breathing on her own after birth. She had problems all the way up until she went home with keeping her oxygen right, but never did they tell me, “We give up. It’s just not in her best interests to keep going.”
And 18 years later that premature baby is graduating high school. Read the whole post, its well worth it, and gives us more then enough reasons to fight back against the kind of health care Obama and company wants us to have.
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