Healthcare and End-of-Life Issues


I’ve been posting a lot on healthcare reform lately, so I’ve also been reading a lot about the subject. I happened to run across an editorial by Eugene Robinson that has some good comments on healthcare reform as it relates to end-of-life decisions.

First, there’s been a lot of angst being displayed at town hall meetings and other political gatherings across the country by a whole range of people, from conservative to liberal, rich to poor, black to white, etc. Some have charged that these are largely a result of crazies and of insurance companies and other organizations whipping up people into a frightened frenzy and actually paying people to attend these meetings and disrupt them. Now, I’m not naive enough to think that that is not partly true. I’m sure some at these meetings aren’t necessarily there with the purest of intentions. However, the sentiments being displayed at these gatherings run far too deep for that to be blanket truth. I don’t buy for a minute that most or even a large percentage of those people are being persuaded by organizations to display fake outrage like that. I’ve studied the debate, read, and experienced too much to believe that load of crap.

Anyway, Mr. Robinson brings up a good point regarding this line of thinking:

But the nut jobs and carpetbaggers are outnumbered by confused and concerned Americans who seem genuinely convinced they’re not being told the whole truth about health-care reform.

And they have a point.

Another big point by those pushing the government option is that it’s just outlandish to believe that the government is going to ration healthcare. I hold the opinion that, though it may not start out that way, it will likely end up that way.  Robinson makes a similar point:

But reform is being sold not just as a moral obligation but also as a way to control rising health-care costs. That should have been a separate discussion. It is not illogical for skeptics to suspect that if millions of people are going to be newly covered by health insurance, either costs are going to skyrocket or services are going to be curtailed.

The unvarnished truth is that services are ultimately going to have to be curtailed regardless of what happens with reform. We perform more expensive tests, questionable surgeries and high-tech diagnostic scans than we can afford. We spend unsustainable amounts of money on patients during the final year of life.

Yes, it’s true that doctors order some questionable procedures defensively, to keep from getting sued. But it’s a cop-out to blame the doctors or the tort lawyers. We’re the ones who demand these tests, scans and surgeries. And why not? If a technology exists that can prolong life or improve its quality, even for a few weeks or months, why shouldn’t we want it?

That’s the reason people are so frightened and enraged about the proposed measure that would allow Medicare to pay for end-of-life counseling. If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending. It’s irresponsible for politicians, such as Sarah Palin, to claim — outlandishly and falsely — that there’s going to be some kind of “death panel” to decide when to pull the plug on Aunt Sylvia. But it’s understandable why people might associate the phrase “health-care reform” with limiting their choices during Aunt Sylvia’s final days.

He makes a great point. Something has to be done about the cost of the system, which is outrageously high regardless of having the government option in place or not. If the dollar continues to be devalued and our government keeps spending those dollars like they have been over the last few months, there’s no way that I see a healthcare option like the one being considered NOT ending up in rationing. For a related article, please see my previous post “Complete Lives & Obama’s Plans for Your Healthcare“.

You can read Eugene Robinson’s entire article here.

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