The health care industry is spending about $1.5 million a day on lobbying efforts in Congress. Most of those dollars are spent fighting against the threat of “rationing.” That doesn’t count the money that’s spent on TV ads in which disgruntled people from Canada tell why they come to the United States for surgery ( supposedly because public plans ration care.) The rant about rationing is designed to make consumers feel that no one will be able to get in to see a doctor under a public plan, and that grandma will be denied her hip replacement because she’s — heaven forbid — over 65. It’s designed to make efforts at real health care reform fail. Fear can be a powerful motivator, and the lobbyists and advertising campaigns are trying desperately to evoke as much fear as they can in the mind of the consumer, hoping that will influence Congress.
What most Americans don’t realize is that our health care is rationed now. If you aren’t employed by someone who provides health insurance your access to health care is limited by your ability to pay for it. That’s rationing. If you are insured, but your plan doesn’t cover the test your doctor thinks you need, or you think you want, your care is also rationed. It you lose your job, your care is rationed, because you probably can’t afford COBRA. Right now, people who have health insurance that’s provided by their employers feel complacent and, understandably, don’t want reform. That perspective shifts in a minute when they get sick, or are unemployed.
Rationing can be done well. We can ration care that has not been proven to prolong life, or to be effective. My late husband, a radiologist, used to see cancer patients all the time. One of the things that made him most upset was when a patient was given chemotherapy or radiation therapy that would make them sick immediately with only a small chance of prolonging life for a few weeks. He thought that this “standard of care” –try everything — was permanent employment for oncologists, and he often counseled his friends to refuse treatment and live well, if not healthy, until they died.
He died twelve years ago this week. He was a Progressive, a man who believed in access to health care as a right. When he became ill, he looked at his own X-rays, realized he was terminal, and did the same thing he told his patients to do: he refused treatment. He happily played with grandchildren and went out to dinner until a week before he died, and then he asked me to make sure he would not receive any more treatment that wasn’t just to relieve pain and suffering. He rationed himself.
Most of the US’s health care dollars are spent in the last six months of a person’s life, and often the patient doesn’t even want the extraordinary measures, or doesn’t know he or she is receiving them. It’s the family that “tries anything” and authorizes the medical staff to use extreme measures. It’s not the elderly person having a hip replacement that we should ration — it’s the elderly person who wants to die peacefully, but whose relatives won’t let go, whose care should be “rationed.”
And who should make that decision? The patient: far in advance of the moment it occurs. If we could get people to take charge of their own health, create “Advance Directives,” and ask their families to abide by them, we’d have plenty of money to take care of the people who can actually benefit from the care they get. Not everybody can be saved.
What happens if we implement government based rationing, and then grandma doesn't want to just die like a good progressive? What if grandma or their family wants treatment so they can play with those grandkids for longer than just a couple of weeks? You are making a pretty amazingly judgmental statement when you say the following:
“…often the patient doesn’t even want the extraordinary measures, or doesn’t know he or she is receiving them. It’s the family that “tries anything” and authorizes the medical staff to use extreme measures. “
You are quite elitist if you believe that your views should be forced upon all Americans. How about I tell you this: How dare you!? It should not be up to a government bureaucracy to decide who gets treatment and who gets a pain pill, it should be up to a family, their doctor, and their patient.
Oh, the elitist charge is so hollow coming from the group that thinks health care should only be available to those who have the zillions of dollars to pay for it. You can call me elitist when you show me a viable solution to a 21,000/year health insurance cost, plus a 3,192.00 cost for generic medication not covered under the formulary list, and $35.00/visit for the doctor.
The fact is that health care is available only to the part of this country that is elite. For the rest of us, we get to scrape to get the basics and pray we don't get really sick. So don't toss the term 'elite' in my face.
As for Grandma, she WANTED to die without tubes and life-prolonging measures, so she wrote a living will saying exactly that. Your argument is a straw-man, partisan scare tactic intended to distract from genuine debate into meaningless rhetoric. But hey, it's a free country, have at it.
As a person who has to think about things like this, I have Advance Directives, a Medical Power of Attorney, a Do Not Resuscitate order, and grandchildren. I am also the widow of a physician who saw people die every day, and refused extraordinary measures as a result. Not saying everyone would choose death over extraordinary measures, but if you have ever done research on terminal illness, you would realize that what people fear most isn't death, it's suffering. And I'm not saying it's up to the government to decide these questions. But it's up to the government to decide rationally how to spend YOUR tax dollar.
My mother, weak in the head long before she died of whatever it is people with Parkinson's actually die of, kept at me to make her an appointment for her annual GYN exam and tests. When I pressed her, she acknowledged that if she had cancer, she would not want treatment for it, as she was on the way out, anyway, and it would cost the government a lot of money.
Rationing.
She forgot how she had deteriorated, though, so still asked me to schedule that appointment. I delayed doing it and avoided an outright refusal because I knew which was her right mind, and which was not.
When she was close to dying, a nurse at the nursing home tried to persuade me to request the doctor prescribe an antibiotic. She said she was sure my mother could live longer because all she had was a little infection. (As though she hadn't watched her almost deliberately take to her bed, stop eating, sleep many hours a day and stop speaking altogether.)
I suggested the nurse ask the doctor instead of me and she said he would only tell her my mother was dying anyway. Of course, I agreed, and told her it was my responsibility to do as my mother wished, which was to be looked after and not forced to live longer for no reason.
That was rationing.
The nurse was whacked, and lucky I didn't report her outrageous behavior.
My mother, weak in the head long before she died of whatever it is people with Parkinson's actually die of, kept at me to make her an appointment for her annual GYN exam and tests. When I pressed her, she acknowledged that if she had cancer, she would not want treatment for it, as she was on the way out, anyway, and it would cost the government a lot of money.
Rationing.
She forgot how she had deteriorated, though, so still asked me to schedule that appointment. I delayed doing it and avoided an outright refusal because I knew which was her right mind, and which was not.
When she was close to dying, a nurse at the nursing home tried to persuade me to request the doctor prescribe an antibiotic. She said she was sure my mother could live longer because all she had was a little infection. (As though she hadn't watched her almost deliberately take to her bed, stop eating, sleep many hours a day and stop speaking altogether.)
I suggested the nurse ask the doctor instead of me and she said he would only tell her my mother was dying anyway. Of course, I agreed, and told her it was my responsibility to do as my mother wished, which was to be looked after and not forced to live longer for no reason.
That was rationing.
The nurse was whacked, and lucky I didn't report her outrageous behavior.