Something potentially sinister is emerging because of the health care debate we're failing to have.
No matter which candidate you favor or whose plan you back, if you look at the spiraling costs of medical tests and doctor visits, you have to wonder who will be sacrificed.
Yes, that's what I meant - sacrificed. Now we all know life doesn't go on forever, but a recent Wharton/Stanford study proposes an "empiric estimate of the value of life" that is more than a little unsettling.
The co-authors of the study conclude from their findings that there must be cost effective thresholds of a sort to determine whether to keep patients alive. If a dialysis patient, for example, were to go beyond this threshold, treatment would be terminated and they'd die. In what the researchers call a "pragmatic and modern" application of social justice they advocate thinking about the percentile of patients up to which medical coverage would be provided.
As a business professor, I understand purely economic vantage points and credit the researchers for their work. But my ethics and preventive medicine background render things less clear in this domain. One more "quality-adjusted" year of life can be priceless in what can be accomplished and enjoyed.
When I was diagnosed with breast cancer at age 32, doctors wanted to save me. They were totally vested in the enterprise. I could feel that. I'm still young enough to find a doctor who cares. But it's getting harder. And any of you who have had or have serious illnesses and are, let's say, over forty know what I mean.
So while universal health care is a very good thing, the presidential candidates need to grapple with reality. How will we avoid becoming a society that blames very ill people for depriving those who are less ill? How do we avoid health elitism among those who have not yet come up wanting in the coin toss of life? Will there be thresholds? Who will define them? How do we avoid bias?
And why not work diligently to lower what have become ridiculously high health care costs instead of picking people to die?
My mother lived twenty-six years after five cerebral hemorrhages and coma to walk, talk, laugh, drive and even work again. Someone gave the order to move her out of intensive care at age 52 because there was no hope when I, barely out of my teens and not then "trouble", nonetheless started yelling about mercy killing in the hallways of a Catholic hospital, my determination to contact the bishop and write to the Pope. My mother stayed in intensive care and lived.
But had some "objective" person with a clipboard looked at her potential for a worthwhile "quality-adjusted" life prior to that success, she would have been deprived of it under the guidelines we may soon face.
Who's to say how low the thresholds of sustainable life will go to make health care cost effective? They might continue to move until many of us and those we love with years to live will not be given that opportunity.
Barack Obama proposes for chronic illnesses improvement of coordination and integration. Hillary Clinton provides more details, but neither addresses the dilemmas described above. John McCain is simply going to give us too little money to even purchase health care. I guess that's one way of solving the problem.
It's time for some serious thinking on issues like who among those with chronic disease will be allowed to live and who allowed to die. Better sooner than later when people who could enjoy long, reasonably healthy lives are deemed expendable because according to some statistically impressive callous calculation, they simply aren't worth saving.
Dr. Reardon also blogs at politicsdoc.
Finally due to many injuries I got SSDI, (not SSI) and receive about $627 a month after I pay about $90 of my SSDI for Medicare A and B. I rarely go to the doctor because the Medicare co-pay is beyond my means for almost any medical treatment. The good news in this is that my son now qualifies for a state-run health insurance program for kids, and he gets full coverage. Full. However, the only way that my son got health insurance at all was because my income was so low I could barely survive. Last month my son had a bike accident with a car, and the car won, and I took my boy to the hospital with a sprained foot, a bump on the head, and a nasty leg gash. Three hours, 8 X-rays, a CT scan, and yards of gauze later we left. No serious injuries. Bill about $3,500, half of which was glorified first aid. Without his insurance I would have had to take out a loan on my house.
What do you mean "becoming"? That is the way things already are.
Here's a question: Why is it that universal healthcare works in every other industrilised nation on the face of the earth, and also in the smaller nations of the third world. In Barbados, a little island, you can go to the hospital and if that doesn't suit you then you go to a polyclinic, or you choose to go to a private doctor if you you can afford it. Why does the system work everywhere else but in the USA? Why? Somebody is lyiny to and cheating the american people, and they don't intend to stop... unless they're made to, by the people.
I don't know what will it take for this nation to wake up. But then again, it is the same nation where 54% admit to "knowing" some1 who feels race is an issue in a presidential election. I guess what I am saying - we will elect a president that we _deserve_ . A historic opportunity we have, we will squander - like we did everything else in this country. Crawl from under the tables where the 7x24 loop of RW's doctored footage and Billary's nuclear obliteration fear mongering drove you to and stand up and give this country a chance ! Please, do it for you children .
Now,
All of these industries have powerful lobbies at the state and federal levels. Most of us think overcoming these obstacles is so great a challenge they're next to impossible, but there are things we as individuals can accomplish. We now live in one of the least healthy societies in the industrialized world. Until solutions to a system out of control can be agreed upon, we owe it to ourselves to live as healthy a lifestyle as possible. That includes taking responsibility, accepting that life doesn't go on forever and recognize tough choices are sometimes necessary.
(cont.)
The only solution is to pass laws prohibiting these companies from denying claims, excluding individuals from coverage based on age, illness or pre-existing condition. If it comes to forcing the health insurance industry to become non-profit, then so be it. There are models around the world of companies regulated by government still enjoying a level of success which most of us would gladly associate ourselves.
(cont.)
As a member of the healthcare community for twenty years it's been my pleasure to serve the communities in which I've lived during my career. I'm not a physician, so you may dismiss my views if you wish, but I believe I've seen enough to render opinions relevant to the topic and provide insight into a system so out of control it teeters on the brink of catastrophe, not only for providers of care, but for the economic health of the patients we serve. So who or what is to blame and how can government, or we the people, bring about the change necessary to fix a system vital to our nations health and well being?
(cont.)
The bill was $6,013.00.
I'm fortunate that my problem wasn't more serious than that and there are many people with more severe concerns, However, I am one of 47 million Americans without health care and I have no hope of being able to pay that bill.
Health care is a human right and not a privilege for the lucky few.
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
Not so enlightening, however, was Glen Beck and Ben Stein discussing how universal healthcare is badbecause in Germany, accordin to Stein, doctors give their patients euthenasia pills so they don't have to treat them... And that's why he doesn't believe in universal healthcare for Americans. Cause doctors will kill us when we're depressed... Niether man produced one cognitive thought.
In England for example there has not been enough English citizens attracted to the medical field so many from other countries have come in to fill positions. I am not trying to say that these foreigners are necessarily less qualified but it does talk to the idea that the pay could perhaps not be attractive to the Englanders themselves.
Rationing is of course is going to be politically unpopular in any situation. One way to reduce the rationing to the broad populace would be to somehow "eliminate" those high cost patients that may or may not be terminal. I think your buddies Beck and Stein have a very valid concern.
I saw the Frontline piece and found it to be lacking in balance. That would be expected form a government run TV outlet.