Sunday, August 09, 2009

Should we read between the lines?

'End-of-Life' Counseling Intensifies Health Care Debate - Political News - "'As the nation looks to ways to improve patient care and reduce costs of health care, end-of-life conversations should be considered, ' said the study's senior author, Holly Prigerson, a professor of psychiatry at Harvard Medical School.

'Policies that promote increased communication, such as incentives for end-of-life conversations, may be cost-effective ways to both improve care and reduce some of the rising health care expenditures.'

White House aides acknowledge it's a sensitive issue.

A quarter of all Medicare spending takes place in a patient's final year of life, and studies show most people facing a terminal illness or simply very old age prefer less medical intervention to more. That suggests the potential for savings."

So we, the taxpayers, can achieve "savings" if somebody talks with "people facing a terminal illness or simply very old age" about their...options? I see three. One is getting expensive treatment, the other is not getting that treatment, and the third is drifting away on a drug cocktail, also known as "assisted suicide," as people are now doing in the Netherlands and other European nations. How far would this new approach to health care in the US go, I wonder?


Don Nordeen said...

Many people have living wills to avoid extensive treatment for terminal illnesses.

It seems to me that the easiest way to handle the costs is to offer a premium discount for Medicare Part B, Medicare Supplements, and other healthcare premiums if the person has a living will.

Beth said...

I notice that the "suggests a potential for savings" angle comes from the fox reporters and not from anyone associated with the legislation. Evan, it seems that you are getting spun by your sources. Maybe sites like could help you keep your balance.

Anonymous said... is balanced?????

Evan McKenzie said...

Beth--I am neither spun nor spinning. I made my own points and in reply you dropped two logical fallacies--one ad hominem and one red herring. Check out this list and see what I mean. Invoking the "Fox News" boogieman is not a response to anything.

On the merits, I am not predicting where this debate will head, but anybody who can't see where these end-of-life policies could potentially lead should learn more about the debate. These alternatives are actually being discussed in academia. Prominent ethicists such as Peter Singer have already put them in print. The Obama administration is well aware of all this and they have made explicit reference to the high cost of end-of-life medical care.

Shu Bartholomew said...

I worked under the British national health system many moons ago. Waiting lists for non life threatening procedures were very long that by the time your turn came up it was often too late.

I have family in Canada. The Canadians are not happy with their system. My aunt's brain tumor was misdiagnosed. For years she was told it was arthritis. Even as an inpatient, at the end of her life, they missed the classic signs and symptoms of a brain tumor and sent her home in the care of my 86 year old uncle when she was not even able to sit up on her own. By the time the penny dropped, and they found her brain tumor, it was too late. She died within a few weeks. People are misdiagnosed all the time but this had been going on for over 10 years! Had they spent the money on proper diagnostic tests they could have found this slow grower, removed it and she might have still been with us.

I am not suggesting that our current system is perfect, it is not but the single source alternative that is being rammed down our throats will just make things infinitely worse.

And anyone who thinks the care they have paid for all their lives will be there when they'll need it, is in for a very rude awakening. Starting at the relatively early age of 60, under this new plan we will be reminded repeatedly of what a burden we could become should we live much longer-

Beth said...

Well, Evan, if I'm wrong about your being spun, I apologize. I would point out, though, that

* no one "invoked the fox boogieman"--I pointed out the fact that the article made unsupported claims--which it did.

* Slippery slope is a fallacy too.

* Anonymous, corrects misstatements without regard to who makes them, and it documents its sources so you can assess them yourself. I'll take that over an article based on unsupported assertions any day.

* Shu, we all have relatives and friends in Canada, England, Sweden, wherever, and they all have opinions, good and bad. We also all know people in the U.S. who love their insurance companies and have no fears about ever having trouble getting coverage. Oh, wait, I don't actually know anyone in that last category. :)

I have my own concerns about the health reform legislation, but I have to say, the fear that some soulless government bureaucrat will prescribe a euthanasia cocktail to my elderly parents isn't a big one. Medicare has ensnared much of the nation's elderly already and it hasn't euthanized them yet.

Right now, there are what, five different House bills? And who knows what the Senate will come up with. Some of those bills don't include a public option OR an employer mandate.

It's much more likely that legislators will rearrange the deck chairs & claim all problems have been solved than it is that anything dramatic will be crammed down anyone's throats.

Anonymous said...

Trust me, you REALLY don't want to lose your health insurance today -- or any other day...

It looks like some of us will have ONLY one option until "The One" saves us from the boogieman... ie. a VERY expensive ICHIP healthcare option -- and in the Land of Lincoln there is NO coverage for "preventative care."

Go figure? No more wellness visits and/or annual exams, mammograms, etc. What more should a healthy 50 year old woman expect for $700 a month?

God help us all... If you live in a CID the Netherlands might have the right idea after all?

Anonymous said...

Obama to Jane Sturm: Hey, take a pill

Jane asks the President if her 100 year old mother (now 105) would have gotten a pacemaker under his plan. Well now that's a tough one ... that costs a lot and maybe we will have to say, just take a pill.