Thursday, August 20, 2009

a suggestion

I realize some will vehemently disagree with me on this (and I'm not at all sure it's even a viable suggestion, given the way the world works, sadly) but:

How about the US government, the lobbyists, the drug companies, everyone involved, suspend trying to deal with a "health insurance reform" bill for a MINIMUM of six months.

Talk about something else for a while. Work on something smaller.

Because we're at the point where we have a great deal of heat, but no light. A lot of noise, and very little signal.

So we have things like Sarah Palin talking about death panels (and yes, maybe what she said could be a logical conclusion drawn from some of the parts of one of the plans on the table, but I will say I think it was perhaps a bit rash of her to say it in the way she did).

And we have people screaming and shouting at town hall meetings, and while I understand their frustration at what seems like an oligarchical Congress, and while I understand the fear of what may come, I have to admit that shouting down a representative solves little.

And Peter Singer saying things like:

"The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities. We can accommodate that difference by calculating the number of life-years saved, rather than simply the number of lives saved. If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas if a person of 85 can be expected to live another 5 years, then saving the 85-year-old will count as a gain of only 5 life-years. That suggests that saving one teenager is equivalent to saving 14 85-year-olds."

(He does note these are "generic" individuals and goes on to point out that things might be "different" if the teenager was a violent criminal and the 85 year old was "still working productively." But even that argument makes me shudder a little, because it seems to suggest that an 85 year old who isn't "working productively" is not worth saving.)

He also observes later on (here is the article) that "most people"

"...would prefer, say, 10 years as a quadriplegic to 4 years of nondisabled life, but would choose 6 years of nondisabled life over 10 with quadriplegia, but have difficulty deciding between 5 years of nondisabled life or 10 years with quadriplegia, then they are, in effect, assessing life with quadriplegia as half as good as nondisabled life."

Okay, fine. If the individual in question makes that assessment, not a problem. BUT if some doctor - or some "ethics panel" - or some "cost control specialist*" makes that decision, NO. It is wrong.

Because that begins to say "who has value; who does not have value." I don't want some person telling my my parents' lives no longer have value because of their age, or their health condition, or their degree of impairment, whatever. Yes, my parents have DNR orders in place in case they become compromised to the point where they would no longer have quality of life - but that was THEIR decision, made long before any illness crept on the scene.

(And I am grateful for them doing that. Because if it comes to that, it will save me and my brother and my sister-in-law the agonizing decision of what to do and whether we are doing what they wanted)

(*And yes, I know. Insurance companies have these and sometimes they deny treatment an individual would choose to have. I know in my community there have been several "benefits" to try to raise money to pay for over-and-above treatments for individuals. And in several cases, I've donated. What I'm saying is, the "cost control" specialist would decide, and there would be no recourse - in the name of "fairness," no other option. Not sure if that would happen, but I could see some pushing for it)

I also cannot find the citation, but I think I have heard some bioethicist's suggestion that seriously ill premature babies be allowed to "slip away," because of the cost of caring for them - and the fact that they were likely to be "damaged" as older children (blind, deaf, developmentally delayed, whatever).

And again: if a family, with much thought and discussion and prayer (if they are people of faith) decide that it is preferable to take no "heroic" measures to save the life of a seriously compromised infant, that is one thing. But for an outside agency to recommend to parents to NOT have their infant cared for because it is not "cost effective," well - to me that seems evil.

I cannot think of any other name for it.

Yes, I know. Sick premature babies, their care is exceptionally expensive. But I cannot feel right about "letting" them die because it is "inconvenient" to care for them.

And I realize, there's the big question: where will the money come from? Well, I don't know. I do know in a number of cases (people I knew, or friends/relatives of people I knew), the insurance the family had paid for most of it. And in some cases some seriously sick little babies got to grow up to be reasonably healthy, happy toddlers.

It seems to me that many of the "good" health insurance companies seem to manage. Because they have people like me, who, as I said, take until the year is more than half over to meet our deductible and who maybe go to the doctor twice in a year (both times for check-ups only) and who don't need any heavy-duty medications and all of that. What my university pays in for me - what I would be paying in if I had private health insurance - is more than what I use in a year in health care. But. If I were to get into a car wreck. Or if I were to contract H1N1 flu from a student and needed to be put in the hospital - the fact that that money had been paid in and had covered others would allow me to be covered in my time of need.

I know people who had pretty extensive cancer treatment. And it was mostly paid for by insurance. And I don't see health insurance companies failing the way GM and banks are. (Which is why I'm twitchy about government intervening in health insurance).

Another thing we get are lots of folks sticking their oars in, pointing fingers, trying to blame and shame. What really got me on this hobbyhorse this morning was hearing a quotation from the director of the Cleveland Clinic - who has an article here, who says if it was up to him, he'd stop hiring people who were "obese."

He was quoted (perhaps misquoted, I don't know) on my local news as saying,

"It is our patriotic duty to 'take care of ourselves.'"

Brr. I suddenly feel very cold. What about people who get an unlucky genetic draw? Was it their patriotic duty to choose "better" gene donors? What about people who "do everything right" and still get sick? What about people who get old? A lot of the chronic diseases we spend a lot on are diseases of aging.

And I feel particularly chilled because, as I pointed out the other day - I am overweight. Actually borderline obese, if you read the strictest interpretation of BMI. And I work out and eat vegetables and avoid fried food and fatty meats and keep my food portions small. And still this man seems to HATE me because of what I am.

It scares me to think that some day my keeping a job, or keeping insurance, or having a doctor be willing to treat me could be determined by that 20 pounds I can't seem to lose. Or even by that 5 pounds that pushes me up into the next category.

(Seriously, if it became the case? I'd just stop eating until I dropped to the "necessary" weight. Oh, maybe I'd pass out in class, maybe I'd be grumpy and weak and get sick - but hey, they say being "fat" is more unhealthy than that, no?)

So I don't like where the discussion is leading.

YES, we need to do something for people who are in the "gaps" - who are underemployed, or have some pre-existing condition that makes it hard for them to be insured. We need to make sure that our retirees get continued care.

But I don't want to see interference in the lives of people like me, who are pretty much happy and taken care of and don't need help. (And I realize that that's not the plan now. But it seems that some would like to keep pushing towards a system more like "single payer")

None of the plans on the table, it seems to me, are viable right now. None of the stuff Obama has promoted seems well-enough fleshed-out to work as a plan. Which is why I suggest a "suspension of hostilities" for a while. Get more people involved, more people thinking about it. Try to figure out a way of helping people truly in need without breaking up the system that works well for a lot of us.

1 comment:

Mr. Bingley said...

Try to figure out a way of helping people truly in need without breaking up the system that works well for a lot of us.

That's the dirty little secret, isn't it? Our system provides the best care in the world. How many people fly to Canada or Britain or France for care? Oh sure, some do for 'experimental' treatments the FDA won't allow here, but the truth of the matter is that people flock here for treatment.

This is all about governmental control, plain and simple, because they're smarter than you, you see.

And if you don't then you are obviously mentally challenged.

Or evil.