Pajamas Media

28 Comments

1. don:

The reason all with the means in Europe purchase private medical insurance (when they have “free” national health) is simple, it’s a great idea as long as you are not seriously ill. The reason so many Canadians come to the US for procedures as minor as arthroscopic knee surgery is for the same reason, the national health there puts you on a waiting list, 6 months or more . . . and if you are “too old” with serious illness . . . palliative care “take this pill, sit in the corner and be quiet”, till they physically remove themselves from the population by dying. Managed by Gubment workers (with as high a quality of commitment as at Motor Vehicle) the term “wait in line” achieves a certain deeper meaning. Of course people like Jay Rockafeller will never have to deal with the inadequacies of a system designed to enforce genetic imperatives (that the strong or chosen survive, that the weak and old fall by the wayside) in a petty/partisan way, Jay will buy his insurance and only see private Doctors (or remain under Congress’ plan as the elite of the elite).

National Health here is not a benefit, not an entitlement, it is a population control measure that will become petty, partisan and so burdened with process as to render actual results irrelevant (kind of like a typical corporate Human Resources Department).

Mar 12, 2009 - 4:11 am 2. Sassenach:

“Fifty percent of health-care costs are incurred in the last month of life and those costs rarely change the outcome of the patient’s illness.”

The question is, who gets to decide whether it’s the last month of life? Five years ago, it sure looked like it was my mother’s last month — and the surgery to save her was hugely expensive. She recovered and continues to operate her small business, which has employed 5-7 people and generated a tidy tax revenue for over 17 years.

Five years ago, a surgeon operated to save his patient. Her age was part of the risk equation for survival, but it was not a sole determinant as to whether she received treatment. Under the new health plan where “everybody’s feeling get hurt,” will some group of bureaucrats decide that a woman over age sixty is not eligible for complicated, expensive surgery? And by what moral compass would they make such decisions? My mother thinks she knows the answer, and she — like many others who can conceive of the notion that they someday will also be “too old” or “too sick” — are frightened.

Mar 12, 2009 - 4:18 am 3. Meryl:

Like so many other aspects of the obama “presidency”, there is nothing surprising about this. Just wondering what took so long.

Mar 12, 2009 - 5:26 am 4. Meryl:

Another reason we are not one bit surprised: Since pro-abortion forces devalued life at its beginning, it was only a matter of time before the same death principle got applied at its end. (I’ve always been curious: where ARE the atheist hospitals and medical centers?)

Mar 12, 2009 - 5:30 am 5. Aristotle's Toes:

Sassenach;

The key word is ‘rarely’, especially among the very old. Should we really be doing triple bypasses on 90 years olds? I know about a woman in her 80s with advanced Alzheimers and a number of other physical problems whose family insisted that no effort be spared to keep her alive should something happen.

Our society needs to accept that death is a part of life. We should aim to keep people comfortable as they approach their expiration dates. Intrusive medical procedures that only prolong death by a few months are just too costly and debilitate the patient even further.

In a time where resources and money are limited, a new approach is essential.

Mar 12, 2009 - 6:51 am 6. Craig:

Health care rationing? Sounds irrational to me.

Mar 12, 2009 - 6:57 am 7. Drits:

Sassenach and Aristotle made me think. But before thinking I felt very sad. It should be “the old person” who needs to decide whether expensive medical procedures should be given to him or her.

Mar 12, 2009 - 7:28 am 8. Chemman:

Aristotle’s Toes;
Just remember you are that patient in “x” number of years. Who do you want to make the decision? An absentee government administrator who’s performance raise depends on cutting costs
or a family that values your existence. If you don’t desire these types of end of life decisions then enact an Advanced Health Care directive so the decision remains yours. In the meantime why do you think it is your right to impose your morals on anyone’s health care decisions but you own.

Mar 12, 2009 - 9:19 am 9. SAD IS THIS TIME:

We in this country spend to much money on loss
causes.. babies born to small, people that
drank away their 1st liver..but quit bingo
2nd chance. If we want to fix many problems
we need to have laws to impost reproductive
limits. No job, No husband no baby..limited
income limited off spring..You have to have
a drivers license and expensive insurance to own and drive a car. To bring countless people
into the world that are born into child abuse
with their first breath,and you need either brains or money.
No we not smart enough or committed enough
to limit the people born in this country to
be born equal. As long as we subsidize people
for bad and wrong actions we will keep slipping
down this muddy slope. Why doesn’t the system rewards people for doing the right thing BUT
no, now in the USSA the more useless you are
the more we hold you up. The lack of morals
and accountablity will be the end of any type
of America we can be proud of. The path we are
on will divide us to the point of no return.

Mar 12, 2009 - 10:04 am 10. Zopilote:

I got a kick out of Rockefeller’s comment that we can’t have
everything we want. I wonder when the last time the good
Senator from West Virginia didn’t get what he wanted.

We can’t have the health care we want but you can bet the
farm that Congress…and Senator Rockefeller will have the
health care they want. And it won’t be what they lay on
us peons. Kennedy will get the best brain docs and we will
be told, if we have his problem at his age, that we’re too
old to get a procedure.

Hypocrites all.

Mar 12, 2009 - 10:21 am 11. hoads:

I am an RN and have seen the futile and expensive efforts to save a life hanging by a shoestring. But, the answer is not a government mandate, the answer is in giving the public (including the doctors) anticipatory guidance about end of life healthcare decisions. Most people have no experience with medical decisions until they are staring them in the face when it becomes a knee jerk emotional tsunami. Sure, people fill out “living wills” and the like, but, even then, patients and families are ill-equipped to deal with the permanence of their decisions. Part of the problem is doctors themselves (and, I am married to one). Many doctors lack the necessary communication and personal skills to guide patients and families through impending loss of a loved one. They are afraid to discuss “treat or not treat” for fear that a litigious family may interpret a doctor’s recommendation to not treat as suspect if and when a family member expires. So instead, the family’s preferences lead the medical decisions and many families are simply uneducated, uninformed, misinformed or have such dysfunctional family dynamics that they are incapable of discussing such distressing issues amongst themselves much less, with a doctor or healthcare professional who is often a stranger at the bedside of the dying patient.

This does not require a government takeover of healthcare. It requires a major pubic education effort that gives people the necessary tools to navigate end of life decisions. Look what’s been done to convince people all over the world of the lie of global warming. Something with that magnitude could be undertaken to do something that would truly benefit people — allow them to physically and emotionally prepare for their impending death by promoting discussion with their family members and doctors.

Mar 12, 2009 - 10:23 am 12. NEChris:

Chemman;
Extraordinary treatment at a high cost that prolongs the life of an elder patient in severe pain /low quality of life is wrong.
Too often the patient is incapacitated and the family is responsible for choosing this type of treatment. They understandably want “to give Dad more time”. I too would give my right arm to have another day with my parents who died of cancer. But the day you want is when they were whole, the day you get is one filled with more pain for them. The best medicine in the world can’t reverse the process. It’s not a matter of imposing one’s morals on the rest of society, it’s preparing for their / our inevitable death in a manner that’s responsible to the patient and those paying for the treatment (rate payers /taxpayers).

Mar 12, 2009 - 10:44 am 13. kim:

NEChris,

I agree. My grandmother had a DNR, and she made sure we all knew about it.

But, then if it is wrong to prolong a patient’s life who is in severe pain, then why is it against the law for that patient to choose to take his or her own life when THEY are ready? Many who choose to do so, do it before they get to the point of a painful existence, choosing quality over quantity. Why do people think that this is so wrong?

Why should it be OK for a family member, a doctor or even the government to say enough, but not the patient?

As far as severe pain, if you know that the patient is in pain, that is one thing. However I had an accident last year where I badly broke a bone and was told I should have been in excrutiating pain…..I had absolutely none. It took me awhile to convince the ER person that I didn’t just have a “high tolerence”, but I had no pain at all! And I remained pain free (with no drugs) during the entire recovery, including surgery.

Either way, the government has no right and no business telling someone what they can and can’t have done.

Mar 12, 2009 - 11:41 am 14. I Blame the Parents:

Technology has reached the point were life can be extended longer than ever before. This isn’t always a good thing. Sometimes death can be a blessing. I agree that government should not intervene in cases where people wish to end their own lives because of intolerable pain. The old proverb about walking in another’s shoes comes to bear here.

However, how many people think the taxpayers should be forced to pay for extraordinary and expensive treatment than has little success of prolonging life?

Mar 12, 2009 - 12:18 pm 15. Janet:

I have lived in the USA for 24 years and my health care here has been no better than the U.K. (socialized medicine). My mother who recently died of cancer has had the most amazing care and died at home with dignity. Nurses came in three times a day, the doctor came almost daily. She even had a hospital bed brought in as well as a commode so she would be more comfortable. All the records are electronic which saves money and mistakes. I was able to have telephone calls with my mother’s doctors and they were able to retrieve all her information immediately. Prescriptions are free over age 60.

Mar 12, 2009 - 12:22 pm 16. Shef Rogers:

Janet (#15) is absolutely right: US health care is not only insanely expensive, it’s just not very good. I’ve had better health care in the UK than here. Unfortunately, the place is full of Brits, so it’s uninhabitable. But as far as health care goes, there’s no comparison: America’s privatized care is the worst in the developed world.

Mar 12, 2009 - 12:43 pm 17. whyyeseyec:

Don`t worry about NHC. Americans will do what drug addicts do and find health care on the street corner as doctor will simply move their practice outside the office and probably make more money there than dealing with the gov`n.

Mar 12, 2009 - 1:34 pm 18. Rachel:

Then why do Brits also carry private health insurance if NHS is so great? And why do your nurses don’t want to be treated in the same system? Why do your patients risk MORE infections staying in your hospitals than ours?
And why do people come over to the world’s worst healthcare center (US) to get treatment, esp. Canada.

Look, healthcare in the US is not great. Because I have a chronic condition, i *have* to have a job to get insurance, I can’t self pay. And it is expensive. But I know Americans; we’ll expect top of the line care with no bill whatsoever, incl taxes. They will be pissed with what they would get.

How do I know this? Because I get served in medical clinic that’s supported by my city. The stafff are gruff, the wait hours are long, and the physicians see you two minutes tops. It’s lower pay but you get what you pay for.

Both private and public health care have its pluses and minuses. But no country has it perfect. You either deal with money, time, or judgement by bureaucracy. That’s how life goes. So let’s stop this “my health care is better than you healthcare” games because we’ll all lose.

Mar 12, 2009 - 1:37 pm 19. hoads:

Janet and Shef Rogers,

Of course the UK offers palliative care for the elderly. That’s the least they can do since they deny medical treatment to the elderly.

You both have obviously been blessed with good health because that is the beneficiary of socialized healthcare system–the “common good” equals what’s best for the majority so it is the minority of the sick and dying that must bear the brunt for the common good.

If the UK’s healthcare system is so great then why does Britain have some of the poorest health indicators in all of Europe? They’re #17 in 5 year cancer survival rates while US is number 1.

Mar 12, 2009 - 1:41 pm 20. whyyeseyec:

Oh, by the way, note to Janet 15 and Shef rogers 16.

The reason health care is expensive in the US is because the government has its grubby mitts in it.

Health care was reasonably priced and available until the government got involved with Medicare/Medicaid in the 60`s. That`s when the fraud started and prices began to rise as the gov`n set prices for what it would and wouldn`t pay for. Then add to that the constant lawsuits by `loiyah`s`suing for everything and anything.
Not to mention millions of illegals using emergency rooms for scraped knees and baby making.

Every sector of our business community that is struggling can be traced back to government sticking its big nose in our business through mandates and over-regulation.

Mar 12, 2009 - 1:44 pm 21. DavidN:

Yeah, but the government can do it better than private insurance and private health care. Every time we see a mistake made in a private hospital, every piece of care denied for erroneous reasons, remember: the government could do a much better job. They would never deny care to anyone, and all doctors employed by the government would be happy to take enormous pay cuts, and work the long hours for much less money. They’d also miraculously never make any mistakes again, and the whole system would work without a hitch. All we have to do is trust our President and our Congress to set up a health care system for the rest of us, and our problems are over. They of course are selfless enough to not avail themselves of this wonderful program; they’ll take their chances with the Congressional system already set up, though of course it’s very inferior. Why shouldn’t we trust them?

Mar 12, 2009 - 2:58 pm 22. JED:

Would you all please stop calling this scheme “health care.” It is not health care. The insurance companies and the government could care less about your “health”. It is about disaster control and enabling unhealthy practices. Medicare would benefit except that the retiree are living longer.
There are too many and complicated elements in this spiraling cost of medical insurance and attention. Let us keep this simple:
1. Supply and demand. The supply of the sick is greater than the ability of the system to medicate them. Obesity and the top ten killers are all dietary linked. The price goes up.
2. Litigation raises malpractice. Sometimes 50% of the birth fees goes to insurance.
3. Electronic records are not about health care, they are about future data mining of confidential information.
4. Governments and bureaucrats are inefficient by nature and budget design. Put them in charge of your health and develop a nation of lower middle class co-dependents. Study the health care of France where it is any doctor for a dollar.
5. The biggest predictable problem in health care is the larger population of baby boomers working their way through the system and living longer. The scheme of social security and medicare never predicted the ratio of workers to retiree that were begat 1946-1956. This is the snake which swallowed the porcupine and hopes that it doesn’t back up the system.

Mar 12, 2009 - 3:04 pm 23. Kirly:

here’s my end of life decision… i’m 45 years old. 20 more years tops and i’m outta here!

Mar 12, 2009 - 5:50 pm 24. venividivici:

21. DavidN:

Great post. The only thing you forgot to mention was that of course the government would accurately predict how much it will all cost and it won’t cost a penny more. I mean, look at how accurately they predicted how much Medicare would cost!!

You people who support government-run health care had better be ready to pay 10 to 20 TIMES what they are telling you it will cost. And that’s with all the rationing, etc.

You’d have to be brain-damaged to want to sign up for that. Oh, wait, you clearly are brain-damaged. What was I thinking trying to stop you?

Mar 12, 2009 - 8:08 pm 25. DocDavid:

It may be pertinent to consider the reports I have read that in Holland, one quarter of deaths now occur when the attending physician decides euthanasia is appropriate. The next question, of course, is how that decision is made. I suspect the bureaucracy would latch onto that power with extraordinary enthusiasm.

Mar 12, 2009 - 9:32 pm 26. David W. Lincoln:

They want Canadian health care. Canadian health
care has rationing. They will get rationing.

Does anyone know when those pushing Canadian style health care actually went up to Canada to
see what kind of misbegotten abomination is up here?

Mar 14, 2009 - 2:56 pm 27. Hal:

The problem with our leaders, who want to change our health care system is their fixation on the European system, which they want to install in this country. They ignore that the European system is going broke and is becoming unworkable.
When we have the Lawyers and politicians determining what we should have they ignore several facts and problems that drive up costs. Number one is the lawyers. Tort reform is must. A perfect example is John Edwards. A lawyer who is a multi-millionare by suing doctors for natural occuring birth defects. Mistakes should be paid for but millions for lawyers – No. Trace the money trail, Millions is spent by trial lawyers to protect their cash cow. Another problem is only looking at the Europing health systems. Looking at other countries (Taiwan for instance) we see very different health systems which are effective, lower costs and is not modeled after the currupted and rationed the Europeans systems.
The politicians should be forced to use the same system as the tax payers. When the Labor Party installed their Socialized system, the party leaders built their own private, modern hospital for their leaders
Solving our health care during a one day meeting is not too smart.

Mar 14, 2009 - 3:50 pm 28. Objective:

The proposed medical insurance health care is to start the ante at about $700 billion. We know that number project $18,000 per house hold. The Obama proposal intends to lower the current $27,500 per house hold to $25,000. (Somebody must be visiting the ER a lot.) If these numbers hold then the plan is to spend $18,000 per house hold to save $2,500 per household. That must be what stimulation must mean. Government efficiency must be an oxy-moron.

Mar 14, 2009 - 4:32 pm

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