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I would refuse to treat infants who are born weighing less than a pound. Elderly I would limit them to care costing less than $150K per problem then just keeping them pain free if they needed something like a heart transplant after 80. Mom just died of cancer at 86 because she preferred hospice to a biopsy. So for 20 days she lived with caregivers and pain medicine at home. More treatment would have been expensive and painful so not worth it. She had her gall bladder out after 80 but that isn't a waste of money, grandma had appendix out at 90 or so and a broken leg set at 97, her leg didn't heal well so she was in a wheel chair the last couple of years but it wouldn't have been worth more surgery to try to fix her up so she could walk.
True enough. Anyone committed to ending their life can do so EXCEPT for people hooked up to machines, at the mercy of relatives, or do-gooders who think a no quality life should be supported no matter what. . And I am talking about medically assisted so that the quality of the death is a good one as opposed to someone finding you hanging from a basement joist, or with your brains spattered across a room or just perhaps disappearing into the ocean or deep woods which makes legal settlements more difficult.
If I pay for health insurance then my coverage ought to include death by conscious decision and not by desperation bred by unrelenting pain and misery.
Ever seen a head wound from a .45? I have. Lots of blood and "stuff". No need for that. We execute criminals more mercifully than we treat very ill people who want it to end.
We have a cult of life no matter what. We hate death and dying. It is the most fearful of things to most.
Before I am placed into a nursing home peeing in my diaper as well as defecating into one; sitting for endless hours drooling down my chin in some wheelchair in some dark hallway, I will do the deed. I'd prefer a clean exit however and I do think it is my "right" to do so as much as others seem to think it is their right to hang on until their body finally quits.
FREEDOM!
I don't remember saying anything about putting a gun to your head. I think you're imagining things to support your opinion. It is easy to go to sleep and not wake up from any number of substances. Not much different from your idea of a humane death. Most very ill people are in the state they're in through their own will or those who are responsible for them. Of course there are those who are suddenly thrust into the situation and I do feel for them. Their best recourse would have been a living will and a DNR order.
Last edited by HarryWho?; 12-19-2013 at 07:48 PM..
Ah the death panel nuts. They are rarely this late to the party.
The nations that have single payer health care are not sending their elderly out to an early water grave via ice floe, hyperbole or not.
Reality is life expectancy (and infant mortality for that matter) are HIGHER in single payer systems than ones like ours.
Even in our own country, life expectancy is higher in states like VT and MA, where they are using single payer systems.
So no, death panels are not going to be killing people to save money. Why? Because there is no need to make a profit. Meanwhile, health insurance companies by their very definition make the most money when sick people are refused treatment and left to die rather than treating them. If you want a for profit corporation deciding if you should live or die rather than your doctor, go ahead. It might take some of the stupid out of the population.
Before you jump on my post, perhaps you should go back and read the OP. I will quote the salient point here for you: "
"Is it really someone's RIGHT to: cancer treatments, pain medications, any kind of care for people over 70, and etc." Who's late to the party?
Certainly sounds to me like advocating letting the old people die. And sad to say, no matter what advances medicine has made, they still haven't found a cure for stupid.
If you wish the RIGHT to universal health care, you would need to get the government entirely out of the way.
An example of low cost care: The Wellness Revolution - Geoff Tabin
An example of the inexpensive medical care is cataract surgery in the third world.
Tabin and Ruit deliver cataract surgery at $20 per surgery. Which is 175 times cheaper than $3,500 (U.S.A.) pricetag, thanks to the medical insurance “industry”.
....
The article fails to note the influence of government on the exorbitant cost for privileged health care.
.... PJ Media » How Medical Licensing Laws Harm Patients and Trap Doctors Gangsters In Medicine
Flexner sought to shrink the number of medical schools in the USA...
In 1904, there were 160 M.D. granting institutions with more than 28,000 students. By 1920, there were only 85 M.D. granting institutions, educating only 13,800 students.
By 1935, there were only 66 medical schools operating in the USA.
....
One of the consequences of Flexner's advocacy of university-based medical education was that medical education became much more expensive, putting such education out of reach of all but upper-class white males.
In the nineteenth century, there were over four hundred medical schools in the United States. By 1910, the number was reduced to one hundred and forty-eight medical schools and by 1930 the number totaled only seventy-six.
By 1935, there were only 66 medical schools operating in the USA.
....
BEFORE GOVERNMENT, over 400 medical schools.
AFTER GOVERNMENT, less than 70 medical schools.
....
But feel free to blame everyone else for the problem.
Those who are doing cataract surgery in the third world for $20 are providing a charitable service that is underwritten by contributions. That is hardly a fair comparison.
Why would the insurance industry want care to be more expensive? They try to deny payment when they can get away with it and only want to pay for the cheapest medications.
The schools that closed were by and large diploma mills that operated for profit. They needed to be closed because they were doing a poor job of training doctors.
A friend of mine made the point that the country cannot afford all the medical are everyone in the nation wants. It would not be possible to print enough money to do that.
That means that some rationing is inevitable. In the past that has been accomplished by placing barriers to care, making it so difficult to obtain for some people that they do without. A pediatrician I know saw a patient who needed to see a specialist. The patient lives in Georgia. The nearest specialist participating in the patient's HMO was in Texas. The insurance refused to pay for the patient to see a specialist within a reasonable distance of his home. So the plan could claim the patient was covered, but in actuality it was impossible for him to use the benefit.
So how do we get around the rationing of care and the inevitable cries of "death panels" if the rationing is transparent?
It means establishing perhaps a basic "market basket" of basic services that will be covered for everyone, with the option to pay more for additional services. Choosing what goes into the basic basket will have to mean ranking services by the expected benefit. For example, prenatal care can greatly improve the likelihood of delivery of a healthy baby. Treatment of hypertension and diabetes can reduce the risk of heart attack and stroke. Those things belong in the basket.
Cosmetic surgery does not make it into the market basket. You pay for that yourself.
How about treatment of infertility? You pay an additional premium if you think you might need it or you save up and pay out of pocket.
So if you want coverage beyond the basic package, you should have the option to buy additional insurance.
The touchy area is perhaps expensive treatment near the end of life. At this point, much of the expenditure is driven by family members who have a hard time letting a loved one go. This where the argument that "death panels" will be "killing grandma" comes from. We need to make it easier for our elderly to decline treatment that will only prolong their lives for a few weeks or months but at huge costs. Actually, we need to make sure that anyone understands the economic effect of choosing care of questionable benefit.
There should, however, be no magic age at which a patient no longer is eligible for a treatment that might improve his quality of life. Someone like theatergypsy should not be denied surgery that makes it possible to maintain a previous level of activity solely on the basis of age.
Providing health care is something that I think our country needs to do for its citizens. The question is how to pay for it. I feel that all of us need to chip in, and to me the biggest problem with the ACA is that it affords too many ways to opt out. That leaves too much leeway for some who could pay to avoid doing so.
The biggest thing driving the cost of heath care is technology. The single biggest way to decrease the unnecessary use of technology would be to institute serious tort reform. Everyone with a headache does not need an MRI of the brain, but you are likely to get one if you pop into an ER complaining of a headache because no doctor wants to possibly miss a brain tumor.
We need to provide medical care not because it is a "right" but because it is in the best interest of the country to have a healthy population. It behooves the citizens to take responsibility for maximizing their good health, too.
I would add treatment of infectious diseases (in general) as antibiotics wouldn't cover all of those; this is a public health issue.
Not all infectious diseases are communicable, e.g. tetanus cannot be transmitted person to person. Nor can one "catch" an ear infection by being around someone who has one. I know it sounds picky, but you're talking about communicable disease, rather than infectious disease when you bring up public health.
But you bring up an important dimension. All these people who feel there is no "right" to health care apparently don't care if they get exposed to Gawd knows what by people who can't afford health care or immunizations.
Quote:
Originally Posted by 601halfdozen0theother
I personally think that any treatment that must be continuous - a treatment that prolongs a life rather than solves a specific problem - is not a right.
How would we all ever agree on a definition of a "meaningful life"?
You mean like insulin for diabetics, high blood pressure medication, high cholesterol meds, asthma meds? You have no idea how many people are taking meds to sustain life.
Quote:
Originally Posted by ovcatto
If you are referring to my post your assumption couldn't be more off the mark. We spend exorbitant amounts of money caring for patients in the last six months of life. As a nation we have an irrational fear of death that leads us to chase whatever treatment or therapy for diseases and conditions that are long past efficacious relief, on the chance that some fraction of a percentage of patients will put off death for days, weeks, or months. This by no means that I am an advocate of some age based criteria because this can be applied across any age group so no, I don't think that every individual has a "right" to any and every treatment that is not determined to be efficacious based upon the medical condition of the patient.
As for you question... unless those of us here are practicing physicians or medical researchers I think establishing what degree of health care a person is entitled to is a fools errand. Should 93 year old Lyle Ruterbories or 92 year old Betty Reid Soskin have a right to hip replacement surgery, damn right the two Rangers for the U.S. Park Service do, does a 93 year old stroke victim whose inability to ambulate could lead to increase susceptibility to pulmonary complications need one, despite being a paramedic in the military, I don't feel in the least bit competent to answer that question and I doubt that anyone here is as well.
So you might get folks more arrogant than myself (hard to imagine but it is possible) who will give you definitive answers about who has a right to what, I think that the broader question of who we are as a society is a far more important, accessible conversation that is far more conducive to constructive conversation that the anecdotal gossip that is sure to follow .
We-ell, it's not just fear of death. People are sicker at the end of their lives! We don't just up and die after we've used up a certain amount of health care dollars. Hospice care is not cheap, by a longshot. And so on.
The question really doesn't carry that much weight --- we're splitting hairs here.
Most of us who've helped a loved one through their last days know that in most cases, the patient either has made specific advance directives, or the relatives know what he/she would want. And medical care is already de facto rationed by both HMO's and the bureaucracies in the public sector.
There will, almost certainly, be those extreme cases which "fall through the cracks" and generate outrage among those with an axe to grind on a specific issue. I have no idea how this can possibly be avoided. But for most of us, end-of-life issues will be a personal matter, and the more mundane portions of the medical profession __ dental care and optometry, for example, are going to vary considerably from one locality to another. There will, I'm sure, be a certain number of participants who will learn how to "work the system" to their advantage -- sometimes even involving other nations.
But "uniform standards" on issues like this, are "a rule that sometimes needs to be broken" -- and will be.
I come from what maybe a unique position on this issue because I don't really believe in natural rights. I believe the only rights we have are those that we create for ourselves by law, by statute, and, if necessary, by force.
The real question is not "what rights we have to medical care". The correct question is what rights do we want to create for our citizens to have medical care? At the outset, I will state that I am not comfortable with a "market driven model" when it comes to health care. Such a system results in 80 year old men having bypass surgery while infants and young children do without immunizations and other "well-care" which would prevent hardships for themselves and society down the road.
I would define a "basic healthcare package". That package should include most of the things we take more granted. I would focus heavily on prevention because I think this is the big area where universal health care has a big advantage over the system we currently have in place. Maximizing this advantage will lower the overall cost of a universal health care program. Imagine a system where no one was ever charged for an immunization and the places where immunizations were given were numerically increased. Imagine free, or nearly free cholesterol and high blood pressure medications available to everyone with these problems. We have already significantly reduced deaths from strokes and heart attacks. Making these medications available to everyone would reduce these deaths further.
Imagine clinics that are affiliated with schools treating children on the spot for bronchitis, pneumonia, and infectious disease. It would keep a lot of other children from getting sick as well. An open question might be whether we would want to have such clinics in high schools dispensing condoms and birth control medications. I would say yes. However, this topic is controversial and would require more discussion before universal implementation.
Imagine free, or nearly free health education programs for diabetics and others who suffer from chronic diseases. Most people are unaware that many of the problems that diabetics have are the result of complications that occur because they failed to keep their blood sugar within a narrow range over long periods of time. If these groups could receive more support than they currently do under our "pay as you go" health care system, the potential for avoiding horrific issues like kidney failure and blindness is simply huge. My contention is that, over time, these programs would pay for themselves and than some.
On the other hand, there are simply things we shouldn't be paying for. I don't think we should be paying for expensive anti-cancer drugs that only extend life for a few months. I don't think we should be paying for organ transplants for elderly people. I think we really need to look at the services we provide for very compromised, low birth weight infants. These services are extremely expensive and many of the babies ultimately die or require extensive care for the rest of their lives. I happen to have infertility issues. Yet, I don't believe that fertility treatment should be paid for by such a plan. The possible exception might be very cheap and easy measures that can be taken to enhance fertility.
Ultimately, I think what most of us here are doing is expressing unhappiness with a system of medicine that has put profit first and patients second. I think we began a journey as a country when we passed the ACA. The ACA is unlikely the end of that journey. However, it marks the beginning of a point when a majority of Americans simply became fed up with a system that made patients a secondary priority.
I don't remember saying anything about putting a gun to your head. I think you're imagining things to support your opinion. It is easy to go to sleep and not wake up from any number of substances. Not much different from your idea of a humane death. Most very ill people are in the state they're in through their own will or those who are responsible for them. Of course there are those who are suddenly thrust into the situation and I do feel for them. Their best recourse would have been a living will and a DNR order.
"Seriously, who's stopping you? How hard would it be to end your life if that was your choice? As for health care, I would think it to be an idea of "betterment" or general welfare. What's the use of improving society while leaving the unfortunate behind?"
You seemed to have inferred that anyone, including me, who wants to end their life can do so. You are correct. My issue, not imagined at all, is why should anyone have to end their own life in a brutal manner or possibly not taking enough of some drug? In my opinion, they should not. If medical people can keep someone alive who does not want that for themselves, then that patient ought to be able to have it ended on their terms. DNRs are not always honored. Most people don't have DNRs since they all believe that nothing will happen to them ever. They believe they will die in their sleep at a ripe, but healthy old age. Guy in my neighborhood fell several months ago. Hit something on the way down, broke his neck. Paralyzed from shoulders down. 61 years old. He cannot end his own life unless he deliberately swallows something or chews up his own tongue. In my opinion, he ought to be able to tell his doctors to end his life cleanly and with dignity. He could stop taking nourishment provided people would cooperate with him but typically they do not. He should not have to fight for the right to be euthanized. If he wants to live in his condition, fine. He ought to have a choice.
And yes, of course, I do support my opinions. That is what this forum is all about seems to me. But for sure, I am not imagining the reign of terror that hospitals and doctors inflict on desperate people either out of fear of lawyers but more likely on making lots of money off of desperate people. Cash is king everywhere.
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