The MSM on health care — a second opinion…

The following Associated Press article was entered into the national discourse earlier today, Sunday, August 2, 2009 —…  

This writer would submit that the views advanced in that article might be worthy of further examination and discussion.  My initial intent was to include each two-part segment, entitled “CLAIM” and “THE FACTS”, followed by my commentary, but soon discovered that discussion of the first item was extensive enough to comprise an entire essay in and of itself.  

Should there be sufficient interest in this exercise, it is this writer’s intent for this to be the first of a series, following by subsequent discussions of other “CLAIM” and “THE FACTS” pairings described in the above-referenced article.  

CLAIM: The House bill “may start us down a treacherous path toward government-encouraged euthanasia,” House Republican Leader John Boehner of Ohio said July 23.

Former New York Lt. Gov. Betsy McCaughey said in a July 17 article: “One troubling provision of the House bill compels seniors to submit to a counseling session every five years … about alternatives for end-of-life care.”

THE FACTS: The bill would require Medicare to pay for advance directive consultations with health care professionals. But it would not require anyone to use the benefit.

Advance directives lay out a patient’s wishes for life-extending measures under various scenarios involving terminal illness, severe brain damage and situations. Patients and their families would consult with health professionals, not government agents, if they used the proposed benefit.

Have you ever looked closely at all of the considerations that go into crafting an advance health care directive?  Since my profession requires discussion of advance health care directives with patients on my caseload, I purchased a book on the subject to better familiarize myself with such matters, anticipating numerous questions.  

I thought it best to read the book from the perspective of how I might apply the information to myself.  I found very few answers, and ended up with many more questions.  Perhaps a medical doctor could answer some, or maybe even most of them, but it seemed clear that some answers would only constitute a best guess.  After reading this book, I was convinced that I would only craft an advance health care directive AFTER extensive consultation with a health care professional I trusted 100%.  And even then, I seriously doubted that even the best expert advice would still leave many important questions unanswered.  

Have you created an advance health care directive or desire to do so?  Does your health care insurer afford you the opportunity to discuss your questions and concerns with your medical care provider?  The House measure provides this opportunity to those seniors who wish to avail themselves of this benefit on a purely VOLUNTARY BASIS.

Numerous questions arose, including the following, which constitutes only a small sampling:  1) If you choose, under certain conditions, to terminate some or all life support measures, what is it like to die from thirst (if all life support is removed) or starvation (if only hydration is provided)?  2) Under what conditions would you want a DO NOT RESUSCITATE ORDER to apply, remembering that you could be fully conscious, but unable to communicate your wishes at the time?  For an instructive glimpse into such a situation, films such as “Johnny Got His Gun” and the more recent “The Diving Bell and the Butterfly” come to mind.   3) In the absence of any other guidance, who do you want to make the decision for you — a physician (or two, if a second opinion is required) both employed by the same health care organization that stands to enjoy a five or six-figure windfall by keeping you alive for a few more days, even if you are in excruciating pain with absolutely no hope of improvement OR your insurer, who, although you may stand a good chance of survival and recovery, for whom your care represents a dent to their bottom line?  If you belong to an HMO, remember that any treatment provided to you shrinks their profits, so, their bias, in many respects mirrors that of health care insurers.  

The absolute cruelty of the current system defies comprehension.  Do you have children or grandchildren who are struggling mightily to survive in today’s economy?  Do you wish to leave behind a little of your hard-earned nest egg so that a promising grandson or granddaughter might have a chance to attend college (which would be a non-issue in countries like Denmark, France, etc.), where they would be able to further develop their considerable talents?  At the same time, do you want to remain alive long enough to attend that same grandchild’s high school or college graduation or be present on the day that they marry their fiancĂ©?  Do you spend that nest egg to give yourself a chance to stay alive or, rather, refuse all measures so that your loved one(s) will have a better chance in life, even if you won’t be present to witness such a happy outcome?

Compared with other first-world nations around the globe, the citizens of this country are unique in the risk that they may someday be forced to face such a heart wrenching choice.




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  1. Without adequate health care, life and the pursuit of happiness cannot be guaranteed.  Similarly, liberty takes on a different meaning whenever life and the pursuit of happiness are at risk.  

    Health care is one of many facets of vital importance to all, which also includes concerns such as climate change, environmental degradation, and a myriad of other issues that potentially threaten our quality of life at its most basic level.

    • Edger on August 3, 2009 at 18:15

    this video may (or may not) be helpful:

    Better Ways to Pay for Health Care“, with Harold Luft, Director, Palo Alto Medical Foundation Research Institute; Professor Emeritus of Health Policy and Health Economics explores ways to pay for healthcare. Series: UCSF Mini Medical School for the Public [8/2009]

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