By John Ballard
Sorry about that.
I needed a headline that would get attention.
This is a conversation loooong overdue.
Andrew Sullivan and Ezra Klein are finally getting the subject into the mainstream. Hopefully the spark will catch on. With the final months of life eating up the lion's share of costs, this totally reasonable and rational suggestion has the potential to save more medical costs than all the reforms, regulations and fraud investigations combined.
If everyone aged 40 or over simply made sure we appointed someone to be our power-of-attorney and instructed that person not to prolong our lives by extraordinary measures if we lost consciousness in a long, fatal illness or simply old age, then we'd immediately make a dent in some way on future healthcare costs. A remarkable proportion of healthcare costs go to the very last days or hours of our lives.
This seems to me particularly apposite for the boomers who, even if Paul Ryan got his way, would still be grandfathered into the most generous combination of personal prosperity and government support of any generation in history. Wouldn't a few fewer unconscious hours or days be a sacrifice worth making?
Of course, this would be entirely voluntary - and not even nudged (although, frankly, I see no reason why the government shouldn't nudge you to make arrangements ahead of time given that others will be forced to pay the costs). "Death panels!" Christianists would scream, revealing exactly how un-Christian they are. Christians, of all people, it seems to me, have nothing to fear from death, and a great deal to gain from giving a few of their own unconscious final days to make it feasible for others to have a few more conscious and healthy ones.
His idea is voluntary. But I�d make a different suggestion. What if, to be eligible for Medicare, you had to give someone power of attorney and sign a living will? You could tell your attorney, and write in your will, that you want every possible measure employed to keep you alive. You could say cost is no object, and neither is pain or quality of life. You could make whatever choice, and offer whatever instructions, you want. You just have to do it. You have to make the decision.
Right now, of course, heroic measures are the default. The simple act of making that choice would cut costs, as I suspect many, many people would prefer something besides maximal treatment, and would ensure fewer people suffered needlessly because their health deteriorated before they made their wishes clear. And although Sarah Palin managed to rechristen medical counseling about end-of-life options �death panels,� I choose to believe that that sort of childishness isn�t inevitable and that this country can make adult decisions about adult problems.
Outstanding. But I would specifically require "Final Directives" instead. Comprehensive and legally air-tight. Livng Wills are passe.
I've been preaching Advance Directives (another name for the same documents, less ominous perhaps) til I'm turning blue.
It's good finally to see the subject getting mainstream attention.
~~~~~Step right up, folks. here's the link you need to get started!~~~~~
Original, documented investigation on Kaiser Permanente�s rigged end of life counseling, �Birth of a Real Life Death Panel,� is posted on www.hmohardball.com at http://www.hmohardball.com/Death%20Panel%20Birth%20&%20Attachments%201st%20in%20Series%202-14-2011.pdf
ReplyDeleteTwenty years ago, Dr. Ezekiel Emanuel, ObamaCare�s ethics engineer, published that he had invented a scheme that induced 70% of patients to reject treatment and life support in a 15 minute end of life counseling session.
n. He would deny Rep. Giffords� care, because she may not be able to �meaningfully participate� in the American "polity."
POLITICIANS, BUREAUCRATS, AND DR. STRANGELOVE PHYSICIANS ARE �BENDING THE COST CURVE,� BUT BREAKING THE PATIENTS AND DESTROYING THE DOCTOR- PATIENT RELATIONSHIP.
Robert Finney, Ph.D.
Dr. Finney, I'm leaving this comment and link to a multi-page hit piece for the sake of "balance" if ad hominem attacks and a 18-year old (obsolete) document can be called balance. In the "about" section of your website I found...
ReplyDeleteTEA PARTY ALLIANCE AGAINST JUDICIAL ACTIVISM exposes how federal and state judges intentionally ignore, twist, and strangle the Constitution and patient protection laws to cover up corruption that harms patients, tax payers and citizens.
...which tells more about the source than I could ever do.
Your statement that n. He would deny Rep. Giffords� care, because she may not be able to �meaningfully participate� in the American "polity" borders on libel without any supporting documentation.
I have better things to do than argue with this pile of rubbish. Nobody liked HMO's first time around because they were managed by insurance companies putting profits ahead of medical care. And yes, PPACA can be seen as a reincarnation of the old health maintenance organizations. But this time physicians get to have a crack at making the idea work.
The fee-for-service disease management industrial complex model has resulted in a bloody train wreck. Any alternative will be an improvement. (My own health care directive, incidentally, is only a few pages long, easy to grasp and a model of clarity. One need not be brainwashed to use it but it is important to have a brain.)