Skip to comments.Mark Steyn: Unplugging Grandma isn't the problem
Posted on 08/15/2009 5:14:52 AM PDT by libstripper
Some years ago, when I was a slip of a lad, I found myself commiserating with a distinguished American songwriter about the death of one of his colleagues. My 23-year old girlfriend found all the condolence talk a bit of a bummer and was anxious to cut to the chase and get outta there. "Well," she said breezily. "He had a good innings. He was 85."
"That's easy for you to say," he said. "I'm 84."
(Excerpt) Read more at ocregister.com ...
Geez, THIS is the article that OUGHT to be e-mail blasted to everyone in the country!
Good one Mark!
But, under any government system that interjects a bureaucracy between you and your health, the elderly and not so elderly get denied treatment. And there's nothing you can do about it because, ultimately, government health represents the nationalization of your body.
God, please don't let 'bama pass health care...
The problem is that Obamas American Auschwitz Bill needs acceptance so that the One isn’t embarrassed when it flops.
Bingo! Even better, what we're after should be called "medical treatment," as Thomas Sowell consistently says.
The whole thing has nothing to do with health care.
The Medicare system is bankrupt. The Medicaid system is bankrupt.
The hospitals on the SW border are bankrupt due to the illegals flooding the system.
Obamanation care is designed to end those plans over time, suck money into the government’s new programs and parcel treatment out using the best way to do it: Statistics.
Older, younger less viable get less care.
The Federal Behemoth needs all the tax money it can suck up and Obamanation Care is the way to do it.
Follow the money
BTW, Social Security is on the bankrupt list next year. What do you suppose the elite are going to do with that?
“American Auschwitz Bill” - That is a keeper.
This will happen irrespective of whether Obamacare is enacted or not, or whether conservatives or liberals are in power. It's simply impossible to tax the young and middle aged enough to support unlimited access to unlimited medical technology at the ratio of 1.5 taxpayers per recipient.
If there is a Medicare program in 2035, it will be so different from today's program as to be unrecognizable. Or - there will be no Medicare, and retirees' health care will be determined by what they and their families can afford to pay out of pocket.
I believe America will never force suicide or deny basic life support - but the era of hip replacements and AICDs for nonagerians will be over.
HANDS OFF OUR TOMBS!
What happened to “it’s my body” dealio?
I wonder what age these bureaucrats will determine is “too old” to treat. They say 50 is the new middle age so I assume that there’s a new benchmark for old as well. We’re living longer, healthier lives (due to our current healthcare) but I doubt that will be taken into consideration by the pile of statistics they use to determine “end of life”.
And once it’s carved in stone in their socialist takeover, they will probably only adjust downward in the future even if we live to be 150 because some 60-year old woman will never be able to contribute to society the way a 20-year old can.
The problem with government health systems is not that they pull the plug on Grandma. It’s that Grandma has a hell of a time getting plugged in in the first place. The only way to “control costs” is to restrict access to treatment, and the easiest people to deny treatment to are the oldsters. Don’t worry, it’s all very scientific.
In Britain, they use a “Quality-Adjusted Life Year” formula to decide that you don’t really need that new knee because you’re gonna die in a year or two, maybe a decade-and-a-half tops. So it’s in the national interest for you to go around hobbling in pain rather than divert “finite resources” away from productive members of society to a useless old geezer like you. And you’d be surprised how quickly geezerdom kicks in: A couple of years back, some Quebec facilities were attributing death from hospital-contracted infection of anyone over 55 to “old age.” Well, he had a good innings. He was 57.
This ought to be of particular concern to Americans. As is often pointed out, U.S. life expectancy (78.06 years) lags behind other developed nations with government health care (United Kingdom 78.7, Germany 78.95, Sweden 80.63). So proponents of Obamacare are all but offering an extra “full year” of Euro-Canadian geriatric leisure as a signing bonus.
“Life expectancy” is a very crude indicator. Afghanistan has a life expectancy of 43. Does this mean the geriatric wards of Kandahar are full of Pushtun Jennifer Lopezes and Julia Robertses? No. What it means is that, if you manage to survive the country’s appalling infant-mortality rates, you have a sporting chance of eking out your three-score-and-ten. To say that people in Afghanistan can expect to live till 43 is a bit like saying the couple at No. 6 Elm Street are straight, and the couple at No. 8 are gay so the entire street is bisexual.
And if we get them to stay in the workforce, paying in rather than drawing down, until age 80 or so, that's the only way the Medicare program can be salvaged from financial collapse.
“because some 60-year old woman will never be able to contribute to society the way a 20-year old can.”
I understand your point but based on what I’ve seen, I’d take the 60 year old.
Years ago when my grandpa was visiting us, (he was 89 at the time), in a discussion he said “all I want is TEN more years”. He wasn’t ready to cash in just yet. I thought at the time “what an incredible statement to make at his age. He died at 92. He had prostate cancer and diabetes for about 15 years. Should he not have been treated?
My brother in-law, may God rest his soul, died of cancer. While he was not elderly, he did eat up a large amount of health care dollars. After treatment, (while he never returned completely to his former physical self), he lived 10 quality years and fathered 3 more children. Worth the money? I NEVER want a government bureaucrat deciding who deserves to live and who doesn’t.
Money quote. Wish it would fit on a bumper sticker!
It's the same old, liberal line: "caring" is all that counts. It doesn't matter what the outcome happens to be. Only the intent matters.
As for me, when I go to the doctor, I want results not sympathy.
I am very conflicted by this. My father-in-law died last week after fighting leukemia for 18 months. He also had heart trouble. The amount of money spent by Medicare was incredible but the level of medical treatment was incredible too. I would guess that the bill could have easily been half a million dollars. He was able to make his own decisions so it is not for me to judge his quality of life. And I only geve my opinion when asked.
However; there was something very un-natural about his last 5 months when the doctors said that there was nothing more that they could do. They kept him alive for 5 months by giving weekly blood transfusions. He was in incredible pain, could not get around, had horrible rashes, had zero antibodies so he could not go anywhere. But the whole thing was his call, eventhough he knew it was only buying a few extra weeks. It was also torture on the family to see him go this way.
This experience has been a lesson for me. When I’m 85, I do not intend to linger in pain without dignity. (But I reserve the right to change my mind when I’m 84.)
Lies, damn lies, and statistics. Urkel is a pathological liar. Steyn needs to give Urkel a verbal tongue lashing in front of a camera.
Mark is proving each day to be a powerful researcher as well as writer. He may have research staff helping him but it is his ability to cull the facts and assemble them in a populist column that stands out.
Because I am more knowledgeable than most about medicine in the USA, it is difficult to impress me with commentary about the general standard of USA healthcare delivery.
Mark has just impressed the hell-out-of-me.
We bring in 1.2 million LEGAL IMMIGRANTS ANNUALLY, most of whom are poor and uneducated. They will use our social welfare programs almost twice as much as the native born. We are importing poverty.
The US is the world's largest debtor nation. We have lived beyond our means and are now beginning to pay the price. By 2016, SS goes into the red and Medicare will go bust in a decade. Obamacare will add a huge entitlement program bigger than Medicare and SS combined. Our entitlement programs represent an unfunded liability of close to $60 trillion.
I can see the entitlement programs becoming means tested in terms of benefits. We are already heading that way with Medicare Part B.
The net result of all of this is that they US will no longer be a superpower. We will have to choose between guns and butter and butter will win out.
My pop said..."Never, say never!"
Teri Schaivo's family might dispute you on that one.
>>However; there was something very un-natural about his last 5 months when the doctors said that there was nothing more that they could do. They kept him alive for 5 months by giving weekly blood transfusions. He was in incredible pain, could not get around, had horrible rashes, had zero antibodies so he could not go anywhere. But the whole thing was his call, eventhough he knew it was only buying a few extra weeks. It was also torture on the family to see him go this way.
This experience has been a lesson for me. When Im 85, I do not intend to linger in pain without dignity. (But I reserve the right to change my mind when Im 84.)>>
My father was 52 when he died.
In end stage cancer, the doctors said that he was to be brought in every time he “had a problem” and they would continue chemo and do what they could.
My dad said no. He wanted to die at home. They said he could have six months with luck. He refused their timeline and died after a month. But at home, where he wanted to be.
I will do the same. But it needs to be OUR choice. Not by guilt on draining the system but rather for love of those who suffer with us.
Many issues here that you raise.
First understand that medical clinics have to do what they do to stay in business. The overhead can approach 90% in certain practices especially where Medicare is involved.
1. Once an MD has accepted a patient into their practice, they cannot refuse to see the patient unless there are warnings and good reasons for dismissal.
2. Patients can be less than 65 years when an MD first starts treating them. Once they turn 65 they are required to be under Medicare and the MD cannot turn them away.
3. Medicare reimbursements are whatever the US Govt decides they will be on a monthly basis, and they often not enough to cover the costs of the clinic. Hence, the clinic billing will often ‘double down’ and throw every billing code at the highest level at the US Govt. Because otherwise the doctor can find themselves working for less than minimum wage and often at a loss. And this is not a rare event. In fact it is an expected reality unless something is done to avoid it.
4. When a medical practice becomes a geriatric practice, that is when the MD has been in practice long enough to see many of their patients get on medicare (see no. 2 above), then the practice will start to fail financially. There are only two solutions, retire or relocate. Such practices can’t be sold because they are worthless. Doctors in such clinics that retire or move will try to find their patients continued care but in general it’s a farewell letter with “I will try my best to find you a provider” etc.
So to recap, understand that your observation of the “amount of money spent by Medicare” is a battle between a poor healthcare manager (the US Govt) and the US health industry.
So the question is who is at fault, who is to win?
If the govt wins, they will indeed as Mark Steyn so well expresses provide ‘care’ more often than ‘treatment’.
The US socialist govt is losing the battle with the elderly so they want to take over the entire industry so that MDs cannot escape them by retiring or moving. If they succeed, they will own the doctors and dictate medical policy. The doctor will no longer have our interest in mind but that of the government.
It reminds me of the Canadian who called into Seattle talk radio to comment about Canada Care. He was happy to be covered. He was asked if he was getting treatment for his ailment. He said no, that he was on a waiting list. When asked why that was a good thing, he replied because he was covered. How long had he been waiting? Over a year. How long would he wait in the USA? A day.
So as long as someone thinks they are covered, it is better than getting treatment.
Back to your father-in-law, the US healthcare systen is the most advanced because it ‘strives’, it pulls out all stops to save someone. It must for two reasons, pride of profession and the threat of a kick in the *ss by the legal establishment.
As for solutions to the high billing and cost of healthcare, it is best done outside the lame current govt proposals. The solutions that have merit are:
1. Ability to purchase health insurance across state lines.
2. Longterm 20 year health insurance policies.
3. Business and personal tax credits and deductions for medical clinics and providers who see uncovered patients.
These are but a few items that could go a long ways towards eliminating the high-billing shock of the current system.
I’m an MD/PhD. Ex was an MD practicing for many years. Most friends and colleagues connected to health.
Very good article by Mark Steyn. Thanks for posting.
Those with non-surgical obotomies stand in this line and sign your declaration of dependence, “In the end...”
Absolute ZERO will make sure that it is painless. /sarcasm
This is something I wish Mark would have pointed out in the article. Illegal aliens detract from the life expectancy in the US. They come here, many sick already and most have never had decent medical care. They are sick and they die younger than American born, and legal resident, citizens, this takes away from our life expectancy. Another thing I would like to know, do abortions count towards "Infant Mortality Rate"? If so then they would have a very negative effect on our life expectancy figures.
I understand your point but based on what Ive seen, Id take the 60 year old.
I agree, most 20 somethings don't know $h!t from apple-butter even though they posses a college degree in "analysis and synthesis" (four years totally wasted, both literally and figuratively!)
Our 11 yo daughter has cancer and is due for radiation therapy next week. At our initial visit with the Radiation Oncologist, I was surprised to meet a French Canadian. I asked him what brought him here and he responded that he couldn’t practice in Canada in good faith. His patients have to wait so long for his services that the tumors are frequently too advanced to treat.
Immigration, legal and illegal, has had and will continue to have a major and far-reaching impact across a broad spectrum of existential challenges that confront this nation, e.g., national security, the economy/global competitiveness, jobs, health care, taxes, energy independence, education, entitlement reform, law enforcement, social welfare programs, physical infrastructure, the environment, civil liberties, and a continued sense of national identity/shared sense of endeavor. Immigration is the defining issue of our time with enormous implications for the future of this nation and the preservation of our patrimony. Yet, seldom will you hear immigration mentioned by our political and intellectual elites in connection with these challenges.
That's simple. They'll "means test" the benefits and scr*w the "rich" - that's anybody who collects another pension - by cutting benefits on an offsetting basis.
People who don't get the medical care they need usually become depressed and "give up". That has a profound effect on their health. So I suspect we won't be "living longer, healthier lives" under the new system.
How would you feel if at the age of 55 you lost the ability to walk because you needed a knee replacement and had to wait on a list until you were 60 to get it? Depressed is an understatement.
The same they did in 1983 when SS went into the red, i.e., raise taxes and decrease benefits, including raising the retirement age for full benefits from 65 to 67.
Thank you for your thoughts.
I also want to be at home, surrounded by people I love. My father-in-law’s extra time did not appear to me to be of much value. But again it was his call.
Many points can be debated about the wisdom of your father-in-law's choice but he certainly did not live those 5 last months "without dignity".
"Yes, there were times, I'm sure you knew
When I bit off more than I could chew.
The record shows I took the blows -
And did it MY way!"
And that saves the Canadian Government bean counters a ton of money.
Look at the tragic death of British actress Natasha Richardson (the wife of the actor that played Oskar Schindler on "Schindler's List") from an epidural hematoma after a fall on a Quebec sky slope. After the 911 call was made, it took several hours to get her to a Trauma Center with neurosurgical capabilities. By then, it was far too late to save her life.
Because, in order to save the bean counters money, the province of Quebec lacks a medical helicopter system.
When treated in time by a neurosurgen, an epidural hematoma is very easy to treat with a burr hole (Trepanation). Trepanation has been done for centuries. (See the trepanation scene in the movie "Master and Commander".)
Yet, in Quebec, such an injury can be a death sentence if you are on a ski slope because the Province of Quebec bean counters have decided that burying dead patients costs far less money than having a helicopter service that delivers salvageable patients to a Level I Trauma Center in Montreal.
Doctor: Lack of medical helicopter cost Natasha Richardson .... The province of Quebec lacks a medical helicopter system, common in the United States and other parts of Canada, to airlift stricken patients to major trauma centers. Montreal's top head trauma doctor said Friday that may have played a role in Richardson's death. "It's impossible for me to comment specifically about her case, but what I could say is ... driving to Mont Tremblant from the city (Montreal) is a 2½-hour trip, and the closest trauma center is in the city. Our system isn't set up for traumas and doesn't match what's available in other Canadian cities, let alone in the States," said Tarek Razek, director of trauma services for the McGill University Health Centre, which represents six of Montreal's hospitals
Mark Steyn Thank You!!!!
Mark Steyn Thank You!!!!
"Which brings us to the United States and its allegedly worst health system in the developed world. Here's the reality: The longer you live in America, the longer you live..."
"...if you can make it out of diapers, you'll live longer than you would pretty much anywhere else. By age 40, Americans' life expectancy has caught up with Britons'. By 60, it equals Germany's. At the age of 80, Americans have greater life expectancy than Swedes."