Saturday, April 14, 2012

- Immoral Government Healthcare

In trolling the local papers of my rural youth, I noticed that an ex-girlfriend of mine died a little while back. We only dated for a short while, many many years ago, but I find that her death has had quite an impact on me. She didn't die from a car crash or a some other accident - she died from complications related to pneumonia. She was very young to go from an illness like that, but there it is. Some people buck the odds in a bad way. And I guess it's reminded me how close on my heels father time actually is.

If she had continued to drink and chemically entertained herself like she did way back when I knew her, I can't imagine her health was the very best. That sort of thing will wear you down over time. We were very young and the young can be irresponsible about that sort of thing. When she died she was divorced and had two kids. The last time I spoke to her she was married and pregnant with the first. I thought pregnancy had "straightened her out" a little, but from here it looks like that straightness probably didn't take.

This is the first person I was close to that died from something that's thought of as a part of being old. It's also why I suspect she was probably old before her time. I hadn't seen or spoken to her in... god knows. Certainly more than 25 years. So when I remember her now she's still frozen in time at that moment of perfect youth. I still see her as this wild reckless beautiful thing who didn't know what the future held for her and didn't really care. She was one of those people for whom 'Monday' was as distant as forever, and she wasn't going fret over it until she absolutely had to. It usually doesn't last, but that's the kind of thing that can be appealing when you're still young and indestructible.

Anyway, when I knew her she was poor and uneducated, and things never changed much for her. Her last job was as a staffer in one of those tree nurseries that sell landscaping decorations to homeowners with green thumbs. My cousin owns one in South Carolina, and does pretty well with it. But she just worked at one. Like many people, she never made any money. And now that she's died, her daughter is a poor and uneducated single mom, and her son is a fugitive from the law. Her family like mine, wasn't exactly the Waltons.

I don't mean to dump on her. Her family was even more deeply dysfunctional than mine was, and she was even more troubled by it. For her life was about finding a way, any way at all, to make the pain of getting out of bed in the morning tolerable. And with all that, she was a sweet girl with a generous spirit, who never did anyone a bit of harm that she could find a way to avoid. She may have been her own worst enemy, but she was also most certainly her only one.

Thinking about her death has got me pondering how I might go. At 19 we all think we'll live forever but we won't. None of us. And I've gotten to the age now when I know there will be a period at the end of my sentence. I'm not panicked about it. I probably have nearly as much time in front of me as behind, and I'm in excellent condition - especially for my age. but I confess, these days the end isn't totally unconsidered.

So all this is kind of making me wonder, how do you imagine yourself dying? What circumstances do you imagine will be involved in your end? I'm guessing that very few of us will be in our upper east side mansions with our team of physician/former playboy bunny attendee's close at hand, mightily fending off deaths final grasp. That may be the fantasy, but it almost certainly won't be the reality. So what do you imagine the reality for you will be?

Do you picture yourself reclining in a government run facility, burning through all the pain medication and medical treatment our collective descendants can afford? Do you think that last few minutes of staring up at a hospital ceiling panel will be worth the years of damage done by bankrupting your next four generations of grandchildren to pay for it? Does that seem like a good trade to you?

I'm not asking a policy question here. I don't mean to talk about death panels or euthanasia. Let's exclude that question for a moment, and talk about the morality of the broader issue. Do you think it's OK to pay so much for so little - especially when the person getting the bill has no choice about it? Because someone has to pay for all of it, even if it isn't you. My point is, I think the very idea of government run healthcare system is an immoral proposition because it takes away the choice. It forces people who haven't been born yet, to pick up the tab for people who have no interest in looking out for their interests. The consumer is a person in their most desperate hour of need - disinclined to moderation, and the payer is a person who can't complain because they haven't been born yet. It's a perfect recipe for the immoral use of force.

For myself, I always imagined I'd die alone. I'm not ripping off Captain Kirk; I just figured that anyone who really knew me would be long gone (and probably be doing a little dance) by the time I died so they would be disinclined to make it any easier for me. I figure the best I can hope for is maybe a Catholic nun who doesn't know me and therefore doesn't know any better, to help me on my very last bit of business. I hope it's somewhere warm - I've had my limit of snow. Maybe some central American poverty ward somewhere run by Catholic charities. If I'm dying I'll probably have other things to worry about than the decor.

But one thing I really don't imagine myself doing, is sucking the last drop of water out of the well for myself. I'll go with the odds. If they tell me I have a 50-50 chance of beating whatever it is, I might take the shot. But if the only option is to extend illness - then I think I will very likely refuse treatment. Call it what you like. But I think I'd rather give my daughter a better shot at safety and security, than rob her future to give me just a few more years of withering and age.

It would feel wrong of me to participate in a system like Medicare, which I think is immoral. I've been unemployed and penniless in the past. I've borrowed money from my family, and from my girlfriends, (all of which I paid back) but I've never taken a penny of unemployment. In my mind the government takes it from me by force without my consent. And I'm not going to give them my blessing for it after the fact by using it. Just because they are immoral doesn't mean I have to be. I kind of imagine being the same way about Medicare. I didn't ask for it, and just because the government has robbed me to pay for it doesn't make it right for me to use it.

Anyway, that's my thought on it - today anyway. You know how these things are; I may feel differently when it comes to it. But here, in exceptionally healthy middle age, that's how it looks to me. So as far as I'm concerned they can take away my Medicare, and it wouldn't phase me. And given how poorly the government does anything, it probably won't be worth much by the time I qualify for it anyway.

I think it would be the next perfectly immoral act to steal the from future generations by running up the debt, and then denying the service it promised to pay for with it. It's exactly what I'd expect from government. Eventually.


chess said...

i graduated from med school in 80. then got boarded in int medicine and then got boarded in anesthesia.there were no intensivist boards at that time or id been hangin arond for a 26 yo in medicine i would know a pt that really had no hope and would start talking to the family bout making the pt "comfortable" and let them pass to God. didnt matter if there was 1 family member or 10 i was always able to take their grief eventually and let grandpa go. you could-if you spent enought time with the family to know who was the 1 that might not let go so easily. but if you talked enough eventually they gave you the grief and pain and you took it and let nature do its natural course.and as i said i went 100% in that task...however theres a downside to that and if you enjoyed the movie THE GREEN MILE you understand. because eventually it wore you down taking that pain from the family. it wore me out enough that when i finished those three yrs i went back and did another 3 in anesthesia.i would love to ask how the author of the mile got their idea. so in anesthesia i didnt have to worry bout all the talking and hand holding and i was happier. i did miss some pt interaction but never looked back... but one HUGE thing that changed in medicine over 20-25 yrs was that we went from "make them comfortable doctor" to " do everything possible"..... that was a huge transition.and a costly happened because doctors got busier and it was easier to do "everything" you jus plug the pt into a dozen tests and then actually make some decisions. (the law profession also helped thetransition to protect your ass).. but especially for surgeons it was alot easier to "everything because in todays medicine the surgeon operates and turns em over to a hospital based intensivist.. so the surgeon can operate on somebody that they normally wouldnt and hands em off and goes home . all the 100s of pages etc now go to someone means we now operate on anything wehter dead ,dam near dead etc...its sad.. ive seen so much human life extended for no reason.. the last few weeks turn into torture in an i said once before here we sppend bout 70% of our healthcare dollar in 83 yrs of life and 30% in the last one.....if you fixed that 1 yr then medicare is solved...dendreon a biotech co has a prostrate ca drug. it cost 93000 a treatment to extend life some say 21 days....???? and they arent good days. these are the end of life with mets to bone etc days.. we cant do that cause of what tom says. your kids get the bill.but as a society we arent ready to argue that last yr. until we do were are toast. the eu /canada etc dont spend that o th last yr...sorry i rambled.
one last thought having seen this in my mom. she went thru open heart. then aorta surgery and thought she had covered herself by paying into medicare. our society thinks since they have paid into soc sec and medicare that they deserve "everything".. the reality is they paid enough for a week in hospital and the rest is your kids. same for soc sec... our society needs to hear form someone that the system is broke.and they no matter how much they paid every 2 weeks they didnt pay anything at all.

medicare already price fixes to the tune of ?35 cents on the dollar. you can cut more but doctors will stop taking the pts.. eventually we will get what we deserve in the quality of md's... and it wont be pretty. thanx

chess said...

jesus. sorry guys... both my parents died in hospice with me around to prevent any last minute an orphan but if you have family please let them know your last wishes and a biggie-- donate your organs for someone.thanx

chess said...

even your corneas help... my liver swims in bourbon most nites so thats out but bone eyes etc..hell dick cheney would have loved a 58 yo heart since his was about 155 yo.

Keith said...

Tom, your point that we prolong death, and not life, is spot on. Took my father home after brain cancer diagnosed. Heme-onc doctor offered brain biopsies and radiation in a clearly terminal case. Immoral stupidity. My father died in nine days. We avoided him puking the last eight. Point is, we all need to give it up when the warranties have run out.