@wvpeach,
wvpeach;40176 wrote:You almost had me agreeing with you till you said you'd not give the guy who ate garbage a bypass. So are we going to pick and choose who has been naughty and who has been nice?
I hate to bring this to your attention, Peach, but what you are talking about is rationing of healthcare. The fact is that no matter what we do with healthcare, that is exactly the direction we are heading. We simply will have to do so, for two essential reasons.
The first is the average American's inability to accept death as a natural conclusion to the life cycle. I see it almost every day. A geriatric patient, confined to a nursing home with Alzheimers and heart disease taken to the operating room for cardiac bypass surgery. Even the surgeon knows what he is doing is futile, but we do it because the family wishes it. And if we don't follow the family's wishes, rest assured we will hear from their lawyers.
The fact is that a huge proportion of our health care dollars are spent on people in their last two to three weeks of life. People with terminal conditions of every sort, put in ICU's, ventilated, in the end put through horrendous suffering before the inevitable end comes. The outcome will at best be delayed for a few days, but it will be the same. Why do we do this? Because families and patients demand it. "You have to do everything you can to keep granny alive, we love her so much!" Never mind that granny has metastatic cancer, Alzheimer's disease, heart disease, and is 83 years old. It is an unwise, and worse, inhumane use of resources.
The second reason is at least indirectly tied to the present social policies where medicine is concerned. Every physician knows that a patient over 65 years old is a paying patient. While medicare reimbursement may not be much, "not much" is still more than "none." I personally know orthopedic surgeons who mourn every geriatric patient who dies without some orthopedic appliance being buried with him or her. My own mother was such a patient. I described her above. 83, with heart disease, metastatic cancer, and Alzheimer's disease (that isn't all, it's just the major problems). She fell and broke her femur. The orthopod who consulted on the case told my family that the surgery to repair this fracture was "resident surgery." He also offered them the option of letting her "die of a broken leg." What he didn't tell them (I was not there at the time) was that even with the broken leg, she could be made quite comfortable, and allowed to pass peacefully. He also didn't tell them that given her medical condition, her chances of surviving more than a few days past the surgical correction were slim. So, my family, including at least as many medical professionals as yours, elected to have the surgery at the insistence of the orthopod.
I made it home just in time to tell my mother I loved her before she died. She died having suffered the pain not only of fracturing that bone, but also the pain of having a very expensive titanium rod inserted in that bone. It didn't need to be this way. But, the orthopod saw the opportunity to bill for one last procedure. He took it.
