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A NEW MODEST PROPOSAL

 
 
Reply Mon 10 Mar, 2014 05:42 pm
(Something I wrote a couple years back at another forum.)

In his early eighteenth century satiric essay “A Modest Proposal”, Jonathan Swift, suggested that the Irish poor sell their children to the rich to be used as food. Swift offered ideas for how the children could be fattened before sale; suggested recipes for proper preparation; and ended his treatise by enumerating the benefits that would accrue both to the poor and to the Irish economic system that primarily served the interests of the wealthy.

We Americans might well consider something nearly as extreme as a way out of our present economic predicament—particularly by acknowledging that throughout history the less fortunate have often been asked to make concessions intended to make life more comfortable and prosperous for the already well-to-do.

So—consider this: Politicians from both sides of the aisle—and pundits from both conservative and liberal media—are in substantial agreement that healthcare costs are a major factor in our economic woes—which, if true (a short discussion of “if true” in a moment), begs for a correction that is both expedient and immediate.

Here, for your contemplation, is a modified version of Swift’s modest proposal.

Why not just let old people die rather than waste money keeping them alive? Why tolerate the huge medical costs incurred by the aged rather than just allowing them to die of their illnesses and infirmities—which is what they are going to do sooner or later anyway?

I am 75 years old and incurring more than my fair share of medical costs these days. I have lots of friends my age doing the same—and the older we get, the more costs we incur. Why not just deny us access to medical resources and let us perish if we cannot stay alive without them?

No need for “death squads”—we are more than capable of dying on our own—although providing help in the form of a painless potion would be a welcome sign that our society is not totally heartless. And it goes without saying that there is no reason why healthy, robust oldsters should not continue to live for as long as possible, consistent with not costing taxpayers, especially well-to-do taxpayers, any money to keep them alive.

Which segues me neatly into the “more about that in a moment” that I mentioned earlier.

You see, we have an abundance of doctors, nurses, medical technicians, hospital beds, nursing homes, assisted living facilities, medical diagnostic equipment and drugs. And we have lots of schools and manufacturing facilities that can train more healthcare providers as needed and replenish equipment and drugs as they are depleted. So the truth is that we already have more than enough of all the stuff needed to provide adequate healthcare for everyone in this country.

Unfortunately our economic system and sensibilities will not allow for reasonable, efficient, equitable distribution of these resources. Money has to change hands; profits have to be made; the capitalistic taboo against anything even remotely resembling socialized medicine has to be strictly observed.

Anyway, most of the people in power (and the citizens who put them into power) want to conceive of this problem as a “medical costs” issue rather than an “inefficient medical resources distribution” problem—which is probably the reason we are all spinning our wheels rather than actually coming up with a “solution.”

Folks, we are the wealthiest nation that has ever existed on planet Earth; we’ve got plenty of everything needed to provide adequate health care for everyone—yet we accept, indeed embrace, the notion that because of the way our economic system works “we cannot afford” for everyone to have a reasonable share of that “plenty.” For some reason, we buy into the notion that some people simply have to do without!

That is sad—although “bizarre” might be a more accurate characterization. But the bottom line is that once a mind-set like that is firmly entrenched and a refusal to consider change is laid in concrete, the only way to proceed is to pretend that the easing of medical costs is the only way to help get us out of the pit into which we have fallen.

Which brings us back to the modest proposal of this essay—because that is an absolutely sure way to “ease medical costs.”

Here’s how we could go about letting the old people die rather than “costing us a fortune keeping them alive”—and still maintain a pretence that we are not ruthlessly throwing people off a cliff. We start by cutting off all government aid to anyone 75 or older (there’d be tax savings galore; lots of people would be delighted with that turn of events); we eliminate Medicare completely and allow private insurance companies to refuse coverage to anyone 75 or older (big impact on profits and coverage costs here—and “those people” would be even more delighted!). You can easily see that making these two moves would make treating and/or hospitalizing most old people highly unprofitable—and we all know where that is going to go. Problem essentially solved!

So there it is! Great savings with no damage to the economic system we hold sacred—in fact, we would be working within the system itself. No need even to consider alternate ways to distribute our massive bounty! All we have to do is figure out how to dispose of bodies efficiently—a much easier problem with which to deal.

And the only losers are cranky, old, people of limited means like me—who are going to die soon anyway.

Think about it! If this works, we can improve our situation even further by cutting selected younger people’s access to medical resources—people who cost lots to keep alive for reasons unrelated to advanced age, like heavy smokers; drug addicts; people with congenital diseases; and over-weight people. We could also offer tax incentives for people 65 or older to opt for “an early out.” (See earlier comment about “painless potion.”)

Sure, we Americans can work this out. We can preserve our economic system and insure we never come even close to socialized medicine. We can make do with what we have going right now—and we can do it without sacrificing children or indulging in overt cannibalism.

I say, let’s go for it.
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Type: Discussion • Score: 7 • Views: 1,085 • Replies: 11
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spendius
 
  1  
Reply Mon 10 Mar, 2014 06:16 pm
@Frank Apisa,
That sounds pretty sensible to me. It has to happen anyway. It's happening now.

You've Had Your Time is the title of part of Anthony Burgess's autobiography.
0 Replies
 
dlowan
 
  1  
Reply Mon 10 Mar, 2014 07:22 pm
@Frank Apisa,
Actually, there is more than a grain of sense in your ...ahem....modest proposal.

A great deal of the most intensive cost is incurred as the dying process intensifies, largely putting off, by ridiculously heroic and fairly horrific means, the death that will occur soon anyway.

I don't mean treatments that have a reasonable chance of prolonging reasonable comfortable life, but the heroics that the dying person is often subjected to if an ambulance is called and they end up in an ER.....or even if they are quietly dying in a non-hospice hospital.

Frank Apisa
 
  1  
Reply Tue 11 Mar, 2014 05:33 am
@dlowan,
dlowan wrote:

Actually, there is more than a grain of sense in your ...ahem....modest proposal.

A great deal of the most intensive cost is incurred as the dying process intensifies, largely putting off, by ridiculously heroic and fairly horrific means, the death that will occur soon anyway.

I don't mean treatments that have a reasonable chance of prolonging reasonable comfortable life, but the heroics that the dying person is often subjected to if an ambulance is called and they end up in an ER.....or even if they are quietly dying in a non-hospice hospital.




Although meant as satire (as was Swift's original) the fact is that the costs of heroic efforts to prolong life at the end...truly is an absurdity...and often an intrusion on a persons right to die with a bit of dignity.

Right now, a bill is passing through our (New Jersey's) legislature to have our state become (I think) the fifth state in the Union to allow for physician assisted suicide for terminal patients who want to end life rather than prolong a futile and painful slow end.

I hope it passes...and I hope that there are enough safeguards to satisfy the people who adamantly oppose the measure. I know that when my time comes, I'd like to have that option available.
dlowan
 
  1  
Reply Tue 11 Mar, 2014 02:01 pm
@Frank Apisa,
Oh yes. A friend of mine has been trying to get a bill protecting doctors who assist patients to die, under certain circumstances. No luck so far. Sigh.
Frank Apisa
 
  1  
Reply Tue 11 Mar, 2014 02:17 pm
@dlowan,
dlowan wrote:

Oh yes. A friend of mine has been trying to get a bill protecting doctors who assist patients to die, under certain circumstances. No luck so far. Sigh.


Unfortunately, "leaving when you want to" is something that is going to be done by some people...no matter what. It makes sense to assist them to do it in a way that is as dignified as possible.

I am reminded of the suicide note poet Richard Brautigan left before blowing his brains out with a shotgun. It read in its entirety: Messy isn't it!
0 Replies
 
spendius
 
  1  
Reply Tue 11 Mar, 2014 02:17 pm
@dlowan,
It's unlikely whilst private property, marriage and wills exist.
0 Replies
 
Brandon9000
 
  1  
Reply Sat 22 Mar, 2014 08:24 am
Actually, even more money could be saved, if it were done, as in the film "Logan's Run." A person's maximum age is strictly legislated: 30 years. When people reach this age they report to a "Carousel" ceremony in which they are willingly executed via vaporization. I think 30 is a ridiculous age to do this, but perhaps about 40 or 45?
Frank Apisa
 
  1  
Reply Sat 22 Mar, 2014 10:48 am
@Brandon9000,
Brandon9000 wrote:

Actually, even more money could be saved, if it were done, as in the film "Logan's Run." A person's maximum age is strictly legislated: 30 years. When people reach this age they report to a "Carousel" ceremony in which they are willingly executed via vaporization. I think 30 is a ridiculous age to do this, but perhaps about 40 or 45?


Need lots of very young voters to get that through.

But although I meant this as satire...I have no problem being really serious about heroic efforts to prolong life when the end is near. Spending the amounts that are spent in order to keep someone alive who is confined to bed...who cannot see to day to day functions...and who is on the last leg of this tour...

...just seem absurd to me.

I sure as hell hope I am able to end my life somehow if it ever come to that with me. Death is inevitable. To prolong suffering for self and loved ones just for the sake of prolonging life...disgusts me.
spendius
 
  1  
Reply Sat 22 Mar, 2014 11:58 am
@Frank Apisa,
And there are the nurses and doctors who, in witnessing a long sequence of such things, see the range of possibilities which they know includes their own fate.
0 Replies
 
raprap
 
  1  
Reply Sat 5 Apr, 2014 10:22 pm
Perhaps this whole situation is avoidable. Computer singularity is only about 15 years away. At that point you can be downloaded into a virtual neural reality with such --effectively creating a discorporate you in computer space. The corporate you could go on existing with you and the discorporate you meeting periodically for synchronization.

Once the corporate you has been shut down--the discorporate you continues a you on in time---

Rap
0 Replies
 
knaivete
 
  1  
Reply Sun 6 Apr, 2014 05:16 am
@Frank Apisa,
Frank your estimable genius is inestimable.

May I modestly propose that an adjunct policy of 1 child per family for the next 100 generations would cut palliative care costs to the bone.

And a slow as you go approach wont stifle the burgeoning gerontological industry.
0 Replies
 
 

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