The HORRORS of RATIONING

October 2, 2009 at 11:50 pm | Posted in Uncategorized | 1 Comment
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I have to confess that there are some things I don’t get about the current uproar over health care reform. 

I admit that the programs being proposed, if any of them pass, will constitute major social change, and will therefore inevitably provoke serious resistance. By the same token, I wonder a bit what’s going on in the minds of a number of us as the debate proceeds. 

To fill you in on the context of my perplexity, perhaps I should say that I recently joined the ranks of America’s “senior citizens.” I turned 62 last spring and began taking Social Security. I am totally amazed that anyone would send me $800 a month without my having earned it. I know, I know, I really did earn it, but it still amazes me that the system works and this money gets deposited in my bank account. I am also fortunate because I have relatively good health insurance through my husband’s job, which is not to say that in our thirteen months in Brooklyn I haven’t already had some classic go-rounds with the anonymous webpage of an insurance company we’re tethered to. 

My husband and I also have three grandchildren, the oldest of whom, Macy Russell Brown, is six years old and lives not far from us here in Brooklyn. Macy is tall and thin and blond and looks like the heroine in a children’s book; she’s also extraordinarily articulate–I’m sure she’ll have her own blog soon. I’m also pleased to report that she has good health insurance through her Mom’s job. 

One day last week I got a brochure from the AARP about health care reform. Since senior citizens are among those most opposed to this reform, the brochure is no doubt needed. It assured us that the proposed legislation does not mandate “death panels” and will not result in the rationing of health care or any cut-backs in Medicare. Given the political climate, it’s crucial that such things are excluded from health care reform. I myself do not favor forcing senior citizens to commit suicide (!)

Anybody with a brain in her head knows, however, that the current system is not workable, that Medicare, for example, is heading into the tank, and that the increasing costs of health care are going to bankrupt the country by and by. In addition, the practice of people expecting every test and treatment known to humankind is not sustainable. In a recent discussion about my 93 year old mother who’s in a nursing home and sleeps all the time, no longer recognizes us, can’t see, can’t hear and can’t walk, a nurse apologized before suggesting that my mother is getting ready to die. When I asked why on earth she was apologizing, the nurse said many families, upon hearing this, would demand that the family member be hospitalized and every measure taken to keep her alive. If this sort of thing is what my fellow senior citizens mean by “no rationing,” it’s hard to imagine what’s going to happen to us all. 

I myself hope that it doesn’t come to the point where medical care I need is denied me. I have a pretty nasty genetic defect that causes abdominal cancers and it is more than possible that I will need many of the bells and whistles of American health care to keep me alive as long as Americans are accustomed to living these days. But if my receiving that treatment meant that our granddaughter Macy wouldn’t get the care she needs at her much younger age, I like to think I wouldn’t hesitate. And the way things are going, there may well not be the resources left over for her if I get everything I need, or think I need. Indeed, a lot of little girls not so different from Macy aren’t getting the care they need right now. 

If what “rationing” really means is facing up to the fact that resources are limited, and that younger people need to get basic health care before the elderly get treatments like open-heart surgery, organ transplants, or stem cell therapy, maybe we need to give “rationing” a second thought.

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  1. Furthermore, extravagant interventions like open-heart surgery often do more harm than good to octogenarians like me. An old friend died not long ago under a cardiologist’s knife. That lethal procedure would have cost Medicare something like $30,000. If she had opted instead for a hospice program, she’d probably be alive today.

    I once knew a nurse who claimed she wanted DNR (“Do Not Resuscitate”) tattooed on her forehead. Cardio-pulmonary resuscitation (CPR) Is a poor gamble for the frail elderly. Even when it works (in a fraction of cases), it often “succeeds” in reviving a vegetable.

    Like


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