November 25, 2009

Unplugging Grandma

Hatched by Sachi

When we accused Democrats of trying to unplug Grandma from life-support to save a few bucks, they called us fear-mongers. They called Sarah Palin "delusional" when she rightly pointed out that medical rationing would amount to a "death panel." But a recent airing of CBS's 60 Minutes offers a textbook example of what is going to happen all across the nation if we let ObamaCare pass.

Radio talk-show host Mike Gallagher alerted his listeners to this chilling segment that aired last week, titled The Cost of Dying. Correspondent Steve Kroft noted the enormous cost of end-of-life medical care -- then blamed that expense for bankrupting Medicare:

Every medical study ever conducted has concluded that 100 percent of all Americans will eventually die. This comes as no great surprise, but the amount of money being spent at the very end of people's lives probably will.

Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives -- that's more than the budget of the Department of Homeland Security or the Department of Education.

And it has been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact. [Tell that to Grandma. -- SY] Most of the bills are paid for by the federal government with few or no questions asked.

You might think this would be an obvious thing for Congress and the president to address as they try to reform health care. But what used to be a bipartisan issue has become a politically explosive one -- a perfect example of the costs that threaten to bankrupt the country and how hard it's going to be to rein them in.

The message was crystal: Medicare is spending too much money keeping useless old people alive. Codgers are burning up precious money the government could use for something more important, like protecting endangered species or insuring street bums. The mantra is, "Grandma, shut up and die already."

All right; granted that end-of-life care costs a lot of money. But why? What would it take to "rein in" these costs?

First, it's easier for doctors to manage patient care if the patients are all together in a hospital. Second, Doctors are paid based on the number of patients they see or procedures they order, and hospitals get paid by the number of beds they fill and tests and procedures they perform... this creates financial incentives to hospitalize patients, as opposed to dealing with them as outpatients spread all over a city.

Then once hospitalized, the patient will probably be examined by numerous resident specialists, and each will put the patient through a great many tests, many of which are conducted purely defensively, to ward off malpractice lawsuits. One 85-year-old mother discussed in the 60 Minutes program was seen by twenty-five specialists in the last two months of her life:

"You think they were running up the bill to make money? Or running up the bill or giving her all these tests because they really thought it might help her? Or to cover their…rear?" [Steve] Kroft asked.

"Yeah, to cover their rear," [the patient's daughter] replied.

Finally, there are exhorbitant costs associated with the structure of Medicare itself. It covers the entire cost of medical care, and doctors and hospitals are obliged to accept what Medicare gives them. The patient often does not even know how much the taxpayers are paying. "No cost to the patient" equals no incentive to be frugal about unnecessary tests:

In almost every business, cost-conscious customers and consumers help keep prices down. But not with health care. That's because the customers and consumers who are receiving the care aren't the ones paying the bill.

These are obvious problems, but there are equally obvious solutions:

  • If doctors and hospitals were protected from frivolous lawsuits by strong tort reform, they would not be driven to order a ridiculous number of oddball tests just to guard against litigation that results in "jackpot justice."
  • If Medicare operated more like normal, private insurance -- scrutinizing specific costs, covering only a certain percent of the cost of medical procedures, and requiring patient co-pays -- beneficiaries would probably be more skeptical about authorizing multiple testing regimes. (This is the idea behind Medicare Advantage... which the Barack H. Obama administration is intent upon killing.)
  • And if more procedures could legally be performed by nurses, medical technicians, pharmacists, and other providers below the level of doctor, there would be less incentive for patients to enter the hospital or linger there, since they would have more alternatives.

But, that's too easy -- and it doesn't allow for a complete government takeover of health care, which is the hidden purpose of ObamaCare.

So what is the major goal of a national health service -- as Great Britain has? It certainly doesn't cost less than a private system, nor is the health care itself better, or even as good. None of the reasons given logically make the case for nationalized health care.

But there is another power that governments can only obtain by implementing government health care, national health service, single-payer health care, socialized medicine, or whatever else the government chooses to call it: It gives the national government life-and-death control over every citizen. Every resident is in the same boat as murderers; the government gets to decide, thumbs up or thumbs down.

Under a national health service, the taxpayers foot the bill; which gives the government its hook to demand "regulation and oversight" of how much they spend. This, in practice, means complete control over who gets medical treatment.

The government can set up a "death panel" -- in Medicare, it's called MedPAC, the Medicare Payment Advisory Commission -- that tells us when we're allowed to receive treatment and survive, and when we've outlived our usefulness to the State and must be denied care, so we can hurry up and "decrease the surplus population."

MedPAC doesn't decide on the basis of individual worth or the patient's politics (at least not directly); but by declaring what procedures can be performed on which groups of patients, and having no effective competition, the feds find themselves with the power to decide who gets treated and who gets thrown under the bus, all in the name of cost cutting and protecting the taxpayers (the same ones they plan to soak with huge tax-rate increases):

Charlie Haggart is 68 years old and suffering from liver and kidney failure. He wants a double transplant, which would cost about $450,000. But doctors have told him he's currently too weak to be a candidate for the procedure.

At a meeting with Haggart's family and his doctors, Dr. Byock raised the awkward question of what should be done if he got worse and his heart or lungs were to give out.

He said that all of the available data showed that CPR very rarely works on someone in Haggart's condition, and that it could lead to a drawn out death in the ICU.

"Either way you decide, we will honor your choice, and that's the truth," Byock reassured Haggart. "Should we do CPR if your heart were to suddenly stop?"

Sounds reasonable enough; Dr. Byock is just engaging in end-of-life counseling. But is he really the neutral arbiter, trying to explain all of Charlie Haggart's options? Read on:

"Either way you decide, we will honor your choice, and that's the truth," Byock reassured Haggart. "Should we do CPR if your heart were to suddenly stop?"

"Yes," he replied.

"You'd be okay with being in the ICU again?" Byock asked.

"Yes," Haggart said.

"I know it's an awkward conversation," Byock said.

"It beats second place," Haggart joked, laughing.

"You don't think it makes any sense?" [Steve] Kroft asked the doctor.

"It wouldn't be my choice. It's not what I advise people. At the present time, it's their right to request it. And Medicare pays for it," Byock said....

"I think you cannot make these decisions on a case-by-case basis," Byock said. "It would be much easier for us to say 'We simply do not put defibrillators into people in this condition.' Meaning your age, your functional status, the ability to make full benefit of the defibrillator. Now that's going to outrage a lot of people."

"But you think that should happen?" Kroft asked.

"I think at some point it has to happen," Byock said.

Easier for whom, the patient or the doctor? And how long does Dr. Byock expect each patient still to have the right to be resuscitated if his heart stops? Byock sounds as though he expects "hope and change" to come very soon now for the aged and their cockamamie idea that they might be worth saving.

Dr. Byock's answer seems to have distrubed Steve Kroft, the 60 Minutes correspondent:

"Well, this is a version then of pulling Grandma off the machine?" Kroft asked.

That is exactly what conservatives have been saying; evidently, Sarah Palin isn't the only person who is "delusional."

But here is where it truly strikes home to every American, not just senior citizens on Medicare:

"Every other major industrialized nation but the United States has a budget for how much taxpayer funds are allocated to health care, because they've all recognized that you could bankrupt your country without it," David Walker told Kroft.

Asked if he is talking about rationing, Walker said, "Listen, we ration now. We just don't ration rationally. There's no question that there's gonna have to be some form of rationing. Let me be clear: Individuals and employers ought to be able to spend as much money as they want to have things done. But when you're talking about taxpayer resources, there's a limit as to how much resources we have."

Yes, that's true. But when you're talking about ObamaCare, there is no limit on the number of Americans who will be pushed into a taxpayer-funded system.

Once we all receive our health care at public expense, then we can all be subject to the same rationing that Dr. Byock proposes. "Equality" will reign: Everybody will be equally bankrupt, equally unemployed, and equally short-lived.

Again, the answer is clear; but it's the exact opposite of the direction the Obama administration is taking us: The solution to this dilemma is to reduce the number of people receiving government-run health care, not multiply it by a hundred! That's like trying to cure a flood by sending a tidal wave.

[A]nd the life of man, solitary, poor, nasty, brutish, and short.

Did Thomas Hobbes (1588-1679) have something like ObamaCare in mind?

Hatched by Sachi on this day, November 25, 2009, at the time of 4:36 AM

Trackback Pings

TrackBack URL for this hissing:


The following hissed in response by: cdor

Great post, Dafydd. I missed it when it first went up. When the leftist is asked "what government program is run well?", they inevitably point to medicare. When one points out that medicare will be many trillion dollars in the hole because of underfunded and ever increasing liabilities in the very near future, it becomes difficult to ignore the blank stare emanating from their eyes. Medicare is currently about 40% of healthcare while the private sector insures about 60%. That 60%, hated so effusively by the left, is (dare I say the dirty word) profitable. It not only functions with no drain on government resources, but it actually props up both medicare and the currently uninsured as well. Instead of trying to figure out how to make medicare private, our brilliant leaders are rushing full throttle ahead towards making what is private and profitable into medicare for all...bankrupting the nation along the way.

The innate wisdom of Sarah Palin, who immediately saw this lying boondogle of a bill for what it is, and pronounced the "Death Panels", to which our elite pundits gasp, "such a fool she is!" cannot be ignored. She has from her little hut in Wasilla, using a simple Facebook diary, totally affected the national debate. Good for her and good for you, Dafydd. I hope you are enjoying your Thanksgivng weekend with your family. I see you don't associate Rick Moran's blog here. It's a good thing, he's liable to choke on his turkey if he read this.

The above hissed in response by: cdor [TypeKey Profile Page] at November 29, 2009 11:41 AM

Post a comment

Thanks for hissing in, . Now you can slither in with a comment, o wise. (sign out)

(If you haven't hissed a comment here before, you may need to be approved by the site owner before your comment will appear. Until then, it won't appear on the entry. Hang loose; don't shed your skin!)

Remember me unto the end of days?

© 2005-2009 by Dafydd ab Hugh - All Rights Reserved