Arizona Physicians Debate Rationing
Because these are friends of mine on a private email list, I’m leaving their names off. But here are some opinions about rationing from people who see it every day.
… when you are 60 y/o or more, regardless of your political affiliation, organ systems begin to age and for some, one system may deteriorate more rapidly than another.
The age of your old car, may give you pause to invest in a new or even a rebuilt motor. It is your decision.
In healthcare, it is very likely that another will do that for you. Now you will make the decision with your doctor. In the future – who knows?
Chris Dodd reports that he is having surgery for prostate cancer. He is now 65, but if he was 70, he might be forced to have radiotherapy despite being in general good health because a protocol dictates that.
There is a lot of misinformation regarding the healthcare system that is being used for political gain by both sides.
There is a need for reform but what is being proposed does not address the real issues. Mr. Obama knows that it’s a wonderful time to push for feel good legislation.
Aside from requiring that our legislators be required to be under the same system as the general public, we need to impress upon them that any attempt to implement eugenics, end of life, or age related rationing will create a groundswell of negative sentiment in coming elections.
And that’s the slippery slope we are on when we discuss rationing, which is often called “eugencics” or “euthanasia.”
However, here’s another physician arguing back:
I spent the major part of my medical career in ICU’s running life support systems… and I was impressed that more than 60 % of the patients on these systems were over 70. The medical literature indicates that a very high percentage of older people who survived the illness that put them on life support were dead within a year.
When I was an intern in a big university-city hospital I delivered 150 babies in a period of six weeks. Most of the women were too poor to have had any pre-natal care and had all kinds of medical complications with their pregnancies because of this, and the newborns also had ongoing medical problems requiring prolonged, and expensive medical care.
For the last 15 years I have volunteered in a clinic for the working poor. We cannot provide definitive care for these people because we have no medicines to give them, drug companies donate pitifully few medicines to the clinic, and the patients cannot afford to buy their own medicines because they are too expensive…. For the past 9 months I have been caring for a 47 year old Latina who has hypertension and protein in her urine. I inherited her from another physician who did not investigate her urine abnormality, a sign of kidney disease, over a period 4 months. It took me 4 months to get a kidney ultrasound, which showed a narrowing of an artery to one kidney, probably the cause of the high blood pressure and the protein leaking from her damaged kidney into the urine. It took me another 3 months to get a CT scan of the kidney and artery which confirmed the “renal artery stenosis”, the cause of her high blood pressure..
The next step is to have surgery to repair the narrowed artery in hopes of curing the high blood pressure and preserving her kidney function. Without this surgery she will, before long, descend into kidney failure requiring lifelong dialysis and/or a kidney transplant. The dialysis or the transplant will be infinitely more expensive than if she had surgery now. the surgery would probably cure her high blood pressure and allow her to no longer need the expensive medicine to control her high blood pressure. This same thing happens day after day to patients who have inadequate health insurance coverage (another 10-20 million people?) or lack primary health care access.
There are a multitude of reasons… our health care is so expensive One of the most important ones is not doing the right thing at the right time because of limitations imposed on care by inadequate health insurance. Another is the inadequate education of physicians by medical schools and hospital teaching programs which refuse to change with the times. Inadequate numbers of primary health care providers, inappropriate and scientifically unproven treatments at the hands of narrowly trained specialists and super-specialists add to our outrageous medical costs. And finally, though there are a multitude of other reasons, the commercialization of medicine (one aspect of which is the direct advertising of pharmaceuticals to the public) in this country has greatly added to the bill.
I have been in favor of rationing medical care since I was an intern more than 50 years ago. As far as I’m concerned insurance companies and our health care “non-system” have been rationing medical care for years.
I am soon to be 79 years old. I have told my family for many years not to ever permit me to be put on any life-support system; I’m too old for that, it would cause me only terrible suffering, I would not survive long even if I got off the system, my care would waste a lot of energy and money, and I would prefer that the medical resources be directed into pre-natal, pediatric or primary care for younger people.
…I believe that the Obama administration will not be able to provide a health system in the USA comparable to the western industrialized countries which provide their citizens with very good health care. It’s not because of the Obama administration not trying, but the leadership in Congress is very weak, the American people are members of a very immature, misinformed, divided and “instant gratification” society….
You will want to attend our program on Rationing on September 25.