Friday, January 07, 2011

Death To Death Panels

Talking about end-of-life issues has never been easy in our culture. We don't like even thinking about death, much less talking about it, especially when that fact of life is imminent. It looked for a brief moment like we might finally have a way to be adults on the issue when an end-of-life discussion with one's primary physician was going to be included as a Medicare benefit, but that was snatched away when the conservatives anxious to derail healthcare reform began shrieking "DEATH PANELS!" and "HEALTH CARE RATIONING!" The provision suddenly disappeared from the final bill.

Then, this past week, it looked like the provision was being resurrected via a regulation, and the shrieking returned. Once again, Brave Sir Robin ran away. And that's a shame. The provision had nothing to do with death panels, and the claim that it would lead to rationing was a red herring.

Issac Bailey of The Myrtle Beach Sun took a commonsense look at the provision (featured at McClatchy DC) and did a particularly good job at debunking the objections to end-of-life discussions.

Among the many practical benefits of such a session with a doctor he noted were these:

It would have helped stem the tide of runaway health care costs, given that a ton of money is wasted on unnecessary, inefficient and ineffective services that are performed when it is hardest to make rational decisions about care. The bulk of Medicare expenses are used at this stage of life.

It would improve the final months of life for severely ill patients and reduce the stress on their family and friends. Numerous studies have shown that end-of-life consultations give a patient a stronger say in the kind of care he receives when things are most dire because once those situations occur, the patient's ability to express his wishes declines rapidly.

Nowhere does it give the government the right to pull the plug unilaterally, but that doesn't seem to matter to those who are determined to halt any kind of meaningful healthcare reform lest their donors not make as much money as they would like.

And as to "rationing healthcare"? Well, as Mr. Bailey points out, we've always had healthcare rationed, just not guided by the wishes of the patient. Anyone who has waited days, if not weeks, for the insurance company to authorize a consultation with a specialist or a diagnostic procedure, or who has fought with that insurance company over their refusal to pay for a scheduled office visit has had to deal with healthcare rationing. Under this provision, the rationing would be defined by the patient who does not wish to spend his or her last hours suffering with the pain and indignity of being wired and entubated and who does not wish to torment his or her family with having to witness that seemingly endless scenario.

But common sense isn't allowed in the debate. Our owners won't allow it, so instead we get spurious arguments based in half-truths or outright lies with emotionally charged language to seal the deal. And we get cowardly politicians backing down from a very sensible, very sensitive, very needed provision.

No, not much change here.

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