Tuesday, December 28, 2010

Quality of Life?

I know this post is not in keeping with the purpose of my blog, but all the discussion about healthcare has been on my mind.

I am the youngest of five children, by the time I was born, my mother was 37,  my father 40.  My parents came of age during the depression.  They had values born of losing great wealth (in my father's case) and living through very hard times.  Those lessons never left them.

I was taught something that is not very popular today:

Whoever is paying the tab calls the shots.  That simple.  It makes sense.

In our culture, we like to have the government pay for things and then want to have it our way.  We have been able to do that for a generation or two.  But I think that time is over.

We (as a society, but not ME personally) wanted to have government paid healthcare.  We (as a society, but not ME personally) have called healthcare a RIGHT, not a privilege.  Therefore, it should just come with our other infrastructure - say, like our great roads, postal service, and the IRS.  Well, we are on our way.

And really, it is not new.  Blame LBJ.  On July 30, 1965 we started sliding down this exceedingly slippery slope.   When the US government became a payor for healthcare, it began.

If everyone who turns 65 automatically enrolls in Medicare, without means testing, we all eventually become recipients of healthcare with the government as the payor.  That means that we, as tax payers, are going to pay for the eventual healthcare expense (and it is expensive) for every single obese smoker dining at McDonald's.  We are going to pay for the hip and knee replacements of  70 year olds who happen to have stage IV cancer.

As we all know, the Medicare system also includes the disabled as well as the elderly, and the Medicaid system is the payor for low income folks.  So, the government is already paying for healthcare for the elderly, disabled, and poor.  A big chunk of this money comes from the states, and it is bankrupting them.

How long before the entity paying the tab wants to call the shots?  Really.  It only make sense.

In my first job in healthcare, I was astounded at the extremely expensive surgery being performed every single day on people who are not viable recipients of the surgery.  A hip replacement surgery on a morbidly obese person does not make sense.  And yet, that is one example of something that happens every single day.  I don't want to pay for that.  Sorry.

Now we have this gargantuan health care bill.  I printed it out and have it sitting in a 3 inch binder on my desk.  I have read parts of it.  I, like the lawmakers who passed it, have not had time to read the entire thing.

I don't need to read the whole thing to know that when the government is the payor for almost all of our healthcare, they will, of necessity, begin to start making some tough decisions for us.    Perhaps we will begin (as a society) to determine a person's likely worth to society as they struggle to live.  A tiny baby?  Not so valuable.  Especially if it looks like the tiny baby will have some impairment - that will cost money.

An article in the New York Times earlier this week brought back the specter of "death panels."  There won't be death panels (at first), but CMS (Medicare and Medicaid) will pay for "end of life counseling."  It actually sounds good.  Your doctor will sit down with you and counsel you on some end of life decisions.  Everybody should be doing this now.  Really.

But when they start talking about "Quality of Life," I get really frightened.  When I was 16, I didn't want to live to be 30!  I didn't want to get gross wrinkles and flabby skin.  I honestly remember thinking that if I ever got "fat," I would kill myself!  Funny, wrinkles came, flab came, I even got fat!  I still want to live.  I work very hard to maintain my health, another 59 year old would see that, but a 16 year old wouldn't.

When my father was in a nursing home, I started thinking of this whole "quality of life" idea.  He had none.  But he wanted to live.  He wanted to live until God had another idea.  And eventually God did.  I would then hear others say "If I ever get like that, please just shoot me!"  It makes my stomach turn.

I work in a state psychiatric hospital.  It is full of people who have no "quality of life."  Seriously, they don't.  But they don't want to die.  They want to live and occasionally, there is a crystal, sparkling moment when someone gets better enough to leave the hospital.

It is best not to let others decide what kind of quality our lives should have.

But then it is better to pay our own way, so we don't have to have someone else calling the shots.


  1. Good article. See, there's plenty to write about. Keep it up!

  2. Yes! "Whoever is paying the tab calls the shots." That is exactly it! I never thought about phrasing it that way and that is exactly the problem. One loses all control when one shifts the burden to a single entity, especially one that has all pwer like the government. Perfectly said Mary.

  3. PS. I linked this blog with mine here:

  4. I am sorry but I disagree, perhaps because when I was diagnosed with Breast Cancer I talked with my doctor about what was in my heart, what position I didn't want to put my family in...it was important to me. I had a health directive drawn up by my lawyer, it is in my medical file as well as my legal file. I prayed to God about this issue, I still do pray about it - but I do not want to live as a vegetable or on machines not knowing my loved ones nor do I want my loved ones having to make decisions they don't want to or will have a hard time to live with - this was an informed decision made between me and God and hopefully will be followed through by my doctors. No I don't want needles to be put to death, I just want to go home when I no longer can breathe on my own.....I do respect every one's feelings on this subject, the government will not be making any decision for me, I made my own. We have health care in Canada that includes all of us, no one uses the terms death panels, no one is forced to speak about their death - in my work with terminal patients and patients with chronic pain all have health directives and not all are the same, but all will be respected. This gives the patient control over their illness and pride in their decision.
    No this decision is not at all about government, it is about people who want to live with dignity and die with grace.....:-)Hugs

  5. Bernie,

    The thing that many of us here in the states are afraid of, because we've seen our government in action, is that the choice will not be the patients, but the states. Maybe other governments work better than ours; I don't know. Here, because we don't have the money to do this whole health care thing anyway, the government will be looking for ways to cut cost. But they won't look at sensible ways, they'll focus on the bizarre and strange, choosing to end the lives of those they deem too far gone instead of cutting the amount of bureaucracy involved in the process.

    But this is more than just cutting cost. It also plays to the political sensibilities of those in power today. The left is all wrapped up in the environmental movement and its radical agenda of earth worship. People are viewed as problematic and corruptive to an otherwise pristine and shiny global environment. Well, maybe not all people, just the people that aren't them. John Holdren, the President's science czar, has gone as far as to recommend forced sterilizations to curb population growth. And really, what are death panels other than the same ideology applied to the other end of life?

    Most of us have nothing against end of life planning, short of suicide. As a matter of fact, it makes sense to work out what you want to happen when the time comes while you are healthy and rational. And I agree with you; I don't want extraordinary measures used to keep me alive, either. If I can't breathe on my own and the prognosis is bad then I'll let God make the call.

    But I don't want my tax dollars used to promote suicide. And I don't want the government calling the shots.

  6. Bernie, I also have an advance directive - I think everyone should. I also do not want to go through medical treatment when it is futile.

    But as Catawissa said, we are afraid of decisions being made by heartless tree worshippers who see human life as a "scar upon the land."

  7. I didn't realize there were a group of "heartless tree worshippers" I am not sure sure I understand enough about your government to give an opinion, I do know enough though and realize that gentle and loving words will include everyone in your discussion and not frighten people away or at least I hope not. How we die should be between us and God, should have nothing to do with being a Democrate or GOP, that is just wrong. Much love and Happy New Year.....:-)Hugs

  8. Bernie,

    Our government is corrupt. That's really all you need to know. We live in a plutocracy where business and government collude for their own benefit at the cost of the people.

    I wish that we could trust it but we can't. It's betrayed our trust over and over, the bail out of the banks both here and abroad being only one of the latest examples.

    So we don't and can't trust it with our health care. That's not to say that government doesn't have a legitimate role in health care but that, as it exists today it's far too corrupt to allow it any more power over our lives.

    We don't have a real big problem with health care here in the states and most people know that. Sure, it's not cheap but that could be addressed in ways other than total government control.

    This whole thing, just like every other government program, benefits somebody, just not the people it's supposed to. The insurance companies will benefit because competition will be reduced. The ones that have pull with the politicians will reap the rewards. The rest will be regulated out of business.

    The politicians will benefit because their power will increase along with the money from the chosen companies flowing into their pockets.

    The people on the other hand won't see any improvement. What we'll see is rationing and less choice of insurers, doctors and facilities. My doctor has already shut down because he doesn't want to deal with this.

    Our system works. It's not perfect but it just needs some tweaking, not a complete redesign.

    As far as words frightening people away, I suppose I'm forced to say, in all honesty, who cares? If we all speak honestly and openly when it comes to what we believe why does it matter if some are offended? Would you rather lie than offend someone?

    May I remind you of the words and actions of our Lord when explaining the Bread of Life to his disciples. Many were scandalized by the idea that He seemed to be endorsing cannibalism so they walked away. Did He run after them, offering apologies for his offensive words? No! he upped the ante, making claims that were even more incredible, but true.

    "Many therefore of his disciples, hearing it, said: This saying is hard, and who can hear it?
    But Jesus, knowing in himself, that his disciples murmured at this, said to them: Doth this scandalize you?
    If then you shall see the Son of man ascend up where he was before?
    It is the spirit that quickeneth: the flesh profiteth nothing. The words that I have spoken to you, are spirit and life.
    But there are some of you that believe not. For Jesus knew from the beginning, who they were that did not believe, and who he was, that would betray him.
    And he said: Therefore did I say to you, that no man can come to me, unless it be given him by my Father.
    After this many of his disciples went back; and walked no more with him.
    Then Jesus said to the twelve: Will you also go away?
    John 6:61-68

    If Jesus wasn't worried about offending others with the truth, why should we?