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.