U.S. falling toward a culture of death

[okarol]

U.S. falling toward a culture of death

By DAN SERNOFFSKY
Updated: 10/21/2009 10:00:39 AM EDT

Scientists once determined the worth of a human to be 98 cents, a figure derived by calculating the value of the various chemicals - things like copper and zinc - that were contained in the body.

Inflation alone has added considerably to that determination, as has the advancement of scientific knowledge that now has ascertained that the body includes considerably more of value than just some trace elements. Of course, in making their original evaluation, scientists were quick to note their measurement was based entirely on what was contained in the body, not what the body was capable of doing.

Somehow, however, it appears that determining the worth of a human has now passed beyond the esoteric calculation of the value of chemicals into the realm of political reality. Worth, it appears, will be determined by arbitrary parameters and cost, which is to say 98 cents pretty much covers it.

Nowhere has that become more evident than in the push by progressives to enact government-controlled "health reform."

Long ago, the progressive movement abandoned what had been a unique American culture founded in the principles of life and liberty. Instead, the movement aligned itself with a culture of death, now so ingrained that it has become inarguable. It is that premise that has resulted in the precise nonsequitor that allowed the Democratic elites in Congress and the White House to rail against the use of the term "death panels" while at the same time espousing them.

Consider, after all, that fully a quarter of a century ago Colorado Gov. Richard Lamm, a Democrat, in speaking to a group of elderly citizens, noted that the terminally ill "have got a duty to die and get out of the way. Let the other society, our kids, build a reasonable life."

Two years ago, in a speech in Berkeley, Calif., Robert Reich, a member of the Clinton administration and a noted Democrat, said that a viable candidate could not speak the truth about the kind of health-care reform that progressives were seeking. That truth being, "If you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you going for another couple of months. It's too expensive, so we're going to let you die."

Even President Barack Obama, in talking about the cost of procedures for the elderly, noted, "Maybe you're better off not having the surgery, but taking the painkiller."

Within the culture of death, sacrificing the elderly is entirely logical. They are, after all, long past their prime, and any further contributions they might make are negligible at best. And, of course, end-of-life care generally incurs the most expense. That logic, however, does not take into account how, and for what, dollars might be spent.

Joint-replacement surgery for an otherwise healthy septuagenarian might be costly, but it may add considerable comfort to the remaining years of his life. There are a variety of other surgical procedures that have become rather commonplace that may not only extend but enrich lives.

There is, additionally, another uncomfortable variable involved in asses sing the value of life. What about the various ailments that attack those who are of a younger age?

Cystic fibrosis is usually diagnosed in childhood. It is terminal, except that those diagnosed who would have died before reaching puberty now live into their 30s and longer.

But at what expense?

What about various neuromuscular diseases? What is the cost of kidney dialysis? Why should a septuagenarian be told to "take the painkiller" and a 40-year old on dialysis be afforded the funds to continue the procedure?

Or will he?

The acceptance of the culture of death makes any such decisions easy. The progressive movement counts among its founders Margaret Sanger, the woman who founded Planned Parenthood, the largest abortion provider in the United States.

It was Sanger who spoke of "human weeds," of "human beings who never should have been born." And it is Sanger's philosophy which has been embraced by a man who, while campaigning for the presidency of the United States, suggested that he would not want his daughters to be "punished with a baby."

What is the value of a human? De spite the 98-cent calculation, value re mains entirely within the individual, and the individual ability to pursue the unique American culture of life and liberty.

The progressive movement has rejected that culture. Individual liberty is an anathema to the progressive movement, which seeks to control society. The "health reform" now being espoused by the progressives who dominate the Democrat Party is nothing more than an effort to establish a new American culture, a culture in which it will be the government that decides whose lives are of value, to determine "Lebensunwerten Lebens." History tells us those kind of determinations have been made before. If the progressive culture of death becomes law, the first victim will be the Republic.

Sernoffsky can be reached at danser noffsky@ldnewslcom.

http://www.ldnews.com/ci_13605550?source=most_emailed

[Hemodoc]

Anyone that limits the worth of the elements of the human body to 98 cents is quite ignorant of the millions of dollars that the harvested proteins, enzymes, hormones, tendons, bones, stem cells, nothing to speak of the thousands of dollars people pay illicit organ markets.  Nevertheless, we are moving into a time where the worth of a human becomes a liability instead of an asset to those that count such things.  Sadly, they are usually the ones that also have the power.

[Wallyz]

Spending hundreds of thousands of dollars to keep someone who is not awake alive for another two months at the expense of someone else receiving quality care is unconscionable.    This is the debate. when we say that all measures are available no matter what, we mean all measures available provided we can get someone to pay.     This is why medicare costs are booming.  Many of the measures taken wouldn't be without a bottomless taxpayer funded source of money.  There has to be some discussion of what is and is not to be paid for unless you want the natural constraints of the system to show themselves in a catastrophic failure of the system.

[Hemodoc]

Dialysis care is an excellent mirror of what is happening to the rest of the health care debate.  Here in America, perverse incentives have lead to under use of dialysis modalities with over use of EPO and other separately billable meds leading to terrible outcomes.  We under utilize home dialysis modalities that have proven track records of improved outcomes for half the costs or less.  In center optimal dialysis could realize less than 10% mortality rates here in America should the mindset of utilizing our resources in offering the best care at the point of dialysis services was the mindset of our American system which truly it is not.

Many site the British Health Service as an example of controlled expenditures and universal coverage.  A very interesting study was completed a couple of years ago showing that for the same expenditure of resources, Kaiser offered much better coverage without ANY rationing.  I was always able to take care of even the eldest and most infirm patients as did my other colleagues at Kaiser.  The British system however has a system of answers to the hard questions as you put it where decisions are made on who will or won't obtain certain procedures and treatments.  You don't have to spend much time looking through British papers to see the debates on what should or should not be covered.

Yet, Kaiser is able to achieve much better results without limiting the latest and most effective medical treatments to our patients at the same costs that the NHS in England offers to its patients a much more limited offering of treatments.  What's the difference?  Well, perhaps like Sweden has found, privately owned non profit medical groups competing with other medical groups offers the best compromise between quality control and economic control.  I challenge you to consider that perhaps some of those hard questions as you state that need to be answered actually are best left to the patient and doctor who knows them best, and not heartless bureaucrats who have no vested personal interest in the outcomes.  Even though it is true that Kaiser does place pressure on reducing hospital stays, we did this in part by an extensive outpatient support system where we could do home IV antibiotics and home health follow up once a patient was stabilized.  In all my time taking care of inpatients, I never once was forced to send someone home before I felt that they were stable to do well with our extensive home medical services.  Kaiser allowed the doctor to make the decisions with the patients.  Yes, many times we had to answer hard questions, but those answering the questions were the patient, their family and the doctors.

http://brian.carnell.com/articles/2002/the-british-national-health-system-vs-kaiser-permanente

http://news.bbc.co.uk/2/hi/health/1764713.stm

I suspect that you do not support leaving the hard questions in the hands of the patients, families and doctors.  I shudder to consider any system such as the NHS/NICE that places an insidious bureaucracy in place of what we had at Kaiser.  So, privately owned non profits medical groups which leave control of the clinical decisions to the doctor and patient can achieve much more than what it appears you are implying in your response.

[Zach]

For over 60 years, Kaiser has been doing an exemplary job in the healthcare field.
Unfortunately for the rest of us, it's an outlier. There is a dearth of similar examples around the country.

But things could still change for the better.

[BigSky]

Spending hundreds of thousands of dollars to keep someone who is not awake alive for another two months at the expense of someone else receiving quality care is unconscionable.    This is the debate. when we say that all measures are available no matter what, we mean all measures available provided we can get someone to pay.     This is why medicare costs are booming.  Many of the measures taken wouldn't be without a bottomless taxpayer funded source of money.  There has to be some discussion of what is and is not to be paid for unless you want the natural constraints of the system to show themselves in a catastrophic failure of the system.

Yes but that is occurring in all areas of life in the US now.

Laws that were made with one intention are being abused by lawyers to the point that it includes everything.

[Wallyz]

I suspect that you do not support leaving the hard questions in the hands of the patients, families and doctors.  I shudder to consider any system such as the NHS/NICE that places an insidious bureaucracy in place of what we had at Kaiser.  So, privately owned non profits medical groups which leave control of the clinical decisions to the doctor and patient can achieve much more than what it appears you are implying in your response.

You suspect incorrectly.  I actually prefer the Kaiser and the Cleveland clinic models over the NHS models.  However, I do not oppose a governmental structure that eliminates fee for service providers.   This is what is being defended in the the current debate. From what you are saying, I think that you and I are very close in what we would like to see happen.

[Hemodoc]

dear Wallyz, I was a at a conference with RSN where they showed a video of the different health cares in several nations.  I believe it Was Sweden that had mandated health coverage for all, for those that couldn't afford it there was a publicly funded option until they could afford one themselves.  The key was that it was privately owned, non profit health insurance carriers that competed against other companies for their patients.  This lead to high quality and low costs.  For government mandated health care, if we are to have such a thing, I believe that this is the model best to emulate.

On the other hand, I have nothing against fee for service.  The difficulty is that the government hijacked the health care industry and produced perverse incentives to the docs.  They bit and now are being used as the scape goats for introducing a complete take over of the health care industry.  We did not have this sort of unethical financial quests before the government entered into the arena.  The issue really is not the fee for service aspect as much as the overt governmental control which has lead to a perverse situation we have now.  After all, it is the government that set up our current fee for service practice that people are now complaining about.