Thanks For Nothing

by Allen Kolmes

Today, hundreds if not thousands of terminally ill Americans will reach a point in their disease where further medical treatment will neither prolong nor improve the quality of their life. It will, in fact, make things worse. Many of them will die in an ICU, with a tube down their throat, another in their stomach, and catheters out of every orifice, surrounded my screaming alarms and fluorescent lights that are on 24/7. Most of these could have died at home or in a hospice, surrounded by their loved ones, maybe with a small IV providing medicine that makes them feel better.

The cost of these ICU stays? Tens of billions of dollars every year.

One of the main reasons this happens that patients, and especially their families, have no idea that that point in their disease is coming or happening. Their doctors don't tell them. Our society gives little appropriate guidance in dealing with the end of life. And so patients slip into that irreversible phase with doctors putting on the full court press and their families acting as collaborators, about to spend the last days of their lives being tortured rather than comforted (1).

Whereas a bit of information could have prevented such a fate.

The proposed health care reform took a small, a minimal, step to help prevent this scenario. A provision for Medicare to pay for, not provide, voluntary end-of-life counseling. A good, but insufficient step. Actually, Medicare actually sort-of mandates such counseling. But it doesn't reimburse for it. So, human nature being what it is, those discussions tend to be perfunctory.
The provision would just reimburse doctors for the time spent, with the idea that perhaps under those circumstances a meaningful and useful discussion will occur

Enter that irrepressible GILF, Sarah Palin. This eminently reasonable idea, something that any sane fiscal conservative ought to love, became Death Panels. And a segment of the population whose influence-to-IQ ratio is unacceptably high fell for it.

And so yesterday the Senate Finance Committe dropped payments for end-of-life counseling from its version of the bill. (2)

This is what the right wing is contributing to health care reform.




(1) Personal observation--every day where I work.

(2)http://www.latimes.com/news/nationworld/nation/la-na-health-end-of-life14-2009aug14,0,4670272.story