The New York Times and others report that the Obama administration issued a Medicare regulation providing that senior citizens be provided wellness counseling at their annual wellness checkups. Someone in the Department of Health and Human Services will be deciding what treatment and therapies will be available to patients who are nearing the end of life.
This controversial provision of the Health Care law raises questions that are of particular interest to me as I approach my 75th birthday and would, if this law is allowed to stand, eventually interest my children and grandchildren. For example, when is one deemed to be approaching the end of life? Metaphysically, we are all approaching the end of life. When I scan the obituary pages, I’m struck by the wide range of the ages at which people die. Unfortunately some pass away young. Others leave the century mark behind them with all their faculties intact. (Of course, every time one takes to the road at the wheel of a car, he/she shortens the odds.) While it may be statistically true that people cost “the medical system” more money during the last two years of life, it’s rarely possible to determine when those two years are upon one. (It’s almost as difficult as predicting when the polar ice cap will cease to exist or when Al Gore’s house in Malibu will begin to sink beneath the sea.) At any rate, something as unpredictable as identifying time of death or injury can’t be considered a reliable way to save money.
Furthermore, there doesn’t seem to be any discussion of doctors and their traditional role in recommending treatments. As things stand now, it looks as though doctors are to be given a bureaucratic menu of treatments and pick one from column A or one from column B. But, let’s face it, our physical systems are all different. Different people react to the same medication in drastically different ways. My wife, bless her heart, simply cannot, for example, take a dose of any sulfa drug without instantly becoming nauseous. Others take them with no problem. You can’t go to a Chinese restaurant and expect to order a taco. Heaven help us if the bureaucrats neglect to to put “tacos” on the menu. If you are under the care of a brilliant, up-to-date physician or even a genius who is functioning on the cutting edge of medical practice, who may even have invented a therapy that outshines anything else available, do you want him/her to be limited only to what’s approved by an 11 member panel of mostly Presidential appointees?
I know, I know, all this is premature, I’m oversimplifying, I’m not an expert, blah, blah, blah. Reading between the lines of the new health care law is not nearly as difficult as determining where the TARP money went.
TheMiddleofSomewhere 
Posted by Mary M. Boud (Mickey) on January 7, 2011 at 5:57 am
Excellent! Thanks for this blog. I can relate to the thoughts and feelings that run through a person’s mind when listening to all this talk about “end of life” issues at the behest of the bureaucracy.
I’ve worked most of my life in the healthcare field and I can assure you that a patient can bring up this subjuect with his/her physician at any time and for no additional charge. Also, physicians are free to discuss such issues with any patient for whom they think it would be helpful and appropriate. Physicians do not need permission to do this from anyone except their patients. It’s not as if this “benefit” provides care that was hitherto missing.
In addition, the whole issue of euthanasia raises its ugly head and, like abortion, should not be supported by taxpayers who oppose such practices. Along with Planned Parenthood abortion clinics, will we soon have Planned End-of Live clinics? Shades of “Soylent Green!”