Posted by
Michael Goodell on Friday, August 28, 2009 1:51:00 PM
Bill Streever has written a book called “Cold: Adventures in the World’s Frozen Places,” which is at the same time a splendid travel narrative and a “Cryogenics For Dummies” textbook. Streever’s prose combines the ability to render complex scientific material into comprehensible English with elegant natural descriptions, all delivered with a dry wit and subtle humor. Among other things I learned during his frequent, though by no means obtrusive digressions, is that Mark Twain was not in fact the author of the phrase, “There are three kinds of lies: lies, damn lies and statistics.”
Borrowing a page from Streever’s own writing style, I decided to begin this essay on health care reform with a digression of my own. It is not entirely inapt, as it makes reference to the title of this essay. Plus the book’s title is an evocation of the reception President Barack Obama’s signature initiative is receiving from the majority of Americans.
Having failed on the basics, the Obama Administration, Democrat Congressional leaders and other advocates of radically expanded government, have taken to explaining their failure by name-calling and conspiracy theories. Those Americans who have rejected Nanny Statism are variously dupes, right-wing wackos, un-American, treasonous, or in the employment of the vast Big Insurance machine.
Their bid to cram the wholesale remaking of American medical care down the country’s throats in less than three months unsuccessful, the architects unveiled Plan B which involved the President taking to the airwaves to promote his plan while Democrat Congressmen and women would host town halls to flesh out the details to a fawning nation. Alas, it wasn’t meant to be. Rather than recipients gratefully swallowing their recycled pap, they discovered hostile, disrespectful audiences.
This is where the conspiracy theorists stepped in. These people weren’t there of their own accord. In fact, they were bused in by Big Pharma and Big Insurance, and given instructions on how to behave. Apparently their orders were to boo every time they heard their elected representatives lie, and every time they heard them confess their ignorance of the bill they were so glibly advocating.
Any even cursory review of the raucous Town Halls on Youtube demonstrates that the audiences were better informed than their leaders. The biggest reactions came whenever they were told that medical care wouldn’t be rationed, that it would cost less, that it wouldn’t raise their taxes, or that the most important thing was to pass it as quickly as possible.
The average American is bright enough to know that these outcomes are impossible. Which raises the question. Are the authors and advocates of these bills lying? Or are they so stupid as to believe what they are saying? Though accustomed over the years to expect generic lies from their elected officials, average Americans apparently never expected them to lie directly to their faces.
Because they are lies, and by telling lies, those responsible for providing necessary health care reform are squandering their opportunity to achieve it. Worse than that, they are forestalling the inevitable day when the public will confront the dire consequences of inaction and dishonesty today. Take as one example, the rationing of medical care. Rather than insist that this will never happen, it would be much more responsible if Obama, Reid, Pelosi and all the rest came clean and admitted that rationing will happen regardless of whether this bill, or any other reform package is enacted.
By the time the bulk of the baby boom generation is in its senescence, Medicare will have long since been bankrupted. There will not be enough money to pay for the end-of-life care traditionally provided today. Decisions will have to be made as to who is eligible to receive what little care is available. According to Obamacare, these decisions will be made by a panel of government-appointed medical experts. It would be much better if these decisions were made by aging patients and their primary care physicians.
Rather than completely remaking American medical care, a greater emphasis should be placed on developing the field of geriatric care, and increasing the number of practitioners. This can be achieved in many ways, but one of the most effective would be for the Federal Government to provide free medical school for those willing to study geriatric care, and who agree to work where directed at a basic, liveable salary for a certain number of years.
It would be far better for those seniors approaching the end game to receive practical, effective, where possible non-invasive care from a physician trained to provide it, rather than to be fobbed off on interns and residents as happens so frequently today. The rationing of medical care is not necessarily a bad thing. It is true that the majority of medical expenses incurred happens within the final months of most people’s lives. By definition, those procedures are ineffective, because the patients die. Worse than futile, such treatment is often dehumanizing, creating a situation in which patients end their lives as little more than slabs of meat.
How much better would it be to have a system in place in which physicians and patients make responsible, informed and quality-of-life enhancing, or at least preserving, decisions? This is not to say that invasive or heroic procedures are never practiced, but that they are only when the patients are informed of the risk, and of the cost to their humanity. Often patients will choose a non-invasive, palliative form of treatment. Their lives, and deaths, might be better for it. It will save money, of which, it is necessary to repeat, there won’t be enough anyway.
This is the sort of honest discussion of medical care which ought to be taking place today, rather than disingenuous, self-serving mendacity. If those seeking reform respected the intelligence of the American people, this might be the form of discussion happening today. But then again, if they respected the intelligence of the American people, they wouldn’t be statists.