Monday, September 28, 2009

Waddaya Gonna Do

Newsweek recently had a good article on the cost of health care and the choices that will need to be made in the very near future. Actually, they need to be made right now. And though this article centres on the US, the same thing applies here in Canada, home of free health care.

'Cause it isn't free, not by any stretch of the imagination. I just have to look at my paycheck - over 30% of it goes to the government. So yeah, we do pay for that free health care. And I'm not begrudging the paying. At all. It's just part of the package you know?

But the cost of health care is spiraling out of control. People are living much longer, having less children and in a few years there will be more elderly than there are young people to pay for their care. Old age is extremely costly to the system, and something will have to give somewhere.

Something along the lines of who do you treat? Whose life is more valuable? A 20-year old battling cancer or an 80 year old at the end of his life? Who gets the bucks? Do you spend the money on youth and pull the plug on the elderly? When do you stop treatment?

After all, they're at the end of their lives and however much you spend on curing them, they will die - sooner rather than later. Do you forget about treatment and just keep them as comfortable as possible?

But what about when your loved one is the 80 year old. Or yourself. Despite thinking, on a logical level, yeah, let the old go, when it's your own mom or dad things might feel a little different. Nevertheless, the line will have to be drawn somewhere. Maybe the Soylent Green system of um.. doing away with people at a certain age makes a certain kind of twisted sense*. Will it come to that?

I obviously have no answers, I never do. But what do you think?

* But not eating them as green wafers though. That's just... nasty.


pierre l said...

You are making me feel old. I remember seeing that film shortly after I moved to France.
I also need to read "Un Homme et son Péché" and watch the film, both of which arrived recently. Two things I noticed after a quick scan of the book: the author felt obliged to explain that a novel was fiction and the importance of Monsieur le Curé.
Do you not think that green pellets are the way of the future then?
Here, the NHS seems to spend more and more money, but an awful lot of it seems to go on administrators trying to keep up with a lot of artificial tagets.

Bonnie, Original Art Studio said...

Surely it will not come to that. Life is too precious.

Expat From Hell said...

I am for universal health care. But I am also convinced it won't help our culture. Until we stop "shallowing" out on our precious individuality, and stop throwing our grandparents out with the garbage, none of these programs are going to work. Medical professionals already pronounce us dead before we are. If there were kids and relatives and neighbors around, we would have more vibrant, deepened lives. I think North America has ungrown its roots. That's what I think the problem really is.
Thanks for setting me on fire...EFH

Jeaux said...

Comfortable as possible, and let nature take its course. That’s what I’d want for myself. Technology has made exotic protocols possible to marginally and expensively extend the dwindling life of the elderly. How did this become standard operating procedure? Profit, mostly, and greed on both sides. Being a “lingerer” here used to be thought a defect of character.

There was a time when pneumonia was called “the old man’s friend.” No, I don’t think we should dispatch grandma on an ice floe the moment she stubs her toe. But spending outrageous sums to keep the marginally alive going a little longer strikes me as being more about fear, guilt, posturing and the profit motive, than about dignity and compassion. There may not always be a clear difference between preserving life and unnaturally extending death. But it’s one we should have the courage to at least try to discern.

Rachel said...

Good questions, tough questions.

My personal base solution, the first step, is to remove the profit from the equation. We need doctors and hospitals who care more for the people than for the money. We need pharmacy and device manufacturers who spend more money on research and development than on advertising or lobbying or bonuses. And finally, we need to stop medicalizing conditions as "diseases" that really aren't. Accept differences in bodies rather than enforcing arbitrary norms such as size, behavior, mental states.

After that, maybe we will be better able to see the problem of costs and develop more appropriate controls.

geewits said...

A couple of years before she died, my grandmother wanted to get some sort of surgery on her heart or a valve or something and they told her no that she was too old, so they are already doing that. It was silly that she wanted to do it anyway. She was already decrepit. It would not have made much difference and she probably would have died in surgery anyway.

Gaelyn said...

I believe we all have the right to live and die with dignity, making our own choices about health care. But if you can't afford it, then what?

Suldog said...

I say this as a smoker.

I think we need to let those people who make seriously bad health choices just live with the consequences. I'm not talking about poor unfortunates who were dealt a bad hand by fate, but those, like myself, who choose to ruin some portion of themselves. We should not be expecting to have our bad habits be a drain on others.

Having said that, it also has to work the other way. That is, we should expect to be allowed to ruin ourselves in whatever way we wish, without scolding or wagging fingers.

This will never happen, of course. The folks who ruin themselves will expect care, and the folks who pay for the care will expect better behavior. That's just human nature.

Anonymous said...

Ah Soylent Green, one of the best movies ever. I've referenced it 3 times in my blog in the past, including yesterday. Because I think it is a dead on prediction of what our future is going to be like if we keep on as we are. As for the health care issue, I keep thinking we have to focus on prevention and teaching people how to take better care of themselves and getting rid of all the crap we sell people in the guise of food and encouraging exercise programs in the workplace and schools and putting money into complementary therapies so everyone can access them as well because sometimes a bit of chiropracty or massage therapy can eliminate problems before they begin, fester and require surgery 30 years down the road. In short (oh, too late) we need to be very visionary about health care instead of just pumping tons of money into short-term solutions.

choochoo said...

how about we focus more on keeping old people alive who want to be alive and less on forcing people who want to die to receive all sorts of life-prolonging treatments. I think that makes sense.

Anonymous said...

I have no answers either, and as my own years go by I have even fewer. Interesting stat from WHO recently which puts Canada, despite our smugness about the preciousness of us, at #30 globally in terms of quality of health care -- miles behind Oman, for example.

secret agent woman said...

It's tough, to be sure. But I don't think a national healthcare system necessarily means that any and all treatment ha =s to be available. And may be of more of the resources were put into preventive health care, that would also reduce costs over-all.