Rationing Health Care for Elderly?

Jane Gross writes in the NYT, "How old is too old for lifesaving surgery?"  She quotes Dr. Daniel Callahan and provides "a provocative conversation about his long-standing — and controversial — support for rationing health care for the elderly." 

He views rationing as a way of keeping Medicare solvent in an era of more and more old people, more and more advancements in high-tech medical care, and more and more confidence that age is no barrier to successful heart surgery, cancer treatment and the like.

“The biggest change in the last 40 years,” Mr. Callahan said to me, “is that there are no limits. There’s nothing we can’t do for an old person, and there’s a lot of pressure to do it. This is considered progress, and it’s considered ageism to be skeptical. But we can’t go on this way. It’s unaffordable. And it’s the hardest dilemma in our society because there’s no good way to deal with it other than saying ‘no.”’

Mr. Callahan’s essay follows.   [snip] 

...

There are in the end only two decisive ways to control Medicare costs: raise taxes, cut benefits, or both. Neither political party is game to raise taxes, for Medicare or anything else. As for cutting benefits, Congress this year voted for $20 billion in new expenditures, ignoring the need for frugality.

Yet there is nothing of importance left to do other than to reduce benefits. That move would mean denying elderly patients both what they might want and need. Or are there some less draconian alternatives? A long-standing refrain of many older people is that much money could be saved if they were more easily free — by living wills or the appointment of surrogates — to turn down expensive life-prolonging measures of dubious benefit. Maybe so, but some studies have shown that would not make much economic difference in an overall Medicare budget of hundreds of billions.

More important, despite what they say in advance, many elderly people will in fact choose to be aggressively treated for a critical illness even when there is a good chance it will not save them — but just might. Doctors endlessly complain to me that excessive patient expectations of medical miracles, or those of their family members, make it harder, not easier, these days to curtail aggressive treatment. Not all of us can resist the lure of a slightly longer life, despite what we may have said in advance. (continue reading at NYT)

I am in favor of living wills and the appointment of surrogates to make decisions for me, if and when I am unable to make them for myself.  A living will is my opportunity to set down in a legal document what medical procedures I want, and which ones I do not want, if I am unable to speak for myself. 

Dr. Callahan does not think this will help the cost of Medicare, and he's probably correct.  Medical care should be a matter of personal choice and personal responsibility.  However, when the government is your health care insurance provider, some of your choice may be taken away.  Look out young folks, because a government health care system might put limits on you too.

Comments

[penis size]

More & more people know that Blog are goods for every one where we can get more knowledge nice job keep it up !!!

[Katie]

First it will be with the elderly, then those with genetic diseases (MS, MD, etc...), AIDS patients will follow, then it will be to the rest of society so only a select group will get any medical treatment.

[MK]

It already happens in places like Britain, socialised medicine leads to rationing, inferior care and high cost. That's the way it is if you won't pay for your own healthcare.

[Debbie]

I would suggest that everybody get a living will and power of attorney for yourselves and for your parents and family members.

[Angel]

Deb..stopped by again to remind ya not to leave a link in your comment by me because u may end up in the spam filter and I dont want that girl!..heh

[Debbied]

MomInTheFlyOverZone:

Great comment. Actually if you read the Doctor's complete article, he may have changed his thinking now that he is older.

Skunkfeathers:

A large number of the congress is pretty old, maybe they will want to leave this one alone, heh.

AOI: Good for you, I did the same with my parents.

Angel: Yep, since November 4, downhill may be the word of the day for awhile.

Faultline: You have to be pretty quick to beat Skunkfeathers.

[MomInTheFlyOverZone]

One can only hope that he reaches the ripe old age of "non-viability" before anyone else. When people start talking about ending life for the convenience of the government, then this world is really screwed. Let the Dr. go first and enjoy the "non-right" of someone putting him down like an animal. What has our country become?

[erik ehst]

remember the riots are a white man's fear not a reality; this is not the 60
's all over again; these are more civil times with radical hope for change;sadly no matter wherever or whoever takes the reins!

[erik ehst]

Just a shout out to all the GOP's like me who voted democrat this year as my possible once in a lifetime radical vote; i did however vote all republican for my local constituents who are blind-sided democrats; the balance of power is necessary locally & also federally! i do not wish a short/ assassination of the President -elect; this is a phobia of jfk survivors & Jesus Christ intercedes for his longevity; else we might just have those riots in US cities your warmongering bloggers have dared to type!

[Faultline USA]

Excellent article Debbie. Skunkfeathers beat me to it and said pretty much what I was going to say!

[Aoi]

I sat down with both my parents a while back and got them to set up living wills, et al. And I've read in many places the half of a person's lifetime medical costs are incurred in the last year of life. We have a big problem looming out there, and no one seems to have a good solution.

[Angel]

here it goes Deb..were goin down the tubes!

[Skunkfeathers]

Well, it isn't hard to reckon where the liberals will stand on this one. They actively support abortion on demand on the public dime; if "universal" health care under control of a "progressive" government is established, expect to start hearing from the libs about the elderly's "duty to die", "death with dignity", or even "elder abortion".