Some of the tough questions are bubbling to the surface, only to be pushed back down so that they are invisible again.
Any health care system has to deal with a very critical decision on a daily basis. That is who lives and who dies. Usually that is decided by who runs out of $$ first. The poor, the weak, the elderly are always on the bottom of the list and both private and public insurance plans have limits which require the care givers to pull the plug at some point. More resources are applied to those who are young and vital (or rich) and the reason for that, after you factor in the basis for the emotional factors, is economic potential. These are difficult concepts for us humans to swallow, but it’s part of the whole ‘death is part of life’ reality that we all must face eventually.
No health care system can survive economically without a rationing system in place. Otherwise a small minority of extremely ill patients will suck down the entire economy trying to stay alive. The brother to Obamas chief of staff, a Dr Ezekiel Emmanuel, devised (with a government grant) a system called the ‘Complete Lives System’. Once the system started to see the light of day it sent a chill down the spine of legislators, and the Senate pulled it from the proposed health care bill. Dr Emmanuel is now distancing himself from his own work saying that his thinking has evolved in a different direction now.
It is understandable that it is a chilling concept, deciding who dies. It is Orwellian, to say the least, to consider that the old, the weak, and the poor end up in the morgue, while the young, the strong, and the rich live on with tubes and machines pumping life giving fluids, and lots of $$, into their ailing bodies. The proposed Complete Lives System may be flawed. But if not that, then what?
Without an end game, a structured method for calling it quits, no system can work. It’s a tough decision that must be made. Until now we have allowed it to be made in the dark. Care is provided until the $$ runs out and then the economically exhausted patients are pushed aside where they quietly expire. That method worked, but only because it is politically invisible.
I wonder if we are ready to actually tackle this issue under the political spotlight. I doubt that we are. Maybe the only solution, politically, is to find out how to make it invisible again.