Health Care Needs Common Sense Rationing

[Chemisse]

The sky is the limit for treating people with terminal disease, massive birth defects, and devastating brain injury. And we all chip in to pay these costs.

Sure if it was my child in a coma after a car accident I would want to spare no cost. So cooler heads need to prevail. If there is no hope of a life outside of a rehab facility, society should not have to pay. If you are going to die from cancer in a year, you don't need hip replacement surgery. And you certainly should not expect society to pay if you want to have octuplets, eight little babies who will most likely suffer expensive, life-long handicaps.

There need to be guidelines that are consistently enacted. There is no reason why we should all be pitching in huge sums of money to pay for care in the last year of people's lives.

Until we seriously look at these issues, the health care costs will continue to spiral.

[stray cat]

1. Health care can not be unlimited

sad but true and it is irresponsible to pretend otherwise

[LaurenG]

2. Yuck

I don't even know how to respond to this. Sure lets let our congress decide who lives and dies!1!!:sarcasm: We've all seen the terriffic job they did of agreeing to murder and torture already.

[cosmik debris]

3. Life or death based on dollar cost?

That's what we have now with our wonderful insurance industry. :sarcasm:

[fasttense]

4. Then we should also ration food and water.

Why feed kids who are just going to end up as criminals anyway? Why provide water to the disabled 80 year old? They are going to die in a couple of years anyway. All that food and water could go to people who are really productive in this society. You know, like the kids of rich CEOs, bankers and government officials.

That's why the cost of food and water keeps going up. So many more people expect to get adequate amounts of food and water when they are just a drain on society.:sarcasm:

[shraby]

5. And who, pray tell will be the ones to make those

kinds of decisions?? You are so wrong on so many counts that I can't count them all. Go back under your rock please.

[Celebration]

6. He is right, actually

We can't provide unlimited health care in to everyone in all circumstances. It wouldn't make scientific sense, or economic sense. Health care is rationed now, and will always be rationed, when we are talking about pooled money paying for it (whether insurance, or government).

Hopefully the ones making the decisions will be well versed in the science and likely outcomes.

[WillYourVoteBCounted]

18. first: whack off those subsidies for the 4 hour erection pills

snicker.



:rofl:

[Fire_Medic_Dave]

20. That's pretty funny.

The problem of course is that viagra was designed with the idea of treating angina in patients who responded poorly to nitroglycerin, primarily African Americans and some women. During clinical trials it was found to not be effective at treating angina but very effective at giving men erections when they hadn't had them for years.

David

[mopinko]

21. for all they contribute to the world of humor, those meds have a legit function

many treatments for serious conditions result in loss of said function. if you had to choose between medication for say, high blood pressure, which has no symptoms, and your love life, which would you choose.
they are way too expensive. but they are not without real medical value.

[kickysnana]

7. This is already a can of worms and we are not doing a good job now.

A friend had a mother in her 70's who had been starting to get forgetful, not unlike a lot of seniors. She fell and needed hip replacement. She was on Medicare. What she had and no one could have known was the beginning of Alzheimer's. The surgery (anesthesia?, shock?). Immediately after the surgery her mental condition took a turn for the worse and she had difficulty meeting the rehab milestones that do not take into account any other physical conditions. She was deemed non-complaint and Medicare stopped paying and she ended up in long term nursing care because she still needed help learning to walk again, only on a slower schedule but was not eligible. Two more weeks of rehab vs 5 years of nursing home, you do the math.

My Dad had gotten pneumonia shortly after my Mom passed that held on so he was seeing a lung specialist who detected a tiny nodule in his lung. The doctor and oncologist who was consulted thought that there was only a 10% chance it was something other than a left over from the pneumonia but it needed to be checked in three months. During that time my Dad's heart arteries became seriously occluded and he needed angioplasty or stents to open them back up. He was/is extremely fit and active at 83. He had the repeat CAT scan done and was to see the lung doctor who had moved to another clinic in the same HMO. He either did not hear that or they did not tell him so when he showed up for the appointment for the results the day before the heart procedure he was in the wrong place. A call was placed that the results (negative) needed to be in his chart by the next day and he was assured that they would see that they were. Dad goes in and an hour later the surgeon comes out and tell us that he did the scanning part of the procedure with the scope but not the angio or stents because he did not see the results and procedure was that anyone with lung cancer could not have the "fix" done. Nobody came out to tell us before they closed so we could do something. So a repeat procedure was done (twice the cost) was scheduled 5 weeks later. It also doubled the chances of clots because of the procedure and during the waiting time between procedures. Dad's retirement health insurance is still in effect but only as a Medigap provider.

I live in a Senior building ages 55-103 I could go on and on.

[Chemisse]

8. Oh the Horror

Okay, I concede that it is shocking to even say such a thing. There are all sorts of potential pitfalls, as you all so thoughtfully pointed out. That's why we need to talk about it. We sure don't want the insurance companies or the government to be in charge of these ethical decisions. We as a society need to decide where to draw the line. That's a little tough to do if the topic is taboo.

Until somebody dares to suggest the unthinkable, we are only going to dig a deeper hole for our health care system.

By the way, I am a 'she.'

[Why Syzygy]

9. They've already got a system they like.

Rich people get to live, poor people do not.

That's the system that is hanging on the tightest against citizens who, truth be told, can probably make responsible decisions for themselves when presented with accurate and timely results. Some people really are ready to let go of this place. Not every consumer is a greedy reflection of TPTB.

[cosmik debris]

10. You changed the framing

In the OP you frame the issue as an economic decision.

Now you frame it as an ethical decision.

I know that you do not believe that ethics and economics are the same thing, do you?

[WillYourVoteBCounted]

17. Single Payer Health Care - does not equal Soylent Green

Im pretty sure that we will have increased access once we remove the profiteers from the equation.

[Warpy]

11. If you're going to die from cancer in a year and you broke your hip

you absolutely do need hip replacement or pinning to preserve your quality of life for that remaining year.

As for the huge costs in the last year of life, there's no way to know it's the last year of life until the person is dead. I signed my dad into a very serious surgery when he was 78 and then into intensive rehab. It bought him 11 years of life at 95% of his original function. Others, far younger, have had that surgery and done poorly, ending up in intensive care for days or weeks until their deaths.

Common sense rationing is already practiced at the physician level. They won't do liver transplants on active alcoholics and they won't to heart transplants on chainsmokers who refuse to stop. Some neonatologists know which premature births are going to make it and which are not and only give palliative care to newborns who are under the weight limit. Doctors usually consider age and condition as factors in administering heroics.

I believe it was Oregon some years ago that tried to codify those common sense rations into law and the prolifers pitched an ungodly fit, not realizing that most of them were already done right under their blue noses.

We do need more common sense guidelines and a way to rein in rigidly prolife physicians who don't know when to give up and call hospice in. However, your examples were poor ones.

[uppityperson]

12. Financing is limited. How to best use it is quite a serious question indeed

Do you spend it on those 8 premies, or on vaccines for a bunch more kids (using as an example, not to set off vaccine issues)?

We all chip in to help pay for each other's health care, but there need to be guidelines. And setting those guidelines is a moral and ethical issue which is not easy.

Health care costs continue to spiral, though, NOT because we are paying for extraordinary health care, but because insurance companies continue to make huge profits from both patients and health care providers.

[Delphinus]

14. This is what so many fail to realize:

Health care costs continue to spiral, though, NOT because we are paying for extraordinary health care, but because insurance companies continue to make huge profits from both patients and health care providers.

[sandyd921]

13. End of life care is not the problem as far as costs.

This is a canard put out by the libertarian right. Far more costly are all of the people who are not insured or who have crappy insurance who do not seek care for conditions that can be treated much less expensively when they first have symptoms. The condition then progresses or they have complications and eventually require very expensive care at public expense. We could also save tons of money through far more preventative care than is now provided in the US. In a publicly financed system we could get these costs under control.

As far as end of life care, this is primarily an ethical issue, not so much a cost issue. Actually when you ask people they almost always say they do not want heroic measures at the end of life or if there is no hope for anything approaching meaningful life. In reality, what I hear doctors and nurses say, is that means to hasten the end are often quietly administered.

To the OP: Hope you stay on DU and keep reading, responding, and posting. You'll learn a lot. Welcome to DU. :hi:

[Fire_Medic_Dave]

15. Except when those cooler heads are idiots.

My father had a stroke I was with him the second night in the hospital and the doctor said we needed to sign a DNR we refused. Later that night I noticed my dad was having some sleep apnea and brought it up to the nurses. They called the doctor and he said it was Cheyne-Stokes respirations, usually referred to as a dying rhythm, he refused to come back to the floor. Only problem was that it went away when dad woke up. Dad is now in a rehab facility and stood up on his own today. Then there was the man who regained consciousness 2 years ago after 13 years in a vegetative state. We need to learn a whole lot more about the brain before we start giving up on people to save a little money.

David

[WillYourVoteBCounted]

16. strongly agree with you. Your dad is lucky to have vigilient family

glad he is doing better.

[Fire_Medic_Dave]

19. Many thanks.