Sunday, August 02, 2009
My wife and I disagree about some of the key end-of-life issues. When such morbid subjects arise, as they must and as they have with increasing frequency as the debate over medical care rages on, she remains adamant that she does not want to linger in pain, holding on to those final months, weeks, days or moments through any extraordinary medical intervention.
On the other hand, I want to live for every additional second modern medicine or Providence might permit. Dylan Thomas summed up my feelings in his most famous poem:
Do not go gentle into that good night.
Rage, rage against the dying of the light.
As President Barack Obama and Congress discuss health care legislation, and we citizens worry over the ramifications of possible policy outcomes, there arises the haunting specter of euthanasia. My wife and I may disagree on what end-of-life decision to make, but we agree that it should be our decision, not the government's.
A proposal to cover millions more Americans with medical insurance predicated on spending less on medical care in the process perplexes enough. But for those who care about freedom -- not having government tell you how to live -- and those who wish to live as long as they can -- by definition, not having the government tell you to hang it up and die -- there is even more to fear.
It's not that Obamacare is a one-step federal government takeover of medicine. But it does qualify as another giant step in that same frightening direction.
We've known for years that the more the government picks up the tab for our doctors, nurses, and drugs, the more the government will tell us how to live our lives. What to eat. What not to eat. What not to smoke or drink. What recreations not to engage in (too dangerous), and that we need to do more leg-lifts and jumping jacks with more gusto -- like a scene I recall from 1984.
Already cities have banned trans fat. The poor, who happen to smoke or drink alcohol in larger percentages than those more well off, are increasingly crushed under sin taxes. There's talk of hiking taxes on Dr. Pepper -- and candy.
We can hope that the power of police unions can keep donuts on the market at relatively low expense.
But expect much worse. And though the excuse for ever greater nannying will always be to protect the taxpayers (forced by politicians to pay the medical bills of everyone else), it will be government experts, not taxpayers, dictating dietary and exercise mandates to the population.
Still, the issue of euthanasia is even more frightening. Older people, as their bodies deteriorate, cost more money. Putting hospitals under increased government budgetary oversight and command will not miraculously increase government budgets for hospitals. Cutting costs will become a draconian theme, never ending . . . until death.
Even now, "death by waiting" is a common rationing procedure in Britain and Canada. If you are young and living under socialized medicine, getting dialysis from government-run hospitals is fairly easy; if you are old, wait. The system's limited medical facilities, doctors and nurses practice a kind of triage. The aged are the hopeless, in this common scenario, and give up their lives for the good of the hospital budget.
This is hardly an "easy death" or "good killing" ("euthanasia" comes from euthanos or “good death”). It is death by bureaucracy. Bureaucrats love their queues, need their queues. And the impetus is clear: Saving "the taxpayers" -- not the patients.
Former Colorado Governor Dick Lamm addressed this issue decades ago when he philosophized, "We've got a duty to die and get out of the way with all of our machines and artificial hearts and everything else like that and let the other society, our kids, build a reasonable life."
Mr. Obama and the congressional architects of their new medical regime are promising to cut the overall cost of care. Are we really to believe there will be no pressure to deny expensive treatments in order to save money?
Many opponents of Obamacare are jumping on a provision in one version of this legislative work-in-progress, a directive to pay doctors to counsel the elderly -- and terminally ill patients -- on various end-of-life issues. In the New York Post, Betsy McCaughey said this mandate "invites abuse" and that "seniors could easily be pushed to refuse care."
A front-page Washington Post article, headlined "Talk Radio Campaign Frightening Seniors," reported that this controversy "undercuts what many say is the fundamental challenge of discussing sensitive costly societal questions about how to align patient wishes at the end of life with financial realities, for both the family and taxpayers."
Not getting a pacemaker at 75 years old may mean a person dies at 77 or 78, instead of at 83. What are five years of life worth? Who should decide?
With the federal government in the medical care business through the so-called Public Plan, folks in Washington will have the power to decide.
If you don't like your health insurance company, you ain't seen nothing yet.