Doug Ross: Obama and his appointed bureaucrats in Washington — not your family — will decide whether your grandparents live or die.
When the government is rationing health care (and, when the government takes over the health care industry, you can bet your ass there will be rationing) — the government will have to make tough choices between actual health care and health care costs.
In other words, bureaucrats in Washington — not your family and not your doctors — will decide who gets what health care based on return on investment (ROI) tables. In (more) other words, the government will decide if it’s more cost effective to NOT give you the treatment you need because you’re probably just going to die soon anyway.
Most affected will be old people, whom I hope to be someday. You might even know some old people today that would be immediately affected. Like your parents or grandparents.
Here’s the chilling transcript (via the NY Times) on Obama discussing the tough decisions that will have to be made as to whether or not to treat old people:
THE PRESIDENT: …I actually think that the tougher issue around medical care — it’s a related one — is what you do around things like end-of-life care —
Q: Yes, where it’s $20,000 for an extra week of life.
THE PRESIDENT: Exactly. And I just recently went through this. I mean, I’ve told this story, maybe not publicly, but when my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.
So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.
And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart.
I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.
Q: And it’s going to be hard for people who don’t have the option of paying for it.
THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
Q: So how do you — how do we deal with it?
THE PRESIDENT: …you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.
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The biggest concern regarding government-controlled healthcare is having bureaucrats conduct “cost-benefit analyses” on the value of patients’ lives. Who would want a government employee making the decision regarding whether to allow your grandmother to receive a hip replacement rather than just allowing her to languish and die more quickly? A “cost-benefit analysis” based solely upon deducting the financial cost of a medical procedure from the estimated “future contributions” said patient may make, or even from what the patient’s “likely lifespan” might be, would, no doubt, sway the decision in former of the latter, especially in the cases of our elderly and handicapped.
It would be a crime against humanity if the government imposed upon patients more emphasis on the financial bottom line, rather than honoring their own desires and wishes, while leaving no alternative for the patient and the patient’s family if they disagree with the cost-benefit analysis. If the patient and the patient’s family desire the hip replacement and believe it would improve the patient’s quality of life, then the government would be out of line dictating that the costs offset any possible benefits.
If the government does indeed begin to dictate to the healthcare industry what procedure may be done on which patient, then so much for the gains made in recent decades within the healthcare industry of respecting patient autonomy. The autonomy enabling patients to hold the power to make their own end-of-life decisions was hard-earned by a series of judicial proceedings carried out over a time-span of many decades. Physicians now encourage patients to actively participate in making their own medical decisions. This power should remain in the hands of patients and families, who hold a vested interest in the life of the patient.
Before the 1950′s, medicine was very paternalistic and patients were limited in their ability to make their own decisions regarding their own health care, particularly end-of-life decisions. Now, we may just find our healthcare reverting back to paternalism. Only this time, rather than the power being solely in the hands of physicians to make life-or-death decisions, the power will be in the hands of government bureaucrats more interested in the financial bottom line. When it comes to our health, especially concerning end-of-life decision-making, the government should not interfere with the intimate relationship between the patient, the patient’s family, and the attending physician.