The elephant in the Health Care living room
Since I will begin the first day of the 75th year of my life in 13 days I feel that I can discuss this subject clearly and without equivocation. To begin with I am a lucky man because I don’t need antacids, headache, or backache pills. I ride a bike regularly uphill and down dale. I walk energetically for many kilometers.
But as the screamers in the US about “death panels” for grandparents vent their anticipated victimhood anger all too loudly, I am forced to think about the ending of my life. Not a happy subject.
Yesterday, my wife who is Chinese and asks these kind of brutal questions said “How long are you going to be allowed to drive a car?” I answered quickly and bluntly “As long as my health, physical and mental is OK”.
The this morning I read Tim Egan’s latest blog from Oregon about how life ended for an elderly couple who had a son, who was Governor of Oregon when they lived with difficulty through their final months. Of course Oregon is well known in the US for its ending life laws. But the Governor was very thoughtful in considering how the last months of his parents characterized the biggest bias in Health Care spending:
About $67 billion — nearly a third of the money spent by Medicare — goes to patients in the last two years of life. The need to spend less money at the end of life “is the elephant in the room,” Evan Thomas wrote in “The Case for Killing Granny,” the cover story in last week’s Newsweek. “Everyone sees it but no one wants to talk about it.”
John Kitzhaber, M.D., politician, and son who watched both parents die in a dignified way, cannot stop talking about it. His parents’ generation won the war, built the interstate highway system, cured polio, eradicated smallpox and created the two greatest social programs of the 20th century — Social Security and Medicare.
Now the baton has been passed to the Baby Boomers. But the hour is late, Kitzhaber says, with no answer to a pressing generational question: “What is our legacy?”
The “news” about projections in the population of dementia and Alzheimer’s also troubled me this week. If I can do anything about it, I do not intend in spending my waning years and months in the control of our ugly hospital-doctor-nursing home industry. The whole smell and feel of that fills me with disgust and anxiety.
Yes, I want a dignified end to my life and the less it costs me and the public purse the better!
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