thegreekdog wrote:Yeah, the "Exchange" is a rather different issue, one that I have not looked into closely, mostly because I take the cynical view that the government is going to try its hardest to eventually be a single payor.
To be completely honest, I just want a measured, well-thought out healthcare bill, not one that was put together seemingly on a whim without the input of anyone from the other side of the aisle. I know this is a lot to ask (seriously), but healthcare is an important enough issue that it bears some more discussion. I understand the political ramifications of not passing the thing as soon as possible, but I'd still like to see some kind of compromise on this.
I do not believe this bill was put together on a whim at all. It has been modified to try and appease some opposition.
I have said all along that I prefer a single payor system for many, many reasons, for basic coverage. Th eproblem is that too many people want to use health care as leverage to their own personal issues. This talk of "limiting" care for seniors is a good example.
Talk to any doctor who deals with elder care and you hear a resounding complaint. They are just not given the time to talk to patients about their options in a reasonable and caring way, unless they take upaid time out of their day. No one is saying that elderly people aren't important and don't deserve care. However,
most people, when they find out of the options available like being able to make some kind of plans. At the age of 90, do most people really want to go through the pain and difficulty of having a heart transplant? Or even (sometimes) a knee replacement? How many 90 year olds are really and truly healthy enough to endure? Some are, but many are just not. A lot of the anger that comes with "end of life" decisions comes from just plain lack of clarity and understanding. Its only fairly recently that the whole concept of DNRs, etc have become accepted in hospitals. In many cases, if the doctor does not either know the patient or have loved ones there willing to agree, they will STILL be ignored! Why? Not because it will do anything at all for the patient, but because it may save the doctor some headaches.
IN many cases, its not even a matter of whether its wise to provide extensive tests and such to an older patient. Often times, elderly patients just respond differently. Many elderly problems, for example, are due to simple dehydration because their bodies do not absorb water as effciently, they often don't drink like they ought, etc. So, while it may be a good idea to put a younger patient with certain symptoms through all sorts of aggressive tests, the best course for an older patient might be to give fluids and wait an hour or two to see what happens. (note, I am almost exactly quoting a well known hospice doctor on this).
I have had to make some serious decisions for family members, have just this past winter gone through the slow death of my father-in-law and will be, it turns out, facing something similar with my mother-in-law soon, too. So believe me, these are not hypthetical issues for me.
Hospice is NOT about ending people's lives early. It is not about killing people. It is about recognizing that even the best doctor and medicine can only do so much, and, at some point, most people would rather spend their time "making peace" (which can include being very, very, VERY angry at times!), connecting with loved ones, etc than listening to the drone of machines in uncomfortable surroundings. At some point, people just die. Fighting that end tooth and nail is not the best way for everyone to go.
So, this bill has included provisions that will give doctors time to discuss all of these options with people. Is that idea scary? Well, death is scary. Most of us like to pretend it does not exist until we must face the facts. However, for those of us who have had to deal with that ..either for ourselves or loved ones, most of us know that a reasoned understanding and acceptance makes things go much, much better for all concerned.