A few more thoughts on health care

Wow. Charles Krauthammer has an excellent column today on health care reform, proposing a system which he argues will lead to universal coverage and which can pass Congress. You can and should read it here: (Doctor’s orders!)

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/27/AR2009082703262.html?wpisrc=newsletter

This is amazing since I absolutely never agree with Krauthammer, and I have to wonder if he even agrees with himself in this instance since his proposal, he says, will inevitably lead to health-care rationing and, (shudder), end-of-life counseling, also known as Death Panels.

My question is what’s so bad about rationing? It’s the only way to significantly control costs, something everybody agrees we have to do.

Take a typical case as an example: A 75-year-old man has advanced lung cancer. He has a 95 percent chance of dying within two months. With aggressive and expensive treatment, there’s a good chance he could live for six months, though with serious side effects to the treatments. Or, he could accept palliative treatment for his remaining two months—hospice care which includes pain control, assistance to stay at home, and support for the family—which would cost a fraction of what the aggressive treatment would cost.

Why would anyone suggest the government has a moral obligation to pay for the aggressive and expensive treatment? The free market should be at play here. Anyone who wants additional coverage beyond what the government would offer should buy private policies, exactly like they already do with Medicare supplements. This is also how it works in Canada, our socialist neighbor to the north.

Krauthammer suggests that counseling about options at this point would constitute subtle pressure to check out early, but in my view it would amount to an opportunity to explain clearly what the patient’s options are. These panels are optional in the current proposals, by the way; I think they should be mandatory, even though that makes me not pro-life.

Also by the way, and as another example, Mary and I convened our own Death Panels with a local attorney several years ago. We now have end-of-life directives on file that make clear that if we’re brain dead with no chance of recovery—barring direct intervention by the Baby Jesus, which can always happen but isn’t likely in our case—we don’t want any extraordinary measures to keep us alive. This would include things like tube feeding, breathing machines, or deep tissue foot massage by a sexy nurse of the opposite gender.

On second thought, I’ll take the foot massage.

Of course we put subtle pressure on each other since our pension benefits continue to the survivor, but still, we think we made the right decisions. Of course, we might have chosen the tube feeding on the chance the Baby Jesus would change his mind and not hold a grudge, but I wouldn’t expect the government to keep paying to keep me alive indefinitely.

So I would buy into the Krauthammer policy in a K-Falls minute (roughly twelve minutes, actually), which means there still has to be room for compromise in the Congressionaal negotiations.

Maybe health-care reform isn’t dead after all. It just needs a foot massage.