A difficult dission. Please, kindly, proceed with caution.

[johnandtinagilbert]

I'm not even sure how to word this in a way that won't hurt or offend, so I will tread lightly. Please forgive me if I don't find the words. I am wondering this honestly. I do not believe I have the answer by any stretch of my imagination, I'd just like to see where others sit.

 

In all of the health care debate there are 2 points that turn my mind in the same direction: end of life care for the elderly and long term care for those with chronic illness. Both are costly. Extremely costly.

 

When does medical advancement and/or intervention cross the line? Does it? Are we prolonging life via medication at an irresponsible rate? As life expectancy grows are we unnecessarily or inappropriately keeping people alive (I gulp as I type that).

 

I want to restate I do not believe I have the answer by any stretch, I just think people aren't talking about this (at least that I've heard) and I believe it is a component to the discussion.

 

A public example was the story of the 95 y.o. woman who was denied a pace maker, then was given one. Was she on other medication? If so, where those medications keeping her alive?

 

Will our society get to a point where most of our bodies are either being manipulated by medication or simply replaced with artificial parts? When is enough, enough?

[Perry]

nm

Edited August 15, 2009 by Perry

[nova147]

I agree that there are times when life is prolonged irresponsibly. But I think the most important question is when? And who gets to decide? I know a lot of people are up in arms about older people having to discuss end of life care every five years (as proposed by one of the health care bills). While I understand that on an emotional level (who wants to think about dying?), on a practical level I think it's a good thing. Now, I'm uncomfortable with the idea that the discussion would be with someone other than your own doctor. But beyond that, talking about your current medical condition, possible problems that could develop, and how YOU want them handled is good. It's VERY important to me that individuals are making these decisions with their doctors and that they are not being unduly influenced to refuse treatments. But being fully informed of the potential outcomes of getting treatment (or not getting treatment) can only benefit us. Certainly, some people will choose to continue their lives, no matter what. But I suspect many will choose only those treatments that will improve their quality of life while extending it. And that is cost effective as well as humane.

[TXMomof4]

This is something I have struggled with as well. Watching my parents deal with their aging parents has made this a real issue. When do you say enough is enough. When is it more cruel to extend a life that is painful and miserable than it is to let it end? I don't think there is an answer to this. I think it is a personal decision and there isn't a one size fits all answer.

 

A good friend of mine just died this last week. She lost her leg to cancer when she was in her early 20s. Then she had a double mastectomy a few years later. Then she had colon cancer. Then she had another type of stomach cancer. Then her colon cancer returned. I only knew her to be "well" for about 2 years of the 10 years that I knew her. BUT I can't imagine her giving in at any point in the journey. As long as there was a battle to be fought, she fought it and lived a full and joyful life for the entire time. It would be easy to say after 3 primary cancers before you're thirty that maybe there isn't much point in fighting - but there was still immeasurable value and joy in her life.

 

Like I said, I don't think there is one answer to this at all.

[Heather in Neverland]

All I can give is my own personal view. I believe that I am alive to bring glory to God and share the gospel. when I am in a position that I can no longer do that then I am ready to meet Him face to face. YMMV.

[Lovedtodeath]

All I can give is my own personal view. I believe that I am alive to bring glory to God and share the gospel. when I am in a position that I can no longer do that then I am ready to meet Him face to face. YMMV.

:iagree:My uncle was sharing the news of God's Kingdom until he died. He fought the fine fight. He had stomach cancer which had spread throughout almost all of his organs. He was also smiling and joyful telling jokes. I only hope that I can follow his example.

 

I realize that I am not doing a good job now.

[WTMCassandra]

:lurk5:

[Plucky]

I think when someone has a strong desire to live they should be offered that opportunity. Life is so precious. I think it should be up to the individual whether or not they want to battle through one more round of chemo for a mere 6 months. As long as someone wants to live and there is hope, I think it should be granted.

[katemary63]

I think this is an easy question, honestly. Everybody's opinion will be different. There will never be a consenses; no chart to look up on, oh yes, according to row e, column 6, this old guy is past the point of worth saving. So....we leave it to the individual and the family and his doctors. What's so hard about that? No insurance company, no government agency, no panel of objective judges. I think EVERY life is precious and only an individual and his/ her loved ones have the right to have a say in weather or not it's "worth" it to continue supporting that life.

[Julie in Austin]

I think it is useful to separate this into two issues: (1) What should I do for myself? and (2) What should society do?

 

Let me start with (2). I do not think that any govt program should provide anything more than pain relief, hospice, and very basic care for anyone 10+ years beyond the normal life expectancy. So if you want care beyond that, you should plan and budget for it in advance.

 

And then (1): you should do whatever you want. And I should do whatever I want. And we should honor each other's decisions. (And we should all make our wishes known in writing so that our families don't fight about what to do!) As for me personally, I have no desire whatsoever to have heroic medicine when I am very elderly. In fact, I'd be pretty mad if someone kept me from God's realm when I'm naturally ready to head there!

[BabyBre]

Will our society get to a point where most of our bodies are either being manipulated by medication or simply replaced with artificial parts? When is enough, enough?

 

I think we've been there for quite a while. Some of the increase in life expectancy, of course, can be attributed to better diets, preventative care, environmental factors, etc, but I doubt there's any way of knowing exactly how much. I think it's more likely that we're largely prolonging our lives through the use of medication. We've been outliving our bodies for decades.

[Plucky]

I think this is an easy question, honestly. Everybody's opinion will be different. There will never be a consenses; no chart to look up on, oh yes, according to row e, column 6, this old guy is past the point of worth saving. So....we leave it to the individual and the family and his doctors. What's so hard about that? No insurance company, no government agency, no panel of objective judges. I think EVERY life is precious and only an individual and his/ her loved ones have the right to have a say in weather or not it's "worth" it to continue supporting that life.

 

I agree. Your post is much better than mine. Thank you.

[elegantlion]

I don't know. I believe there is a very fine line between my personal decision and having that decision forced upon me.

 

I am alive today because of technological advances made in health care in the last 50 years. I had cancer at age 26. The form I had has a fairly high cure rate, but 50 years ago it was not unusual for people to die from the same form of cancer. So I am very thankful for advances made today.

 

My dh's grandmother is a breast cancer survivor. She was 80 years old when she had her tx. She is now a very healthy woman in her 90s.

 

I think the decision to prolong life is a personal/family one. I think families need to communicate their desires to other family members well before the issues of age arise. IMO the days of being able to avoid conversations about long term health with family is gone. We need to have a more educated populace and one that is willing to acknowledge these inevitable issues.

 

I also believe that "we" (rhetorical we) need to stay better informed about technological advances in medicine. The book I am using this year for science, Science Matters, addresses the need for us to have an understanding about how scientific advances affect our day-to-day lives.

 

I believe the better understanding we have about these issues, the more informed choices we can make about the direction of our personal health care.

[Plucky]

I think it is useful to separate this into two issues: (1) What should I do for myself? and (2) What should society do?

 

Let me start with (2). I do not think that any govt program should provide anything more than pain relief, hospice, and very basic care for anyone 10+ years beyond the normal life expectancy. So if you want care beyond that, you should plan and budget for it in advance.

 

And then (1): you should do whatever you want. And I should do whatever I want. And we should honor each other's decisions. (And we should all make our wishes known in writing so that our families don't fight about what to do!) As for me personally, I have no desire whatsoever to have heroic medicine when I am very elderly. In fact, I'd be pretty mad if someone kept me from God's realm when I'm naturally ready to head there!

 

I don't think people should be limited by their age, so being 10+ years older than the average life span doesn't change things for me. I think some very elderly people can still be vibrant, clear thinking, and full of life. We may think very differently on the subject of aging once we've experienced it. The elderly receiving Medicare sure think their lives are worth living.

[Stacy in NJ]

These are decisions for the individual, their family, and their physician. As a society we have no right to interject ourselves into these personnal choices. This is why a government funded and managed national healthcare program is a non-starter for me.

[Plucky]

These are decisions for the individual, their family, and their physician. As a society we have no right to interject ourselves into these personnal choices. This is why a government funded and managed national healthcare program is a non-starter for me.

 

Well said as usual.

[tricia]

IMOP only. We need not forget who exactly IS in charge here. God or man? Regardless of what meds are given, etc, etc, etc.

[Julie in Austin]

I don't think people should be limited by their age, so being 10+ years older than the average life span doesn't change things for me. I think some very elderly people can still be vibrant, clear thinking, and full of life. We may think very differently on the subject of aging once we've experienced it. The elderly receiving Medicare sure think their lives are worth living.

 

If someone wants surgery at 102, I'm fine with that, but I don't think the govt should pay for it.

[Plucky]

If someone wants surgery at 102, I'm fine with that, but I don't think the govt should pay for it.

 

102 does seem pretty old for surgery. Doesn't the ability to heal at that age really diminish? I'd have to know more. I'd probably still fall back on the doctors recommendation.

[Pamela H in Texas]

Tina, the desire to live forever is natural for us. We weren't created to die. Death is a punishment to emphasize we cannot do it on our own or under satan, that we need God. It's temporary though as those who have died will soon be resurrected and there will soon be a world full of people who never have to die.

 

Anyway, I'm not preaching, I promise. The point is that I SO can understand why man keeps TRYING to push more and more in order to live longer and better and even longer still. It is deep down in our nature.

 

As for when is enough enough? I don't know. Obviously some things should be abstained from if it's against something God has said or if consciences are bothered based on His principles. Past that? I really just don't know. I can definitely see the concerns as the individual. I don't want healthcare limited or cut off due to my situation or age or whatever. And I definitely can see the concerns of the group of people who are paying. And then of course there are those effected (the person's immediate family, the next generations of taxpayers, etc).

 

So then I just hang on to my faith, to a time of abundant peace, when no one will say "I am sick," no pain or death.

[Laura Corin]

I've told this story before, but I have a friend who worked on cancer policy for the British government. She researched the number of 'lines' of treatment offered by different health systems all over the world. The US offered by far the most, but she had to wonder at what cost. By the time you have already tried so many kinds of treatment which have failed, the likelihood of success is vanishingly small. Of course, that 'case' is a real person with real loved ones. But at what point does continued treatment become an abuse rather than a blessing.

 

My father died of cancer. He had had a couple of standard treatments, then was part of an experimental study when the initial treatments started to fail. He had previously survived another cancer and a heart bypass. When the experimental treatment didn't work any longer, he decided that the time had come to stop.

 

Laura

[2cents]

I have wondered the same thing but when I think of this debate, I look at it like this: If we impose limitations on what someone deems extreme measures then where does the line get drawn. Society risks defining where that line should be drawn. When (not if) the insurance companies weigh in then you will have them making longevity decisions. It may be expensive in terms of money the way things are now but the alternative could present horrible consequences IMO.

[Cera]

I think it is useful to separate this into two issues: (1) What should I do for myself? and (2) What should society do?

 

Let me start with (2). I do not think that any govt program should provide anything more than pain relief, hospice, and very basic care for anyone 10+ years beyond the normal life expectancy. So if you want care beyond that, you should plan and budget for it in advance.

 

I think this is impossibly simplistic. In our family it isn't uncommon for the women to live independently to 100, with very little intervention. People in my best friend's family are generally lucky to make it to 60 without major interventions.

 

I do believe there need to be some ethical guidelines in place for doctors to guide patients but I also am not ready to agree to what would basically be state mandated euthanasia. Something has to change because we (as a nation) have finite resources to use for health care and no guidelines for using them at this point.

 

I also find it interesting that those who want to die are not allowed to (a recent quadriplegics case, he had to sue for the right to refuse life saving medical treatment). I see no reason why someone who does not want to be treated should be.

[Plucky]

I've told this story before, but I have a friend who worked on cancer policy for the British government. She researched the number of 'lines' of treatment offered by different health systems all over the world. The US offered by far the most, but she had to wonder at what cost. By the time you have already tried so many kinds of treatment which have failed, the likelihood of success is vanishingly small. Of course, that 'case' is a real person with real loved ones. But at what point does continued treatment become an abuse rather than a blessing.

 

 

Laura

 

I still think it should be up to the individual. I worry more about a government program that looks at numbers of lines and thinks of money over the desire of a person to live. Yes, in the US we want to live longer. We are a fight to the death people.

Edited August 15, 2009 by True Blue

[Mrs Mungo]

I don't think for a minute that end of life counseling=a death panel making decisions for you.

 

A dear friend of mine had a sister-in-law with ovarian cancer. It was stage 3 before they found it. The SIL was a nurse, young and had a young daughter. She wanted to fight for every minute of her life with her daughter even though she was going to die, no matter what they did. Even when they told her "it will be much easier to die this way than for us to do surgery and you to go on and be in more pain when you die." But she wanted to fight and because she knew the doctors, they helped her fight as long as she could and longer than they would have let most people.

 

My grandfather had a series of strokes that left him basically completely incapacitated for years and years and years. My uncle didn't believe in letting anyone die and had then do surgeries, put in a feeding tube, treat illnesses, even when the doctors said "if this was my father I would not treat this and let him go." I think that's a cruel way to live and I would never want that for myself.

 

Every story is personal. Every story is different. Counselling people on what is to come and what options they have is honest and right.

[Shelly in IL]

What about the younger people who refuse medical treatment and the government forces it upon them? I"m thinking of the teenager who was recently forced to undergo some treatments that his religion made him want to resist. Do you think they should be forced to conform?

[Julie in Austin]

. . . .but I also am not ready to agree to what would basically be state mandated euthanasia.

 

Not wanting to argue but just to be completely clear on my own position: I absolutely do not support state mandated euthanasia. All I said in my first comment was that if someone is 10+ life expectancy, then care paid for by the govt should be extremely limited (no surgery, chemo, etc.). If you want more than that, well, you've had an entire lifetime plus nine years to make arrangements to pay for it yourself.

[Plucky]

I don't think for a minute that end of life counseling=a death panel making decisions for you.

 

A dear friend of mine had a sister-in-law with ovarian cancer. It was stage 3 before they found it. The SIL was a nurse, young and had a young daughter. She wanted to fight for every minute of her life with her daughter even though she was going to die, no matter what they did. Even when they told her "it will be much easier to die this way than for us to do surgery and you to go on and be in more pain when you die." But she wanted to fight and because she knew the doctors, they helped her fight as long as she could and longer than they would have let most people.

 

My grandfather had a series of strokes that left him basically completely incapacitated for years and years and years. My uncle didn't believe in letting anyone die and had then do surgeries, put in a feeding tube, treat illnesses, even when the doctors said "if this was my father I would not treat this and let him go." I think that's a cruel way to live and I would never want that for myself.

 

Every story is personal. Every story is different. Counselling people on what is to come and what options they have is honest and right.

 

I saw this happen with my sister. My mother cared for her and did everything in her power to extend her life past what I thought was reasonable. I was surprised because my mom is a nurse. My mother simply wasn't able to let her go. My sister was heavily medicated and unconcious at the time. Hospice supported my mother because it wasn't just about my sister either, my mom was suffering. It was heartbreaking.

[Peek a Boo]

If I'm going to make what might end up being an irresponsible decision, I'd rather err on the side of life.

Period.

[Plucky]

What about the younger people who refuse medical treatment and the government forces it upon them? I"m thinking of the teenager who was recently forced to undergo some treatments that his religion made him want to resist. Do you think they should be forced to conform?

 

Good question. I don't know. I don't think I could make those kind of decisions for others.

[Lovedtodeath]

What about the younger people who refuse medical treatment and the government forces it upon them? I"m thinking of the teenager who was recently forced to undergo some treatments that his religion made him want to resist. Do you think they should be forced to conform?

I think that anyone should have a right to decide for themselves what medical treatments to refuse, in any case. I think when it becomes controversial is when parents refuse medical care for very young children.

 

If someone is refusing medical treatment due to religious belief then forcing the treatment on them is the same as r*pe. And yes. I do know that. I have been through both.

Edited August 15, 2009 by Lovedtodeath

[Cera]

Not wanting to argue but just to be completely clear on my own position: I absolutely do not support state mandated euthanasia. All I said in my first comment was that if someone is 10+ life expectancy, then care paid for by the govt should be extremely limited (no surgery, chemo, etc.). If you want more than that, well, you've had an entire lifetime plus nine years to make arrangements to pay for it yourself.

 

 

My point was that if the government is withholding care it is not all that different from actively ending lives (yes, it's passive not active but for those who do not have the means to obtain their own care it would be the same thing).

 

I do agree with you to a degree as far as saving up to afford your own care but I am also realistic enough to know that it truly isn't possible for all people. Requiring that people fund their own care after a certain age would lead down the road of two separate life expectancies, one for the wealthy and one for the poor. I'm not a huge fan of social services (poorly administered and overused) but I am willing to pay in a bit to not have the death of other people directly on my comfortably middle class shoulders.

[Carol in Cal.]

...had a stent put in at age 82. He heard on the radio that in Britain they won't give you a stent after age 59. Ridiculous! He is vigorous and otherwise healthy and productive. To let him die would have been horribly wrong. And even if he was not vigorous, healthy, and productive, he would still be a person, deserving of dignity and care. Deserving to make these decisions himself.

 

I believe that these decisions should be up to the patients, not the government or insurance companies. And, having seen how the income tax implementation became a slippery slope to very high taxes, I am very sensitive to ANYTHING that gets the camel's nose of rationing health care or taking away patient choice into the tent that is cost containment. No, no, and no.

[Laura Corin]

...had a stent put in at age 82. He heard on the radio that in Britain they won't give you a stent after age 59.

 

This article talks about some of the misinformation. The Telegraph is a main stream, right wing (in UK terms) newspaper.

 

Laura

[Carol in Cal.]

This article talks about some of the misinformation. The Telegraph is a main stream, right wing (in UK terms) newspaper.

 

Laura

 

See, this is why I have not participated in the health care threads. I agree, there is a lot of misinformation floating around.

 

The specific quote I mentioned was from someone that said that they specifically were from England and that this is the policy there. That's why I thought it was credible. If it's not true in fact, I do apologize. I much prefer to add light than heat to this kind of conversation.

 

Either way, though, my concern with rationing by the government or insurance companies is still serious and the basis for my views. I think that in these kinds of circumstances, there is a high likelihood 'just a little' rationing to start with, and then a gradual increase to levels that had been unthinkable before. That's why I oppose decision making by those other than the patient, although informed decision making should be enabled.

[Laura Corin]

See, this is why I have not participated in the health care threads. I agree, there is a lot of misinformation floating around.

 

 

My favourite one this week was the idea that Stephen Hawking would not have been considered worth treating under the NHS, whereas of course he actually lives in the UK and had extensive treatment for a chest infection this year.

 

Laura

[katemary63]

I don't think people should be limited by their age, so being 10+ years older than the average life span doesn't change things for me. I think some very elderly people can still be vibrant, clear thinking, and full of life.

 

:iagree: Absolutely! I could never go along with a "rule" or law that stated an age as the cutoff for certain types of treatment or care.

[Mommyof4ks]

I think these decisions should be left up to the patients. My grandmother had a pacemaker put in in her early 70s, a stint just a few months ago at 79, and she still takes care of 'old people' (her words). She still has plenty of fight in her, but when she makes it clear that she is done then that should be honored.

 

For those with cancer or chronic conditions even if they end up losing their own fight with the disease, they could help others in the future through the discoveries that docs have made during their treatment. My son is alive today because in the mid 1900s docs started experimenting on kids with leukemia to find a treatment. They had no idea that 50 years later 80% of the kids who were diagnosed with it would live 5 years after diagnosis let alone some of them would grow up and have families of their own (with no higher risk as far as it is know that their kids will have cancer). In my parents' lifetime this one disease went from a death sentence to 'the good cancer' (not my words, but the way it is perceived).

 

Without 'heroic medicine' we lose advancements. If we miss treating grandma at 80, then we may miss an opportunity to learn something that may save our 40 yr old spouse in the future.

[HRAAB]

I value all human life. My 91 yr. old fil's life is just a valuable as my 51 yr. old dh's life. My sil's life, who was profoundly handicapped (Down's Syndrome), was just a valuable as my life. It's impossible for me to somehow rate or chart the value of life based on some set of qualities that human's decide are most important. From the moment of conception until natural death all life is worth fighting for. Still, I think we many times we try to pull out all the stops to prevent death - at a huge cost, financial and emotional - when in the end death will be the victor. I'm not willing to tell someone else when that moment is, nor do I want anyone telling me when to stop fighting. That's a very personal decision that should be left up to the person involved (done prior to incapacitating illness), family, minister/priest, etc. I would rather try more than not do anything, but at some point I'm willing to admit that death is the natural end of life. I've been through this with both my mother and father. Never easy.

 

Janet

[Quad Shot Academy]

Will our society get to a point where most of our bodies are either being manipulated by medication or simply replaced with artificial parts? When is enough, enough?

 

My grandma lived to 90 w/o any medical intervention or medication. She always said that she was ready to go when the good Lord called and would not go to any extreme measures to elongate her life. She had a heart attack 6 months ago and the doctors told her that she was a decade too old for the standard treatment of an angiogram and a pace maker. For months she suffered horribly with edema so bad that her skin actually split open and lungs so full of fluid that she could not breathe or lie down. In desperation she begged for any medical treatment that would ease her suffering. The doctors put in a pace maker, bringing her heart rate from 45 to 65. 3 days later she went home, 2 weeks later she was out and about garage sale shopping and having fun. She did not get the pace maker to elongate her life, but to make it bearable. Now at 91 she is bed ridden, under the care of hospice and miserable, but at least she can lie down and she has no edema. It is one thing to make decisions ahead of time, or on paper, but you truly never know what will happen and what options you will want. I am so thankful for the doctors that were able to by-step standard protocol and use their good judgement to let her have the risk of dying on the table vs suffering like that for many more months.

[EKS]

You know, I think this is an incredibly important issue, one that is not given enough consideration in our society.

 

My FIL, who was 85, was diagnosed with kidney cancer then lung cancer. Both of these diagnoses were as the result of full body scans to figure out why he was having vision problems. He saw one oncologist who recommended that he forgo treatment because at his age it would result in more misery than cure. My FIL was very offended by this idea and sought additional opinions. He ended up doing chemotherapy that had horrific side effects. Twice. The second time shut down his kidneys. He died a few months later.

 

His vision issue, the entire problem to begin with, was actually the result of Parkinson's disease. Once his Parkinson's was treated properly, the vision problem went away.

 

I believe that if his Parkinson's had been properly diagnosed and treated *and* if he had refused treatment for the cancer that he had absolutely no symptoms for, he would still be alive today.

 

Even if this were not the case, I believe that the end of his life would have been much less tragic without the chemo.

 

BUT

 

My best friend, when she was 34 was diagnosed with metastatic breast cancer. Her daughter was 2 years old at the time. She pulled out all the stops, did everything her doctors recommended and managed to live for five years. Then it spread to her brain. They did every last medical intervention known but she died at age 39 and her daughter was 8.

 

This is an example of a situation where I believe it was totally appropriate to extend life as long as possible.

 

A very big issue in my friend's life was the fact that she was the sole wage earner in her family when she was diagnosed. Her husband, who was in school, had to get a job to pay for COBRA. Thank goodness she didn't outlive her COBRA benefits as she was uninsurable otherwise. A huge portion of her husband's wages went to paying the COBRA just for her.

 

The whole health insurance thing makes me sick. Anyone who is against a public option should be forced to deal with buying insurance for their family on the open market.

Edited August 15, 2009 by EKS

[Peek a Boo]

The whole health insurance thing makes me sick. Anyone who is against a public option should be forced to deal with buying insurance for their family on the open market.

 

many do.

many would also WELCOME the opportunity to do that if the health insurance would STOP being tied to a JOB.

 

I think that people who are disgusted with the current health insurance issues should band together and pool THEIR resources to address those concerns. i might even decide to join.

[EKS]

many do.

many would also WELCOME the opportunity to do that if the health insurance would STOP being tied to a JOB.

 

I think that people who are disgusted with the current health insurance issues should band together and pool THEIR resources to address those concerns. i might even decide to join.

 

Health insurance is *not* tied to a job. *Affordable* health insurance is tied to a job.

[johnandtinagilbert]

Health insurance is *not* tied to a job. *Affordable* health insurance is tied to a job.

Not necessarily affordable.

[johnandtinagilbert]

You know, I think this is an incredibly important issue, one that is not given enough consideration in our society.

 

My FIL, who was 85, was diagnosed with kidney cancer then lung cancer. Both of these diagnoses were as the result of full body scans to figure out why he was having vision problems. He saw one oncologist who recommended that he forgo treatment because at his age it would result in more misery than cure. My FIL was very offended by this idea and sought additional opinions. He ended up doing chemotherapy that had horrific side effects. Twice. The second time shut down his kidneys. He died a few months later.

 

His vision issue, the entire problem to begin with, was actually the result of Parkinson's disease. Once his Parkinson's was treated properly, the vision problem went away.

 

I believe that if his Parkinson's had been properly diagnosed and treated *and* if he had refused treatment for the cancer that he had absolutely no symptoms for, he would still be alive today.

 

Even if this were not the case, I believe that the end of his life would have been much less tragic without the chemo.

 

BUT

 

My best friend, when she was 34 was diagnosed with metastatic breast cancer. Her daughter was 2 years old at the time. She pulled out all the stops, did everything her doctors recommended and managed to live for five years. Then it spread to her brain. They did every last medical intervention known but she died at age 39 and her daughter was 8.

 

This is an example of a situation where I believe it was totally appropriate to extend life as long as possible.

 

A very big issue in my friend's life was the fact that she was the sole wage earner in her family when she was diagnosed. Her husband, who was in school, had to get a job to pay for COBRA. Thank goodness she didn't outlive her COBRA benefits as she was uninsurable otherwise. A huge portion of her husband's wages went to paying the COBRA just for her.

 

The whole health insurance thing makes me sick. Anyone who is against a public option should be forced to deal with buying insurance for their family on the open market.

:grouphug: I am sorry for your loss. I thank you for honestly addressing this. I agree with your assessment. I think 85 is a grand old age, not that I would choose him to die, but such drastic measures *for me* at that age would not be appropriate. Your friend, however, is young with small children, I'd pull out all the stops too!

[EKS]

Not necessarily affordable.

 

Exactly!

 

But insurance on the open market is even less so. If you can get it at all.

[Peek a Boo]

Health insurance is *not* tied to a job. *Affordable* health insurance is tied to a job.

 

a LOT of health insurance IS tied to a job --so much so that it is practically expected as a benefit. And now insisted upon as a right.

 

part of what makes insurance NOT affordable is an excessive amount of legislative, gvt, and lawsuit intrusions --a contaminated industry. We need to tackle those problems before trying to make a batch of spoiled milk be mandatory for everyone.

[TXMary2]

If someone wants surgery at 102, I'm fine with that, but I don't think the govt should pay for it.

 

 

I don't think the government should pay for lots of things, but if the 102 yo has insurance they deserve the surgery in exchange for their premiums.

[Julie in Austin]

I don't think the government should pay for lots of things, but if the 102 yo has insurance they deserve the surgery in exchange for their premiums.

 

Just to be clear, that's 100% my position.

[Carol in Cal.]

This article talks about some of the misinformation. The Telegraph is a main stream, right wing (in UK terms) newspaper.

 

Laura

 

And here it is:

 

"We don't put a limit on the amount the NHS can spend on an individual," said Andrew Dillon, the chief executive of the National Institute for Health and Clinical Excellence (Nice), the Government's drugs rationing body. "The basis of Nice's system of appraising drugs and other treatments is simple: something will be recommended for use if the benefits to patients are worth what the NHS is being asked to pay."

 

Who decides here whether the benefits are 'worth it'? The NICE drugs' rationing body. This is where the camel's nose is in the tent after all, IMV. This should be the decision of the patient with her doctor, not of some other entity that assesses 'worth'.

 

And truly, I have seen this go down. I have a good health plan but one that is somewhat limited. Years ago I went to them for infertility treatments. They didn't even mention IVF. I exhausted all of their capabilities, knowing that ART and IVF were not covered, but expecting to be advised without regard to that fact. I was not. Finally I asked the doctor about it, and he jumped on it so hard that I had the distinct impression that he was not supposed to bring it up but had been hoping that I would do so so that he could respond very positively. He told me immediately that it was absolutely the best thing to pursue, that the specifics of my case were such that it was more than usually likely to work, though still not more likely than not, and that I should not wait. Well, I had BEEN waiting, for him to say something. What if I had not asked??? What if I had not informed myself? I might never have had my DD. In this case, he responded appropriately but IMO was not appropriately proactive, and knowing him, I think that he was limited by his organization. That's not right.

 

I suspect, further, that if we had the same conversation now, he would not even be allowed to encourage me to pursue something that was outside of their plan, let alone bring it up.

 

These are the chilling effects on the doctor patient relationship of limiting access to care.

 

In a system such as England's, how long would it be before doctors were simply not allowed or inclined to mention drugs or treatments that they are pretty sure would be too expensive to be approved?

 

Then again, I do think that we need a good public option. It is inhuman not to be able to get reasonably priced health insurance that covers everything between you and your doctor. We need a change. But the change has to safe guard the doctor/patient relationship and avoid rationing of care, or the cure could end up being as bad as the disease.

Edited August 16, 2009 by Carol in Cal.