Yes, we need “death panels”

This morning, my colleague Jay Bookman had a very thoughtful post on why rationing health care — “death panels,” if you will — is quite necessary. I wrote on a similar subject in my Sunday column.

If we keeping spending our health care dollars disproportionately on the elderly, we will have little left to spend on children. That makes for an upside-down society that cannot thrive for long.

I happen to think the entire column is worth reading, but if your time (and patience) are short, focus on the grafs in which my brother, a Boston kidney doc, talks about dialysis for the elderly who are already dying:

If resources are limited (and they are), the nation needs to make choices – some more painful than others. My brother, Kevin, a Boston physician who treats kidney disease, talks about the Medicare program that pays for dialysis for anyone with failing kidneys — including the terminally ill. Started in the 1970s to help adults still in the workforce, its fastest-growing population is now over 65, he said.  And it costs tens of billions a year.

“It may not be the best use of resources for the frail and infirm elderly, and it also forces many elderly patients to spend their last days in the hospital, rather than at home,” a more comfortable setting, Kevin told me.

Yet, many patients, even octogenarians who don’t expect to recover, find it difficult to turn down the treatment. “And physicians resist having a conversation with patients that recommends they forego dialysis because it’s an uncomfortable conversation to have. It’s easier just to recommend the treatment,” he said.

But those are exactly the adult conversations we ought to be having.

Those will undoubtedly be very painful conversations. But we simply don’t have the money to spend to prolong the life of a terminally ill 87-year-old for a few weeks.

234 comments Add your comment

Richard

April 20th, 2011
2:48 pm

I guess the simple question is who in the government is responsible for determining when to cut off the medicare.

Thulsa Doom

April 20th, 2011
2:53 pm

We knew it! After denying and denying it the Dems are finally admitting what they’ve been thinking all along. We need rationed health care and death panels. And to think its the Dems who are always scaring elderly people with nonsense that the repubs are going to take away all their soc security, medicare, etc.

MM

April 20th, 2011
3:03 pm

Every day, private insurance companies act as “death panels” but we ignore that reality largely because the media likes the titillating “big bad goverment” storyline. The private sector treatment decision is heavily biased by the profit motive while, in theory, the government treatment decision is subject to rules which originate from the people we elect to office. I would rather take my chances with a public sector decision; at least if that decision is not biased by a health system under the influence of industry lobbyists. Some choice, though.

Toby

April 20th, 2011
3:03 pm

Doom, you got anything constructive to say?

Del,

April 20th, 2011
3:03 pm

Cynthia believes that senior voters won’t back Obama, so she wants to kill them off.

Thulsa Doom

April 20th, 2011
3:04 pm

So who was that Democratic congressman in Florida who said on the House floor that the Republican’s health care plan for seniors was for seniors “to die”- was it Allen West? Can’t remember who but the irony of it all is just too funny. Yep. It looks pretty obvious that its the Dems whose plan it is for the seniors to “just die”. After denying and denying the truth finally comes out- they want the death panels. They really do.

Thulsa Doom

April 20th, 2011
3:06 pm

MM,

Here’s the difference that you are obviously not able to discern on your own. If you are denied care by a private plan you have several layers of appeals and then you have the court system. You have recourse. If the gubment denies you care who do you appeal to?

arnold

April 20th, 2011
3:08 pm

I agree withholding care on terminally ill patients. I am 71 and do not wish to waste my time and money on unnecessary care. Just keep me comfortable and as pain free as possible.

My sister recently passed away at age 60 from colon cancer. She tried chemo for about a year and came to the conclusion it wasn’t worth the side effects nor expense. Once a condition is terminal, to continue treating the illness is foolish and wasteful.

Shean

April 20th, 2011
3:11 pm

Tucker,

Why no mention of the barbaric HATE crime that occured this morning on Marta? 30 gutless African American savages nearly beat to death two white Delta emplyees.

Of course in expected fashion, you are silent.

Thulsa Doom

April 20th, 2011
3:12 pm

Toby,

Actually I do have something constructive to say. Let’s take a look at claim denial/claim rejection rates. Guess who leads the pack? Yep. Medicare! And to think some of you guys actually think you’re better off getting your claim or treatment approved by the gubment. Better think again.

Libs will inevitably state that private plans can simply choose not to pay for expensive treatments. I call baloney on that. In a recent study last year health plans denied claims on an average of 2-3%. United denied payment for 2.5% of all claims, Humana 2.88%, Coventry 2.88%, Cigna 3.44% and Aetna was way out of whack at 6.8% of all claims denied.

So who was higher than all of them? That’s right. Medicare at 6.85% claim denial rate.

Del,

April 20th, 2011
3:13 pm

The libs exaggerate insurance company profits, while ignoring the power that doc’s have in dealing with insurers and securing covered treatments for their patients. They have many ways to get around insurance company objections. Factor in the appeals and legal recourse options that T.D. points out and the private sector is far better than government.

derer

April 20th, 2011
3:13 pm

So those “compassionate” libs Bookman and Tucker both favor murdering babies and the elderly. Not the least bit surprising.

Dr. Pangloss

April 20th, 2011
3:17 pm

In some states we already have death panels. In Texas, for instance, the hospital can pull the proverbial plug, regardless of the family’s wishes, if the hospital ethics board decides that it’s a hopeless case. That’s in a very red state.

Del,

April 20th, 2011
3:18 pm

“My sister recently passed away at age 60 from colon cancer. She tried chemo for about a year and came to the conclusion it wasn’t worth the side effects nor expense.”

Sorry for your loss. Your story, however, is an example of why death panels aren’t necessary. Most terminally ill patients like your sister make the correct decision on their own.

Thulsa Doom

April 20th, 2011
3:21 pm

So what was that that keep up the good fight, Jay Bookman, and the other libs were saying the other day about MARTA doesn’t bring any crime with it? What was that we were talking yesterday about hate crimes? Funny that the 2 white men were attacked by the mob but the other passengers were not harmed. Wonder why that is? Think these thugs will be charged with a hate crime? Somehow I seriously doubt it. Just like I doubt that Cynthia or Jay will write about it.

Roughly two dozen teens, reportedly chanting the name of an Atlanta gang, invaded a MARTA train early Sunday morning, beating and robbing two Delta flight attendants.

The train’s other passengers, overwhelmed by the aggressive youths — believed to range in age from 13 to 18 — watched the attacks unfold.

“There was blood everywhere, people were hollering and screaming,” a witness told Channel 2 Action News. “We were intimidated. People were terrified. People were trying to run. But there was nowhere to run.”

Flight attendant Parker Stanea, 28, told officers a diminutive black male, no taller than 5′4″, emerged from the pack of teens to hit him over the left eye with a soda can. Stanea was pushed to the ground by the other youths and his wallet, stolen.

His friend, Jose Souza, said he was assaulted by the same suspect, according to the MARTA police incident report. The pink-clad teen punched him in the lip, the 24-year-old Delta employee said, but before they could take anything two unidentified male passengers intervened.

Meanwhile, witnesses said they heard the youths chanting “B.P.F.L,” an Atlanta gang that appears to have established a presence within Zone 3 on the south side. They departed the train at the Oakland City station.

you dont say?

April 20th, 2011
3:22 pm

So after decades of the kooks lying to voters about how it is really Repubs that want kill off the elderly they are finally coming clean.

So we can now officially add old people to the DNC hit list. Make room babies, Christians, educated whites, educated blacks, educated hispanics, Jews, Pro lifers and capitalists!!

bogart

April 20th, 2011
3:25 pm

@ Shean

Dont you know? There is no such thing as hate crimes against the white man. Cynithia would be the first to explain.

Thulsa Doom

April 20th, 2011
3:27 pm

Del,

You’re right. Most patients and their families do reach the conclusion on their own that its just misery and a wasted expense to prolong the inevitable and they make the decision of their own accord. My best friend’s family had to pull the plug on his grandmother several years back. It seemed cruel to my friend at the time because by pulling the plug his brain dead granny’s body would starve to death from dehydration and lack of food. But his mother a nurse told him that it was painless to his granny and the natural way to die. Being a nurse she realized the obvious expense and needlessness of keeping her body alive. She was a lovely ole lady and died at 93.

Bob

April 20th, 2011
3:30 pm

I can not believe it. Mark it down somewhere. The liberals that vilified Sarah Palin when she stated that death panels were coming are saying she was right. And don’t forget Alan Grayson on the floor of the House stating that Republicans want old people to die. HYPOCRITES!

quartz

April 20th, 2011
3:32 pm

Zen

The only other white witness that was able to hide said it looked like an episode of something on Animal Planet.

Go figure.

Really last word

April 20th, 2011
3:35 pm

Cynthia Tucker . . when will you learn that everything in life is NOT apportioned equally! Children do not need the health care dollars that elderly people need . . . that is common sense! And, one day those children will become elderly!! The NEEDS of children are great if you consider ALL of their needs . . . the cost of education, the cost of health care, the cost of food and a roof over their heads!! Why education alone is enormous!! And, as I age I still (even though my children are adults) pay for education on my property taxes!!! In other words I’m paying for children’s education and I don’t have any children in school!!!
And for “MM” ~~ you post ” The private sector treatment decision is heavily biased by the profit motive while, in theory, the government treatment decision is subject to rules which originate from the people we elect to office” You are wrong . . the private sector treatment decision is based on keeping premiums low so people can afford health care . . they do so by using panels of “doctors” to review treatment and procedures (which by the way have to be approved by FDA and Medicare; no experimental treatment and procedures). I would rather have them deciding my treatment than a bunch of bureacratic dimwits who can’t come together for the good of this country because they are too worried about the next election!

Really last word

April 20th, 2011
3:38 pm

Bogart . . it might not be called “hate” against whites but that is exactly what it is!! All you have to do is read a few opinions written by certain journalist on the AJG website to know there is “hate” for the whites!!

Tommy Maddox

April 20th, 2011
3:38 pm

Now this IS the tip-top of hypocrisy. Shame on you and your cohorts on the Left.

L.Phillips

April 20th, 2011
3:57 pm

In other words:Genocide for all he elderly.
Medical personnel are already practicing this. I have been told several times that “at your age we are not going to do
anything about it “. My age is 84 and I am a functional individual in my community.
Your doctor appointments do little to assure good health. I have been going to my present G.P. for six years and he has of yet to do no more than lift my shirt and listen to my heart and lungs.
It is another example of the “me” society for which we can be blamed for giving our children more than we had etc.

ctucker

April 20th, 2011
4:01 pm

L. Phillips@3:57, If your response is “genocide for all the elderly,” that demonstrates why these conversations are so difficult for physicians and politicians

ctucker

April 20th, 2011
4:02 pm

Bob@3:30, I’m pretty sure you didn’t read my post. There is nothing in it about kids with Down’s Syndrome, which is what Palin was talking about it

ctucker

April 20th, 2011
4:03 pm

Del@3:18, Some do, some don’t. The patient may be ready to say “no extraordinary measures,” but their family members often persuade them to do otherwise.

ctucker

April 20th, 2011
4:04 pm

Dr. Pangloss@3:17, That’s true in many places.

detritusUSA

April 20th, 2011
4:09 pm

It’s really easy to talk of rationing health care when you’re relatively young and have enough money to afford treatment for whatever disease you may contract. Maybe, also, you’ve never had to honor the Living Will of a parent or other loved one and tell the doctor: Let them die. Even knowing that is the wish of a loved one, and that modern medicine could keep them here a while longer the action is about as devastating as it can get.

So before you equate life and longevity with a dollar bill, remember you are going to die also, and death is forever. And all those dollar bills in your bank account won’t go with you.

Apparently, capitalism and compassion are antonyms.

Joe

April 20th, 2011
4:09 pm

What about the young thugs crowding our penal system? Why should we give them free healthcare and not law abiding elderly folks who worked hard and obeyed the law their whole life????

jt

April 20th, 2011
4:11 pm

After the Federal government takes over every aspect of our life and the U.S. becomes a progressive paradise………the Death panel conundrum will solve itself.

Who would want to live in a Progressive paradise?

Driving silly cars/mopeds, nothing but NPR,Obama or Barbara Streisand on the radio, eating tasteless no-fat food, only soccer for sports and no cigarettes.

There will be a line at the nearest Death Panel.

Joe

April 20th, 2011
4:13 pm

I hope your readership picks up Tucker. I get a good laugh out of you lefty loons and wouldn’t want you to lose your job. By the way.. People like you help get Republicans elected almost every year…. Just think.. You can actually take some credit in making Georgia a bright red state…..

Rufus

April 20th, 2011
4:13 pm

Well, Cynthia, who do will the president appoint to play the role of God. Oops! God is a non-entity with you.

Scooter (The Original)

April 20th, 2011
4:17 pm

“If we keeping spending our health care dollars disproportionately on the elderly, we will have little left to spend on children.”

I believe people can spend THEIR money on whatever they want and they should allow me the same freedom and liberty. CT obviously believes theft is alright as long as it is through the ballot box and she is a net receiver, most liberals do.

Robin

April 20th, 2011
4:22 pm

Having family member who have worked in the health care industry specializing in older adult care, I can understand the sentiment expressed by Ms. Tucker. The difficulty is that this is not a question that the health care system can tackle. Quality of life (and death) are topics we should discuss with our family frequently, not just at times of crisis. It’s OK to say you want to die in peace with your family surrounding you at home, and it’s OK to grant this wish to your loved one. We feel like we’re not “good enough” children unless we fight for every last medical treatment, but sometimes allowing your loved ones to die with dignity is the best gift we can give our parents.

Fed-Up

April 20th, 2011
4:22 pm

Let me get this straight Cynthia. We should deny healthcare to those who fought for and who helped build this country. Most of these elderly who you want to deny have paid into the system for decades and decades. Yet you are all for providing healthcare to people who have no business even being in this country and to the low life leeches who spend their entire lives draining the system and sucking the life out of this once great nation.

Fed-Up

April 20th, 2011
4:24 pm

“If resources are limited (and they are), the nation needs to make choices – some more painful than others”. Exactly ! At the top of this list should be deporting those who are here illegally in order to stop them from draining the billions and billions that they “Take” illegally from the taxpayers in this country. 2nd on the list needs to be a 6 month maximum for any and all healthy welfare collectors.

Lil' Barry Bailout

April 20th, 2011
4:32 pm

Libbtards denied there were Death Panels in Obozocare when they needed to bash Sarah Palin, but now that their fascist dream has become law, they’re free to admit that they will exist, and they even cheerlead for them.

Whatever it takes to remain orally attached to their Idiot Messiah’s crank, they’ll do.

sambo

April 20th, 2011
4:32 pm

You’re playing the adult conversation card? Killing people off because they are useless to you now and a drain?

You are dangerously stupid.

Tundra Dude

April 20th, 2011
4:40 pm

ctucker@4:01 wrote:

L. Phillips@3:57, If your response is “genocide for all the elderly,” that demonstrates why these conversations are so difficult for physicians and politicians

I’d guess it’s also difficult for a ME ($$medical entrepreneur$$) to turn down all this EZ money, especially if working in a for-profit hospital that pays “performance ” bonuses.

Also difficult for our contribution-dependent political class to propose changes which might adversely effect the bottom line of various segments of the medical industry.

The Real problem is, the Hippocratic Oath and the $$Profit Motive$$ are a poor mixture.

Alatsea

April 20th, 2011
4:41 pm

If you can’t afford the expenses involved with raising a child don’t have any. Your article just feeds more entitlement to people that have lived on it for generations. You are one sickbitch CT

Fed-Up

April 20th, 2011
4:44 pm

“Those will undoubtedly be very painful conversations. But we simply don’t have the money to spend to prolong the “…..the laziness and ignorance of the average loser who spends their lives on the government dole. You will no longer be rewarded for bringing additional leeches into the world and you’re complete lack of self respect and ambition will now cause you to starve unless you get off of your lazy #% and go to work.

Lil' Barry Bailout

April 20th, 2011
4:46 pm

This morning, my colleague Jay Bookman had a very thoughtful post on why rationing health care — “death panels,” if you will — is quite necessary.
—————-

Rationing isn’t necessary. Rationing is what the government does when it has a fixed amount of money to spend and a parasite constituency demanding more health care than can be paid for with that fixed amount.

Health insurance companies don’t ration–they cover every procedure they’ve committed to in their contract.

Tundra Dude

April 20th, 2011
4:55 pm

Thulsa Doom@3:12 wrote, in part:

Actually I do have something constructive to say. Let’s take a look at claim denial/claim rejection rates.

(the rest of his comment snipped, tossed into garbage)
Nice piece of work tho, considering only a few states require submitting denial rates.
Obviously this “study” was done by AHIP or one of their ($$corporate-dependent$$) think tanks.

Sorry, but I rather trust the integrity of the Calif. Nurses Ass’n. (CNA)

Claims denial rates by leading California insurers, second half of 2009,
compared to the first six months of 2009:

• PacifiCare — 41.17% (up from 39.6 % ,the first six mos of 09)
• Cigna – 35.43 % (up from 32.7 %)
• HealthNet – 25.82 % (down from 30 %)
• Kaiser Permanente – 26.96 % (down from 28.3 %)
• Anthem Blue Cross – 24.5 % (down from 27.9 %)
• Aetna — 6.4 % (no change)
• Blue Shield – 22 % (Blue Shield had previously not reported separate denial data, and only began reporting after the media reports on denials)

“What we see over and over is an arrogant industry that is indifferent to the pain and suffering caused by routine care denials or economic catastrophe prompted by outrageous price gouging,” said CNA/NNOC Co-President Geri Jenkins.

Richard

April 20th, 2011
4:58 pm

Allow me to quote Lewis Black:
“The way is works is a Democrat stands up and yells “I GOT A REALLY BAD IDEA.” To which the Republican says: “AND I CAN MAKE IT SPITTIER!”"

frans ferdinand

April 20th, 2011
4:58 pm

golf clap for the fundamentalist christians’ who refuse treatment for their dying children. talk about taking one for the team.

Fed-Up

April 20th, 2011
5:05 pm

Golf clap to the millions of liberal scum who produce children for the sole purpose of increasing their monthly government check. I think that they far outnumber the few loonies who deny their kids medical coverage for religious purposes.

Really last word

April 20th, 2011
5:06 pm

You tell it like it is “Fed Up” . . . I agree w/you wholeheartedly!!!

frans ferdinand

April 20th, 2011
5:07 pm

fed,

I’m serious. If more christians’ were true believers’ and put it all in God’s hands-the healthcare debacle would resolve itself. Amen.

Fed-Up

April 20th, 2011
5:10 pm

Frans,
If more liberal politicians truly cared more about the downtrodden in this country and less about buying votes…we would have a lot fewer downtrodden and this country would be flush with cash. A liberal politicians worst nightmare is a well educated working class.