OrthodoxyToday.org | Wesley J. Smith | Mar. 1, 2009
Imagine that you have lung cancer. It has been in remission, but tests show the cancer has returned and is likely to be terminal. Still, there is some hope. Chemotherapy could extend your life, if not save it. You ask to begin treatment. But you soon receive more devastating news. A letter from the government informs you that the cost of chemotherapy is deemed an unjustified expense for the limited extra time it would provide. However, the government is not without compassion. You are informed that whenever you are ready, it will gladly pay for your assisted suicide.
Think that’s an alarmist scenario to scare you away from supporting “death with dignity”? Wrong. That is exactly what happened last year to two cancer patients in Oregon, where assisted suicide is legal.
Barbara Wagner had recurrent lung cancer and Randy Stroup had prostate cancer. Both were on Medicaid, the state’s health insurance plan for the poor that, like some NHS services, is rationed. The state denied both treatment, but told them it would pay for their assisted suicide. “It dropped my chin to the floor,” Stroup told the media. “[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?” (Wagner eventually received free medication from the drug manufacturer. She has since died. The denial of chemotherapy to Stroup was reversed on appeal after his story hit the media.)
Despite Wagner and Stroup’s cases, advocates continue to insist that Oregon proves assisted suicide can be legalised with no abuses. But the more one learns about the actual experience, the shakier such assurances become.
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First, you’re just as likely to get a denial letter from an insurance company as you are from a State Medicaid program. In this case the drug in question was both expensive and highly unlikely to do any good:
“Research indicates that 8 percent of advanced lung cancers respond to Tarceva, with a chance to extend life from an average of 4 months to 6 months. The likelihood of no response to the drug is 92 percent, yet 19 percent of patients develop toxic side effects like diarrhea and rash. Based on the low indicators of effectiveness, Oregon Health Plan denied coverage.”
Not surprisingly, the lady died shortly after starting the drug.
Not mentioned (of course) in this article, the denial letter also included many other options that the State would pay for including “hospice, medical equipment, palliative services and state-of-the-art pain and symptom management.”
While mentioning the State assisted-suicide program in the denial letter was certainly clumsy and inappropriate, at no time was the lady pressured to take advantage of the program. It is simply one option.
And for all those who revile “socialized medicine,” note that without the Oregon Health Plan the lady would likely have had no health care at all.
All health care is rationed now, mostly be one’s ability to pay. He who pays gets to decide how much and for what the money is used. The only question that ever seems to come up is who pays. The whole philosophical underpinnings of the treatment are most often ignored. The debate is conducted solely on the basis of rights. Rights require government to enforce otherwise they are merely emotional and philosophical constructs.
Our understanding of rights comes from a decidedly unChristian understanding of who we are as human beings and how we are made to interact with one another. Rights are a deist/humanist construct designed to replace the need for actual communion with God.
Medicine today tends to be founded on the wrong belief that human beings are solely biomechanical. Again, there is no need for God or the mystery of man’s being because if we just work hard enough, we’ll be able to understand how everything works and how to prevent or cure all disease or injury. Not true.
The solution does not lie in manufacturing a new mega-system that will bank roll us all nor does it lie in ‘letting the market’ decide. Both solutions are inherently anti-human.
Mr. Bauman, if both a new government-run system that attempts to bankroll health care for everyone (which is impossible without the government dictating who gets what care to reduce costs) and letting the market effect rationing are both inherently anti-human, what system of health care distribution would be morally acceptable?
Not all markets are the same. Industrialized medical care even in capitalist mode puts simple monetary cost above acutal patient outcome and maximizes markets for treatments that most people will consume, i.e, Viagra, cosmetic surgery that is not medically necessary, abortions. It has been well known for a long time, I remember a conversation with a professional hosptial administrator in Boston about 30 years ago, that the optimum size of care facilities for patient care was inefficient from a monetary stand point. The same thing afflicts us not only in health care but in just about every facet of our lives. We have to find a way that focused not just on monetary cost that balances genuine Christ centered ethics, human scale and a degree of micro-market capitalism. As Orthodox Christians we should look to the model of the Unmercenary Physicians . I know one modern unmercenary personally, and have heard of others who ‘retire’ from the system and still practice medicine asking for nothing from their patients although I’m sure they would not turn down a little old-fashion barter now and again. Just a thought.
If you accept government money, you accept government control. If you accept insurance company money, you accept insurance company control. There are many doctors who opt out of the whole third party payor system for instance and HIPPA.
One of the problems is that so many people have accepted the ‘inalienable right’ of having someone else pay for their care and don’t realize the strings attached.
A true ‘market oriented’ system would allow for and encourage all different kinds of solutions while also allowing for oversight to keep the real quacks out. Machines, pharmocology, consumerism, socialism, and computers don’t make for good medicine.