Should we let dying people die and save tons of money

[Pneumothorax]

Originally posted by: SammyJr

Probably the largest thing is that we need to stop performing medical care of the sake of families. If Gramps is 90 and has advanced cancer, the family has to accept it. Hospice is a good thing.

This...
In Med school 8 years ago, I sat in several ethics board cases where the hospital wanted to terminate "heroic" measures and put gramps on hospice. Instead, family wanted to do everything possible to keep gramps alive. Legal costs/benefit ratios were done and all 3 died in the ICU while hooked up to several machines. At the cost of >$10,000 PER DAY!!! The shortest stay was 16 days for one of the patients before he died.

To the posters who said let the patient and the family decide on "advance directives" That's exactly where we are at this time and it's even worse as majority of people don't even have advance directives or DPOA's.

 

[NetGuySC]

Maybe one day we will be like in the movie "Logans Run" where people were basically put to death at a certain age,and it was considered something to celebrate and even look forward to.

 

[Vic]

If they want to, yes. Besides the money aspect, there is no kindness in keeping people alive a few days longer by hooking them up to a machine. I have always been a supporter of death with dignity and having a living will to that effect for myself should such a scenario happen.

 

[MovingTarget]

Originally posted by: Pneumothorax

Originally posted by: SammyJr

Probably the largest thing is that we need to stop performing medical care of the sake of families. If Gramps is 90 and has advanced cancer, the family has to accept it. Hospice is a good thing.

This...
In Med school 8 years ago, I sat in several ethics board cases where the hospital wanted to terminate "heroic" measures and put gramps on hospice. Instead, family wanted to do everything possible to keep gramps alive. Legal costs/benefit ratios were done and all 3 died in the ICU while hooked up to several machines. At the cost of >$10,000 PER DAY!!! The shortest stay was 16 days for one of the patients before he died.

To the posters who said let the patient and the family decide on "advance directives" That's exactly where we are at this time and it's even worse as majority of people don't even have advance directives or DPOA's.

You do raise some good points, but how much of that >$10k figure is itself justified in terms of what was performed? Sounds to me like that is more a problem of inflated billing (from multiple sources not just including the hospital), but I could be wrong here...

 

[monovillage]

This is a serious issue that needs to be confronted before any omnibus health care bill gets passed. I've had to deal with this issue when my Mother, Father, Grandmother and Mother-in-law passed away and it isn't easy. As for end of life directives, those are chancy at best, hospitals can/will ignore them especially if not all family members agree. To have dmCowen try to demonize this issue is typical, but not a help.

 

[Patranus]

This is an interesting question. I was thinking yesterday about the abortion issue and how it relates to preventative care.

The gist of the pro abortion crowd is "keep government off my body".

Now, with "preventative care" the only way to make it effective is to force people into making correct life choices or the people who do not look for preventative care will continue to not seek it and the people who seek it now will only continue.

Personally, I really do not understand the need for this massive government spending package. Every single person in the USA weather they are legal or illegal can walk into a hospital and receive care no matter their ability to pay, income, race, gender, or age.

The only way to cut costs is to cut services. All other perceived cost cuts are just subsidies provided by the government and are paid through taxes. The actual costs are not lowered.

Looking at a cost benefit analysis, cutting care for the "worthless" (in terms of production) elderly is only logical.

 

[SammyJr]

Originally posted by: Patranus
Personally, I really do not understand the need for this massive government spending package. Every single person in the USA weather they are legal or illegal can walk into a hospital and receive care no matter their ability to pay, income, race, gender, or age.

LOL. Whatever.

 

[WHAMPOM]

Originally posted by: daveymark
it's a question that needs to be asked, and a serious discussion needs to be had about it, because if UHC passes, I'm sure this is likely going to be an issue that the gov't will certainly be looking at.

Does anyone have some statistics on how much money is spent on an individual's last dying days? It would be interesting to see the numbers, say for how much it costs to keep the average person alive for the last week of their life.

I keep hearing/seeing/reading about the following scenario:

Bobby has cancer, and his only two options are:

1)spend thousands to keep him alive for a few more days, even though he will be in complete agony

2)hop Bobby up on painkillers so he is not in pain for his last moments and let him die without trying to "save" him, thus saving thousands.

Is this really the scenario everyone goes through when they are dying? If not, does it really happen often enough that we can really save a significant amount of money?

For anyone with a critical condition. Either cure them or let them go. If they are terminal do your best to make them comfortable. Your options for Bobby need a little work, davey.

 

[BansheeX]

If the government required everyone to have personal health savings accounts and people were spending their own money on procedures, that would work a hell of a lot better than what we have now. Really, nobody gives a shit what doctors charge beyond the deductible and thus, they charge an assload and it gets tacked onto the national credit card. And then somehow we walk away thinking that all we paid was the deductible, when that's not true. We pay indirectly through massive taxes, currency debasement, and layoffs from the burden it poses to employers. We don't have market prices.

I'm amazed that some 90 year old can rack up millions in medicare bills to extend their life. Who the fuck is paying for that? Most individuals don't make that much in their entire lifetime. If you gave me a choice between a million dollars throughout life and two extra weeks on my life, I'm choosing the fucking money. Just like, if given the choice, I would opt out of SS to get no SS, because I think improving the younger part of my life is far better than dying at 80 instead of 90. This is what socialist health care defeats, it assumes that none of us would rather do the former, that we'd rather have a longer life than a better life.

 

[alchemize]

Originally posted by: NetGuySC
Maybe one day we will be like in the movie "Logans Run" where people were basically put to death at a certain age,and it was considered something to celebrate and even look forward to.

Oh you're gonna get Dave all excited again.

 

[IGBT]

shure. why not. let ted kennedy be the first to step up to the plate on the new "hurry up and die" policy.

 

[sandorski]

It's a tough question. Certainly the Braindead should just be let go...unless the Family is willing to Pay the Full Cost. Those on their Deathbed with next to no chance of regaining Consciousness should not be kept Artificially Alive(might be difficult to determine in many cases). Those who can be kept Alive and Conscious for an extended period only with significant Life Support, could be kept Alive, but I think at some point the Family should start picking up the Bill or at least part of it(this is a tough one). Older people with a reasonable chance of Independence(no longterm Life Support/no need for long term Hospital stay) after a Procedure should get that Procedure, regardless of Age. I think Patients who are Able should be asked before Procedures whether they should be Revived, or whatnot, and those wishes should be followed.

 

[dmcowen674]

Originally posted by: SammyJr

Originally posted by: dmcowen674

Originally posted by: daveymark
Topic Title: Should we let dying people die and save tons of money
Topic Summary: instead of paying tons of money just to keep them alive for a few more days/weeks/months?

This UHC subject is really bringing out the evil of Republicans.

Meh. Remember Terry Schavio? The Republicans were trying to keep alive a brain dead woman.

I knew someone would bring in the straw man.

They argued for the brain dead one on religious grounds not financial.

Not even a good try

 

[Gonad the Barbarian]

As long as doctors and hospitals have the incentives to pile on these expenses and are allowed to they will. We don't have to ration treatment to fix this problem, we just have to remove those incentives. This goes for these expensive procedures on the dying as well as a lot of those tests and procedures that get blamed on "defensive medicine" that tort reformers love to crow about.

 

[StageLeft]

It's necessary that ultimately we will have to as a society. Really we already do in a practical sense, but heroic and expensive feats at the end of one's natural life come at the expense of resources put to younger people and it's silly.

 

[DrPizza]

Originally posted by: Pneumothorax

Originally posted by: SammyJr

Probably the largest thing is that we need to stop performing medical care of the sake of families. If Gramps is 90 and has advanced cancer, the family has to accept it. Hospice is a good thing.

This...
In Med school 8 years ago, I sat in several ethics board cases where the hospital wanted to terminate "heroic" measures and put gramps on hospice. Instead, family wanted to do everything possible to keep gramps alive. Legal costs/benefit ratios were done and all 3 died in the ICU while hooked up to several machines. At the cost of >$10,000 PER DAY!!! The shortest stay was 16 days for one of the patients before he died.

To the posters who said let the patient and the family decide on "advance directives" That's exactly where we are at this time and it's even worse as majority of people don't even have advance directives or DPOA's.

So true. It's very naive for people to think that even half of all people have "advance directives." When my wife was working on the floors, she frequently had to counsel people that "it's time to let gramps go." It seems that some people feel that if they give the okay to pull the plug and let someone pass naturally, that it's morally equivalent to them killing the person. They don't want to live with it on their conscience that they were the one to actually make that decision. "What if gramps regained consciousness for even 5 minutes and was able to say good-bye to everyone?" There have been times when families have accepted that their relative is going to die, but prolonged treatment simply so more of the family would be able to gather at the relative's side to say good-bye (while that person was unconscious). "Can't let him die now! Betsy has a flight up from Florida tomorrow! "

 

[Darwin333]

Originally posted by: dmcowen674

Originally posted by: Extelleron
If a person can be "saved" and brought back close to full health and live for a year or more, then they should be despite the cost. But when it comes to keeping someone alive in pain for a few weeks at tremendous cost, no.

I'd like to hear you say that should you be in that position.

Another Republican for Carousel :roll:

Just out of curiousity, when the Dems pass UHC and health care is indeed rationed and people die after being denied expensive procedures with low chances of success.... how do you intend to blame the republicans?

 

[MovingTarget]

Originally posted by: Patranus
This is an interesting question. I was thinking yesterday about the abortion issue and how it relates to preventative care.

The gist of the pro abortion crowd is "keep government off my body".

Now, with "preventative care" the only way to make it effective is to force people into making correct life choices or the people who do not look for preventative care will continue to not seek it and the people who seek it now will only continue.

Personally, I really do not understand the need for this massive government spending package. Every single person in the USA weather they are legal or illegal can walk into a hospital and receive care no matter their ability to pay, income, race, gender, or age.

The only way to cut costs is to cut services. All other perceived cost cuts are just subsidies provided by the government and are paid through taxes. The actual costs are not lowered.

Looking at a cost benefit analysis, cutting care for the "worthless" (in terms of production) elderly is only logical.

First, "keep the government off my body" is a part of what they claim, but you don't seem to acknowledge that there is a difference between government legislation regarding abortion and the government simply offering to provide care which patients still have the right to refuse.

Second, preventative care is in the best interest of everybody. You don't have to force it on people, as again patients have the right to refuse medical treatment. Many people simply choose not to do preventative care because it is either unaffordable or unavailable to them. Making it affordable/available takes care of these people who want to be responsible for their own health but otherwise cannot. Don't underestimate the size of this population. Those who have the means to get preventative care but don't - fuck 'em.

The only way to cut costs is to cut services - wrong. Improve efficiency, eliminate middlemen, limit profit percentages, shopping around for better deals on equipment/facilities/supplies, etc etc etc are all ways of cutting costs. Cutting costs != cutting services.

Finally, not everything yields itself to cost-benefit analysis and passes ethical muster. That should be a given in our society by now. Besides, the elderly are not worthless in terms of production. Far from it. In many cases (although not statistically as high as younger demographics) they can still be as productive. Experience >>> youth when it comes to a lot of different jobs and/or situations. Screw the actuarial tables, we need to take care of the elderly and infirm to the best of our ability. We owe it to them if we are to call ourselves compassionate as a society.

 

[Darwin333]

Originally posted by: MovingTarget
I don't think that this is as big of an issue as many people say it is. When somebody becomes terminally ill with cancer or whatever, these things tend to work themselves out. Leave it up to the patients if they are still in control of their faculties. Generally in those circumstances they just want to go peacefully without unnecessarily prolonging life and suffering. Seriously, how many people bitching about "prolonging life for a few days/weeks" due to cost have dealt with those with terminal cancer before?

For those that aren't in control of their faculties, then you either have to look to a living will or the will of the family. Beyond that, it devolves into beating the dead horse of the Terry Schiavo case...

Edit: Perhaps I should summarize. Let the patients themselves decide about their own life. We as a society tend to respect that, so under a UHC system it shouldn't be any different.

I think the topic is aimed at extremely risky/experimental procedures that have a low chance (but a chance nonetheless) at extending the patients life.

 

[MovingTarget]

Originally posted by: Darwin333

Originally posted by: dmcowen674

Originally posted by: Extelleron
If a person can be "saved" and brought back close to full health and live for a year or more, then they should be despite the cost. But when it comes to keeping someone alive in pain for a few weeks at tremendous cost, no.

I'd like to hear you say that should you be in that position.

Another Republican for Carousel :roll:

Just out of curiousity, when the Dems pass UHC and health care is indeed rationed and people die after being denied expensive procedures with low chances of success.... how do you intend to blame the republicans?

It already is. We blame the Republicans NOW for being in congressional power from 1994-2006 and not doing SQUAT while care is rationed by the ability of the patient to pay for the most basic and successful of treatments. Sure, the current Dem proposal may be a convoluted fiasco, but even that is better than the way we currently do things. I don't forsee any situation where the Dems would have to pull much out of their ass to pin things on them.

 

[MovingTarget]

Originally posted by: Darwin333

Originally posted by: MovingTarget
I don't think that this is as big of an issue as many people say it is. When somebody becomes terminally ill with cancer or whatever, these things tend to work themselves out. Leave it up to the patients if they are still in control of their faculties. Generally in those circumstances they just want to go peacefully without unnecessarily prolonging life and suffering. Seriously, how many people bitching about "prolonging life for a few days/weeks" due to cost have dealt with those with terminal cancer before?

For those that aren't in control of their faculties, then you either have to look to a living will or the will of the family. Beyond that, it devolves into beating the dead horse of the Terry Schiavo case...

Edit: Perhaps I should summarize. Let the patients themselves decide about their own life. We as a society tend to respect that, so under a UHC system it shouldn't be any different.

I think the topic is aimed at extremely risky/experimental procedures that have a low chance (but a chance nonetheless) at extending the patients life.

I know. I just broadened it a bit as we were talking about possible end-of-life care. Risky and experimental procedures != über-expensive ones. I still say let the patient decide.

 

[Hayabusa Rider]

The question has merit on it's own aside from UHC. It's a matter of law and medical ethics as well as cost. The physician is bound to try to provide care as long as the patient lives. Now the form of that depends on the prognosis and current health status of the patient. That will increasingly place demands on whatever system is in place simply because of the aging demographic.

I would not be surprised if that once I retire, my health care will have a much lower priority than others. Well, that can't be helped. At the point I will have lived my life and if it comes down to me or someone with their life ahead of me they take priority.

 

[Darwin333]

Originally posted by: MovingTarget

Originally posted by: Darwin333

Originally posted by: MovingTarget
I don't think that this is as big of an issue as many people say it is. When somebody becomes terminally ill with cancer or whatever, these things tend to work themselves out. Leave it up to the patients if they are still in control of their faculties. Generally in those circumstances they just want to go peacefully without unnecessarily prolonging life and suffering. Seriously, how many people bitching about "prolonging life for a few days/weeks" due to cost have dealt with those with terminal cancer before?

For those that aren't in control of their faculties, then you either have to look to a living will or the will of the family. Beyond that, it devolves into beating the dead horse of the Terry Schiavo case...

Edit: Perhaps I should summarize. Let the patients themselves decide about their own life. We as a society tend to respect that, so under a UHC system it shouldn't be any different.

I think the topic is aimed at extremely risky/experimental procedures that have a low chance (but a chance nonetheless) at extending the patients life.

I know. I just broadened it a bit as we were talking about possible end-of-life care. Risky and experimental procedures != über-expensive ones. I still say let the patient decide.

To what ends do you allow the patient to decide? Do you put a price cap on experimental procedures? What about those uber expensive procedures that are not experimental?

For example, lets pretend an amazing procedure is invented that prolongs terminal cancer patients lives by 10 years as well as giving them relatively good health for those 10 years. What if it cost 80% of our health care budget to provide that procedure to everyone that needed it, would you be in favor of it?

I personally don't have an answer to it but I do know that our resources are finite (even if our politicians don't seem to understand that) and eventually we will be faced with an issue like that.

 

[Darwin333]

Originally posted by: MovingTarget

Originally posted by: Darwin333

Originally posted by: dmcowen674

Originally posted by: Extelleron
If a person can be "saved" and brought back close to full health and live for a year or more, then they should be despite the cost. But when it comes to keeping someone alive in pain for a few weeks at tremendous cost, no.

I'd like to hear you say that should you be in that position.

Another Republican for Carousel :roll:

Just out of curiousity, when the Dems pass UHC and health care is indeed rationed and people die after being denied expensive procedures with low chances of success.... how do you intend to blame the republicans?

It already is. We blame the Republicans NOW for being in congressional power from 1994-2006 and not doing SQUAT while care is rationed by the ability of the patient to pay for the most basic and successful of treatments. Sure, the current Dem proposal may be a convoluted fiasco, but even that is better than the way we currently do things. I don't forsee any situation where the Dems would have to pull much out of their ass to pin things on them.

Perhaps you misunderstood my question to Dave, when the Dems pass their healthcare bill and someone is denied a life saving procedure.... How will it be the Republicans fault?

It wasn't really a serious question, I am amused by Daves creativity when it comes to blaming Republicans for everything wrong in the world. If a earthquake rips apart LA tomorrow (that Dave would have predicted of course) I would wager he could figure out a way to link it to the Republicans. To be fair, there are a ton of people who do the same to the Dems but Dave is by far the best I have seen. Since I don't belong to any of the clubs I get to sit back and enjoy the humor 🙂

 

[Moonbeam]

I came late. Did anybody mention that dying people are people who are going to die. You don't have to let them.