Conservative political and social commentary

Contact us: dstol@prodigy.net
Links
Search

First they came for the communists, but I was not a communist, so I did not speak out. Then they came for the socialists and the trade unionists, but I was neither, so I did not speak out. Then they came for the Jews, but I was not a Jew, so I did not speak out. And when they came for me, there was no one left to speak out for me.
– Pastor Martin Niemoeller.

You are welcome to post or publish these articles, in whole or in part, provided that you cite the author and website.



There are 819 News Items in 819 pages and you are on page number 134

 

Page:  << Prev  1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42  43  44  45  46  47  48  49  50  51  52  53  54  55  56  57  58  59  60  61  62  63  64  65  66  67  68  69  70  71  72  73  74  75  76  77  78  79  80  81  82  83  84  85  86  87  88  89  90  91  92  93  94  95  96  97  98  99  100  101  102  103  104  105  106  107  108  109  110  111  112  113  114  115  116  117  118  119  120  121  122  123  124  125  126  127  128  129  130  131  132  133  134 135  136  137  138  139  140  141  142  143  144  145  146  147  148  149  150  151  152  153  154  155  156  157  158  159  160  161  162  163  164  165  166  167  168  169  170  171  172  173  174  175  176  177  178  179  180  181  182  183  184  185  186  187  188  189  190  191  192  193  194  195  196  197  198  199  200  201  202  203  204  205  206  207  208  209  210  211  212  213  214  215  216  217  218  219  220  221  222  223  224  225  226  227  228  229  230  231  232  233  234  235  236  237  238  239  240  241  242  243  244  245  246  247  248  249  250  251  252  253  254  255  256  257  258  259  260  261  262  263  264  265  266  267  268  269  270  271  272  273  274  275  276  277  278  279  280  281  282  283  284  285  286  287  288  289  290  291  292  293  294  295  296  297  298  299  300  301  302  303  304  305  306  307  308  309  310  311  312  313  314  315  316  317  318  319  320  321  322  323  324  325  326  327  328  329  330  331  332  333  334  335  336  337  338  339  340  341  342  343  344  345  346  347  348  349  350  351  352  353  354  355  356  357  358  359  360  361  362  363  364  365  366  367  368  369  370  371  372  373  374  375  376  377  378  379  380  381  382  383  384  385  386  387  388  389  390  391  392  393  394  395  396  397  398  399  400  401  402  403  404  405  406  407  408  409  410  411  412  413  414  415  416  417  418  419  420  421  422  423  424  425  426  427  428  429  430  431  432  433  434  435  436  437  438  439  440  441  442  443  444  445  446  447  448  449  450  451  452  453  454  455  456  457  458  459  460  461  462  463  464  465  466  467  468  469  470  471  472  473  474  475  476  477  478  479  480  481  482  483  484  485  486  487  488  489  490  491  492  493  494  495  496  497  498  499  500  501  502  503  504  505  506  507  508  509  510  511  512  513  514  515  516  517  518  519  520  521  522  523  524  525  526  527  528  529  530  531  532  533  534  535  536  537  538  539  540  541  542  543  544  545  546  547  548  549  550  551  552  553  554  555  556  557  558  559  560  561  562  563  564  565  566  567  568  569  570  571  572  573  574  575  576  577  578  579  580  581  582  583  584  585  586  587  588  589  590  591  592  593  594  595  596  597  598  599  600  601  602  603  604  605  606  607  608  609  610  611  612  613  614  615  616  617  618  619  620  621  622  623  624  625  626  627  628  629  630  631  632  633  634  635  636  637  638  639  640  641  642  643  644  645  646  647  648  649  650  651  652  653  654  655  656  657  658  659  660  661  662  663  664  665  666  667  668  669  670  671  672  673  674  675  676  677  678  679  680  681  682  683  684  685  686  687  688  689  690  691  692  693  694  695  696  697  698  699  700  701  702  703  704  705  706  707  708  709  710  711  712  713  714  715  716  717  718  719  720  721  722  723  724  725  726  727  728  729  730  731  732  733  734  735  736  737  738  739  740  741  742  743  744  745  746  747  748  749  750  751  752  753  754  755  756  757  758  759  760  761  762  763  764  765  766  767  768  769  770  771  772  773  774  775  776  777  778  779  780  781  782  783  784  785  786  787  788  789  790  791  792  793  794  795  796  797  798  799  800  801  802  803  804  805  806  807  808  809  810  811  812  813  814  815  816  817  818  819  Next >>

Mother of Health Care? - Thursday, July 22, 2010

 

Mother of Health Care?

Or Midwife of the Nanny State?

David C. Stolinsky, MD
July 22, 2010

In an overstatement of cosmic proportions, Vice President Joe Biden referred to Speaker Nancy Pelosi as “the mother of health care.” Did she found a new medical or nursing school? Did she discover a new treatment for a serious illness? Did she volunteer in a hospice?

No, she pushed through a 2000-plus page bill that will fundamentally alter how health care is delivered in this country − I believe for the worse. The bill is so complex that pundits cannot agree even on how many pages it occupies.

And, of course, it will be enforced by more thousands of pages of regulations, written by unelected, unaccountable, faceless bureaucrats. They, not Congress, and surely not you and your doctor, will decide what care you will receive…or not.

“Health insurance = health care.”

Besides grossly exaggerating Pelosi’s accomplishments, the vice president also perpetuated the confusion between health care and health insurance. Ideally, one should have both. But in this country, many people lack insurance and still can get care. On the other hand, in nations with socialized health care, one can have insurance and still lack care. Which alternative would you prefer?

The media tell us that there are 30 to 40 million Americans without health insurance. Granted, the figure includes most of the 10 to 20 million illegal aliens, who would not be entitled to free health care even in a socialist nation. Granted, the figure includes millions of younger Americans who prefer to spend their money elsewhere.

Still, those without insurance are less likely to receive optimum care. The trouble starts when politicians equate having no health insurance with having no health care. This error insults my whole professional life. Like millions of other physicians, nurses, paramedics, technicians and others, I devoted most of my career to caring for patients who could not pay for their care.

“Cost-effective care.”

The effects of President Obama’s health-care plan are not yet apparent. He is on record favoring a single-payer plan − that is, government-controlled medical care. The “stimulus” bill mandates that care be “cost-effective” − as decided by unelected, unaccountable officials.

But what is “cost-effective” is a subjective judgment. What you think is reasonable a bureaucrat may decide is too expensive. How much is a year of life worth? How much is a year walking versus a year lying in bed worth? And since we all die eventually, any care could be called “not cost-effective” if that suited the whim of a bureaucrat. For example, Obama would allow pacemakers for the elderly only if it would “save money.”

“The last year of life.”

Proponents of rationing health care tell us that a large percent of costs occur in the last year of life. Yes, but so what? “The last year of life” is clear in retrospect, but can anyone predict what it will be? I can’t, and I spent 20 years practicing, teaching and doing research in medical oncology.

I can quote statistics for a given disease, but I can’t know whether they apply to a specific patient. Doctors treat patients, not statistics. At least they do now.

“The last year of life” can mean the peaceful end for old persons who were lucky to have lived that long. Or it can mean the tragic end for young or middle-aged persons who were struck down by illness or injury − but who might still have decades of useful life if they received expensive care. “The last year of life” for 45-year-old actress Natasha Richardson was determined by the Canadian government’s decision not to buy medevac helicopters. But think of the “cost savings.”

“The last year of life” can be a self-fulfilling prophecy. If we stop active treatment of a serious injury or illness, we can almost guarantee that it will be “the last year of life.” Death then becomes not a tragedy, but a bureaucratic decision.

We will then face the absurdity of a government so solicitous of terrorists captured in Afghanistan that gives them Miranda warnings, but a government so unconcerned with its own citizens that it sentences them to death if their illness or injury doesn’t fit rigid, bureaucratic guidelines.

“Terminal illness.”

When I was in medical school, the word “terminal” meant that the patient was in the actual process of dying. It didn’t mean that he was expected to die sometime in the future – everyone is. It didn’t mean that she was expected to die within some fixed time – no one could be sure.

All doctors have seen patients who seemed to be near the end, then recovered to live long lives. But now “terminal” has been redefined to mean “expected to die within six months,” or in the case of Obama’s grandmother, within nine months − or in the era of rationing, perhaps within five years.

It is dangerous to predict a bad outcome, when your prediction leads you to stop treatment and make the prediction come true. Then you never realize you made a mistake, and you make the same mistake again.

Doctors are often wrong in their predictions of life expectancy. (Click here and here.) Yet these inaccurate predictions are now the basis of declaring someone “terminal” – and therefore suitable to be taken off treatment.

“Removing life support.”

During a discussion of the Terri Schiavo case, a doctor described removing her feeding tube as “removing an impediment to death.” This doctor headed the ethics committee of a major hospital. He was used to dealing with patients who were at the point of death, and deciding whether to stop active treatment. Of course, pain medication, food and water, and nursing care should always continue.

This doctor was used to withdrawing advanced medical treatment, so it was only a small step to withdrawing food and water. He pointed out that unlike Terri Schiavo, we normally take nourishment by eating, not through a tube.

Yes, and we normally breathe unaided. Surely he wouldn’t take an inhaler away from an asthmatic patient. We normally move by walking. Surely he wouldn’t take a wheelchair away from a paraplegic patient. At least we hope he wouldn’t. The opposite of “normal” is “abnormal.” It isn’t “dead.” At least not yet.

Terri Schiavo wasn’t on “life support.” She was receiving water and food. Death wasn’t approaching. We can’t “remove an impediment” to what isn’t coming. She wasn’t “terminal” until we made her so. We killed her.

“End-of-life issues.”

This term should refer to patients who want some control over the way they leave this world. The problem arises when we use it for people whose lives are not ending.

Articles about Terri Schiavo, and patients like her, refer to “end-of-life” issues. But her life was not ending until someone else decided to end it. She might have lived for many years.

That may, or may not, have been a good thing. But we needed to be clear about it. We needed to say plainly, “Terri has already lived like this for years. Should we allow her to live for more years, or should we kill her now?” That would have been blunt, but it would have been honest.

Terri wasn’t “brain dead.” She may not even have been in a “persistent vegetative state.” There was no “end-of-life” issue, until her estranged husband decided to end her life. We can’t think clearly about serious problems if we use confusing and inaccurate terminology.

We must not allow people to use elastic definitions that stretch to cover whatever they want. We must not allow people to push abandoning treatment, or even euthanasia, for a wider and wider group of patients. Who’s next? Homeless schizophrenics? Disabled people on Social Security? Autistic children?

Without drastic rationing, how can anyone hope to provide health care for everyone at lower cost − and at the same time allow unlimited immigration? This isn’t a logical plan on which to base national policy. This is an irrational fantasy with which to take control of an additional one-sixth of the economy, as well as to make life-and-death decisions affecting us and our loved ones − and thus make us totally subservient to federal bureaucrats.

Why does the “health-care” bill require coin dealers, and other small businesses, to fill out an Internal Revenue form every time they buy $600 worth of anything from an individual in a year? The “health-care” bill undoubtedly contains other intrusive, stifling regulations utterly unrelated to health care.

Is Nancy Pelosi the “mother of health care”? It seems more accurate to call her the midwife of the nanny state. But if we live in a nanny state, that downgrades us into dependent children who are not allowed to run their own lives.

You might think it was a typographical error to put “Is Nancy Pelosi the mother of health care?” under “End-of-life issues.” It wasn’t.

Dr. Stolinsky writes on political and social issues. Contact: dstol@prodigy.net.

www.stolinsky.com


Page:  << Prev  1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42  43  44  45  46  47  48  49  50  51  52  53  54  55  56  57  58  59  60  61  62  63  64  65  66  67  68  69  70  71  72  73  74  75  76  77  78  79  80  81  82  83  84  85  86  87  88  89  90  91  92  93  94  95  96  97  98  99  100  101  102  103  104  105  106  107  108  109  110  111  112  113  114  115  116  117  118  119  120  121  122  123  124  125  126  127  128  129  130  131  132  133  134 135  136  137  138  139  140  141  142  143  144  145  146  147  148  149  150  151  152  153  154  155  156  157  158  159  160  161  162  163  164  165  166  167  168  169  170  171  172  173  174  175  176  177  178  179  180  181  182  183  184  185  186  187  188  189  190  191  192  193  194  195  196  197  198  199  200  201  202  203  204  205  206  207  208  209  210  211  212  213  214  215  216  217  218  219  220  221  222  223  224  225  226  227  228  229  230  231  232  233  234  235  236  237  238  239  240  241  242  243  244  245  246  247  248  249  250  251  252  253  254  255  256  257  258  259  260  261  262  263  264  265  266  267  268  269  270  271  272  273  274  275  276  277  278  279  280  281  282  283  284  285  286  287  288  289  290  291  292  293  294  295  296  297  298  299  300  301  302  303  304  305  306  307  308  309  310  311  312  313  314  315  316  317  318  319  320  321  322  323  324  325  326  327  328  329  330  331  332  333  334  335  336  337  338  339  340  341  342  343  344  345  346  347  348  349  350  351  352  353  354  355  356  357  358  359  360  361  362  363  364  365  366  367  368  369  370  371  372  373  374  375  376  377  378  379  380  381  382  383  384  385  386  387  388  389  390  391  392  393  394  395  396  397  398  399  400  401  402  403  404  405  406  407  408  409  410  411  412  413  414  415  416  417  418  419  420  421  422  423  424  425  426  427  428  429  430  431  432  433  434  435  436  437  438  439  440  441  442  443  444  445  446  447  448  449  450  451  452  453  454  455  456  457  458  459  460  461  462  463  464  465  466  467  468  469  470  471  472  473  474  475  476  477  478  479  480  481  482  483  484  485  486  487  488  489  490  491  492  493  494  495  496  497  498  499  500  501  502  503  504  505  506  507  508  509  510  511  512  513  514  515  516  517  518  519  520  521  522  523  524  525  526  527  528  529  530  531  532  533  534  535  536  537  538  539  540  541  542  543  544  545  546  547  548  549  550  551  552  553  554  555  556  557  558  559  560  561  562  563  564  565  566  567  568  569  570  571  572  573  574  575  576  577  578  579  580  581  582  583  584  585  586  587  588  589  590  591  592  593  594  595  596  597  598  599  600  601  602  603  604  605  606  607  608  609  610  611  612  613  614  615  616  617  618  619  620  621  622  623  624  625  626  627  628  629  630  631  632  633  634  635  636  637  638  639  640  641  642  643  644  645  646  647  648  649  650  651  652  653  654  655  656  657  658  659  660  661  662  663  664  665  666  667  668  669  670  671  672  673  674  675  676  677  678  679  680  681  682  683  684  685  686  687  688  689  690  691  692  693  694  695  696  697  698  699  700  701  702  703  704  705  706  707  708  709  710  711  712  713  714  715  716  717  718  719  720  721  722  723  724  725  726  727  728  729  730  731  732  733  734  735  736  737  738  739  740  741  742  743  744  745  746  747  748  749  750  751  752  753  754  755  756  757  758  759  760  761  762  763  764  765  766  767  768  769  770  771  772  773  774  775  776  777  778  779  780  781  782  783  784  785  786  787  788  789  790  791  792  793  794  795  796  797  798  799  800  801  802  803  804  805  806  807  808  809  810  811  812  813  814  815  816  817  818  819  Next >>