Ron Amundson’s Political Blog

Argh…on the whole death panel thing. Guess what, we already have them. Nearly every time an insurance companies denies life saving treatment, people die sooner than they would have they been given care. Nearly every time congress roles back Medicare funding, care is rationed to someone, and people die. Nearly every day changes to the healthcare environment remain in the status quo, people die due to lack of care. This is not rocket science.

Look at the declines in Medicare funding over the last years… every time funding gets cut, doctors accept fewer folks on Medicare assignment. Some of those folks are going to die prematurely, because care is not available to them.

Every time EMTALA kicks in for acute care, and then government drops the ball on chronic care, it costs a fortune, and folks prematurely die as a result.

Every time the # of births is greater than the # of deaths, there is less care available per person, assuming total funds spent both privately and publicly remain the same. Some folks will prematurely die as a result.

Every time an uninsured baby is born, and due to the lack of funding, the QALY for that infant may be set as low as 1/3rd the cost of a new car. Some babies who need care, will not receive any, or only the minimum required by EMTALA, and some will prematurely die as a result.

Every time a new person reaches 65 and starts to receive Medicare benefits, someone else over 65 is going to get less care, and some of those someone elses are going to prematurely die due to lack of care.

Every time a healthcare provider gets paid less than their costs of doing business, whether it be via insurance, Medicare, or EMTALA, sooner or later, said health care provider will no longer be a going concern. As a result, such payment practices foster longer term shortages in supply, and some folks are going to prematurely die as a result.

There are really only two options

1. Fess up that care MUST be rationed, and accept the moral responsibility as a society up front for doing so. Not every person can have the latest and greatest high tech uber comprehensive care, and a few people who might live had such care been given are going to die. Not every person can have even minimal care, some folks are going to fall through the cracks, and they too may die prematurely.

Or

2. Do not accept rationing of care, and do not deny life extending techniques for anyone (even multimillion dollar QALYs are allowable if patients or their families request such). Accept moral hazard, and accept the huge increases in societal costs to support such ideology.

Option 1, is the only politically feasible solution, as no way, no how, will US society ever go for the costs and moral hazard of option 2, no matter how barbaric it sounds to the rest of the world, or even some US citizens.

The question is, will folks continue to accept the current death panels as the optimum, even though it may result in their own, or their families deaths, or reductions in quality of life due to inefficiencies? Or will folks as a society work to reduce said inefficiencies to minimize the number of preventable deaths or reductions in quality of life? The status quo, as well as current legislative proposals which serve to prop up failing business and government models of healthcare are not the solution.