Sunday, November 27, 2011

Living Wills and the Will to Live

When the public funds your lifestyle, it has a right to question your lifestyle choices.  That includes health care.
"It is a good day to die"
-- Old Lodge Skins in Little Big Man
"We've got a duty to die and get out of the way with all of our machines and artificial hearts and everything else like that and let the other society, our kids, build a reasonable life."
-- Colorado Governor Richard Lamm
A good discussion broke out in the comment thread of a recent blog post, Rule of Law. We got off on a healthcare tangent, but it was an interesting exploration of life and death.

Finntann kicked it off with a raw, ripped-off scab look at reality that had a sad ending ...
The failure of modern medicine is not in treatement or cost but directly attributable to our innate desire for immortality.
It's harsh, but we treat those that we should not treat. We refuse to accept the diagnosis of mortality. We trade vast fortunes for six months, a year, two years to the detriment of all involved, except those making money off of it.
What is reasonable action and what is reasonable cost? How much is six months of additional life worth?
My sister died of breast cancer a little over a year ago with medical bills well into the six figures. In the end, she wished she had gone to Europe instead of to the doctor.
AOW then chimed in with a report from real life about insurance and existing conditions. As her blogger buddies know, she's been navigating the health care system as she nurses her husband back to good health. She knows what she is talking about.

Ducky had good advice on medical directives...
My family knows exactly what to do. If quality of life has been lost, end it.
This spurred KP (after telling a great story about a Vietnam war combat pilot) to remind us that it's not always so simple:
A perfect example would be stroke in the midbrain. Patient is unconcious, surgeon tells you the stroke is "in a good place" making decent recovery possible. You have five minutes to decide what to do at 4:30am. The directive isn't worth the paper it is written on. You will decide while trying to gather some degree of medical certainty.
Quite simply, all of this is properly the purview of the individual and the family, upon consultation with the family's doctor and pastor.

Collectivizing health care by pushing our money into a big government pot makes our private affairs public

In a government-run, publicly funded healthcare system, every medical and lifestyle decision becomes the purview of every taxpayer and of the armies of bureaucrats who are charged with the custody of government funds.

Justice Kagan will shake her gavel at you and tell you to each your congressionally-mandated vegetables, and put out that cigarette!  If government-enforced diets and exercise save me from paying for the diabetes, obesity and other expensive health problems of the fatties among us, why not?

Life and Death

Who's life is worth more, the 87 year old physics PhD who is still doing productive research, or the poor child living in a ghetto?

Government-created scarcity will inevitably bring about such utilitarian decisions.  Wouldn't it be better to get government out of it, completely?  Free up the insurance industry to craft policies tailored to specific groups and let a well-policed free market set prices and determine what care looks like.  More importantly, let the consumer see what the real price of health care is.

Cut out the red tape and overregulation, and set the consumer free in the marketplace with his or her own dollars, and prices will come down.  They always do.  The truly indigent could be helped by government paying their health care premiums instead of setting up a whole bureaucracy.

The alternative is a scolding nanny state making all your decisions for you, creating a nation of infants.  Some would say we're already a long way down that road.