This is a rather long lecture by Milton Friedman on the issues of government in medical care. As it is so long I’m not going to write a lot, but you should watch it because, despite being over 3 decades old, every word is still very relevant.
Tag Archives: healthcare
Ramblings from Conservative Cathy – Help! help I may be dying or maybe not! Or worse, I live in California!….
I just ran into a “California Advance Health Care Directive”and although with research I have found out
that this has been around since 2000 I just found out that hospitals must hand this out to any patient coming into the hospital or ER regardless of why they are there or whether they are actually able to fill it out. (There’s nothing as annoying as filling out paperwork after you been intubated…well, maybe dealing with California bureaucracy).
Basically this is a serious subject but I want to deal with the particular form in my sarcastic humorous way. This form apparently must be accompanied with a signed statement about whether you already have a DNR (do not resuscitate), do you have it on you and do not want one. Sounds exactly like what California or government would produce – now keep in mind that many people enter a hospital in a non-communicative or responsive manner so then a doctor has to sign a form that states he tried to offer to the patient but they could not understand (again huh?).
Now I want you to keep in mind that if you enter the hospital and have a DNR but do not have it with you then you will be given all the appropriate medical services. Actually I believe that without specific instructions by the patient and tons of documentation that you will be given all that anyway as they do not want to be sued.
Now let’s just think about this last part – do you really have this information on file will all hospitals near everywhere you go? Do you have this info on file with every doctor you see and every person you know and do they all carry it on their person just in case? Now that you have answered those questions with an affirmative YES – if you were brought into the ER under a true trauma do you think everyone is going to stop everything until we have confirmed all this information and made sure it is accurate and legal? Probably not, unless the doctors are in agreement with a DNR order. Because litigation probably trumps all that when it comes to medical care or maybe it is because doctors are in the business of saving lives – I wonder.
Now for fun lets deal with some of the individual pages and wording in this form because it really does get funnier. And to think these people are responsible for anything in the world is really scary.
On page 2 they let you know as I stated above that you need to share this form with all your doctors, nurses, social workers (does everyone have one of these?), family and friends along with your health care agent (someone who you pick to make decisions for you – probably better give them a legal medical power of attorney but if it is signed prior to 2000 in CA it is no longer legal and you need a new one). So hopefully you have a lot of copies of this 3 part (12page) document to pass out and hopefully everyone carries it on them at all times (including you). And apparently all of these people on this list can help you fill out the form (really?), so that is whom you should take questions to.
Now this is important as you will see – if your health care choices are not listed then write them on a “piece of paper” and keep it with the forms – sounds legal to me.
If you want a healthcare agent it cannot be your doctor (as they would never look out for your best interests) unless they are a family member. I am sure your doctor does not want to be your agent anyway as there is some legal responsibility here but otherwise Huh??
On page 3 – “ If you are too sick to make your own decisions, your doctors will ask your closet family members to make decisions for you” really – without a legal form – I don’t think so – they will provide the responsible necessary care – I think. Also “If you want your agent to be someone other than family, you must write his or her name on this form” – I think you have to write anyone’s name on the form as you cannot just choose “family” as your option – how would a doctor decide between disputing members (better write that out on that piece of paper)?
On page 6 is where that piece of paper is really going to come in handy.
“My life is only worth living if I can” now there are choices to put an X by:
· talk to family or friends (piece of paper right now because if you have no family or friends and are able to communicate you might want to clarify this line)
· This one is my favorite – wake up from a coma (of course but that piece of paper might come in handy in determining a time line for this hopeful event)
· Feed, bathe, or take care of myself (I guess those death panels are already starting because I always thought that paralysis was not a reason to let someone die)
· Be free from pain (now that is a very subjective statement – a piece of paper might be helpful in stating that if you can still function with pain killers versus vegetable state with pain killers might be a better way to determine but another one might be is the pain forever or only for a period (seems a little early to make a decision just based on being free from pain – I think I need more information – please)…also what level of pain are we talking about…if I come in a with stubbed toe but check this box are they going to kill me?
· Live without being hooked up to machines – well an IV drip is a machine so I think we might need that piece of paper again to be a little more specific. And I don’t think anyone but your Doctor is going to be helpful with most of these specifics unless all your family and friends are medical doctors also.
· My second favorite – and this is the last one on all questions – “I am not sure” – based on the phraseology offered, I wouldn’t be sure either but I don’t think that is what they are referring to – so back into the doctors lap – who would have guessed.
Page 7 is about life support and what treatments can be used. There is this phrase “little hope of getting better” – again a very subjective statement – does it mean that I will die (thought we all were going to do that anyway – is there like a time line involved – better get that piece of paper)
When it goes into the allowed treatments you had better have someone with some medical experience help you as I do not think all of these are considered “life support”.
CPR = well yeah – they would not be doing it if life was not in the balance or slipping away – I think that piece of paper and quality/length of life might be pertinent here
Dialysis – gee you could get a transplant or something so is the death panel again suggesting that dying is a viable alternative – or is your current life expectancy a factor in this decision?
Breathing Machine – a good call but that piece of paper again as is this long term or short term?
Feeding Tube – gosh I hope so if I am unable to consume food – keep in mind that if you are unable to consume food that you will starve to death so I think some other things might be pertinent to this one also – gosh I guess we now have several pieces of paper.
Blood transfusion – really is that all you need to live – unless this is a religious decision I can’t imagine why you wouldn’t want that – but oh well.
Medicine – really I love this very vague term – why wouldn’t you want medicine – I guess we had better talk to a pharmacist also and fill out a whole bunch of pieces of paper on this one – so does he need copies of this form also???
Other treatments – ?? Guess you better spend some time with your Doctor/medical school and lots of pieces of paper
Page 8 – I’m very curious about something on this page – there is a question about whether you want an autopsy and one of them is “I want an autopsy if there are questions about my death”. I want to know if you check no autopsy and you were murdered are they no longer allowed to autopsy your body??? The other question I have is if you request an autopsy when normally one is not done – who pays for it?
Also on this page is this statement – “What should your doctors know about how you want your body to be treated after you die?” Let’s see, doctors work on you and then call your death – do you think they really are doing anything else to your body – they leave the area you are in and go work on someone else or go home – I am not really an expert in all the religions but exactly what is this referring to? Because really do you think that most doctors (unless maybe if they are family/friends) really care about your body after you die? My God you are dead and have left your body – why would they care?? What am I missing here???
Page 10 is where you and witnesses sign. You need two witnesses and one of them cannot be related to you in any manner but they need to know you and they can not inherit anything from you and they can not work for the hospital. So let’s see if you are entering the hospital ER and this form is given to you, what are the odds that you are also accompanied by this friend (but not too close as they can not receive anything from you when you die) to witness your signing – I guess you all should be better prepared. Your only other option is having it witnessed by a Notary – gosh do they now need to be employed 24/7 by hospitals??
I really do not see where this form has alleviated any potential legal problems for the medical field. I just think it is silly when government does things like this – The DNR forms and power of attorney that they have had for decades did this much so how have they helped but they have now made it cost money that this form now must be given to everyone (even when it is not currently applicable). Silly Silly
Everyone better check out their own state and see what’s happening there regarding these issues…or this could just be another symptom of why if you’re placing a bet between Greece and California going down first, safe money says Greece will outlive the Golden State.