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
You are going to die.
How did that sentence make you feel? When you think about it, the correct response is probably something along the lines “well, duh, no kidding”… after all, the whole human thing comes with that pesky you’re going to die thing. It’s all part and parcel of this mortal coil (I could go on but the clichés are already getting a little thick), but to reiterate you already knew that,
You are going to die.
However, I get the feeling that most of you didn’t have a completely rational response. Probably some small measure of revulsion, shock, or even, dare I say it, fear, came up while you read it.
Why do I bring this up? Well, mainly because I realized part of this whole healthcare thing is based on this absolute fear of death. So I feel for just a moment we should forget the numerous flaws Obamacare, or Hillarycare or the useless systems of Canada or Britain or any other godawful place where you wouldn’t want to receive medical treatment if you had a choice…no let’s ignore the economic flaws of these systems and focus on what drives the call for their creation and why that call is terrible.
What drives this call for more and more government control, for more universal healthcare, for constantly doing something in this field. It comes because we all seem to be afraid of coming down with something, and we all have no trust in the insurance companies to be there. But is this a legitimate fear? (And let’s just ignore that the reason why insurance was so bad was government interference in terms of HMO’s, Medicare and Medicaid). Are you likely to come down with something that will get you killed? Right now if you’re reading this, the statistics say that you should reach your 80′s. Now no offense here, but who really wants to live past their 80′s…yes we all know the occasional person in their 90′s who is still lively and active…. but let’s be honest they’re the exception not the rule…most people in their 90′s are in nursing homes or kept in that back guest room and are no exactly the best conversationalists. But the fact is that the odds are in your favor that you will not come down with something that will end your life while you are still able to live it.
But still isn’t it natural to fear death?
No. Why would you fear something you know is coming? You know that prayer, “God give me the serenity to accept the things I cannot change.” This is the ultimate thing you cannot change. Accept it.
But most don’t accept it. How do I know this? Well look at how many people set up shrines on the side of roads where family members died. How many parents become nothing but obsessed with their dead children, even to the exclusion of their living children. There are probably few things worse than to out live your own child, but I seriously doubt that you honor your child’s life by effectively ending your own. And back to those roadside shrines. I have seen them where they will put up new pictures, flowers, toys and other monuments on a WEEKLY basis. Good lord! We are talking about possibly thousands of dollars a year being spent on someone who isn’t even around any more. And this is not at a grave sight; it’s at the sight of the person’s death…talk about morbid. This is somehow not what I would call moving from grief to acceptance; it’s more like digging a trench hole fortification in grief and never leaving. And when you do that, the pursuit of happiness no longer has any meaning and thus life has no meaning–it isn’t the healthy version of “You need to fear death” from the Dark Knight Rising where they really meant you need to love living, this is hating living and only loving breathing. And make no mistake there is a difference.
And then there is the rest of society. Look at the box office. When was the last time you saw a decent Romantic Comedy? Might take you a moment to find one. When was the last time you saw a zombie movie come out? Every month? Horror movies, a genre that has never produced more than a handful of movies that could be labeled as anything but crap.
But doesn’t a fear of death, and what may or may not lie beyond, motivate us to live our lives? Carpe Diem. Seize the Day! Eat, Drink, and Be Merry for tomorrow we die! It’s a nice idea…but when did focusing on the negative ever get anyone anywhere. Again these ideas are your need to make the MOST of something, not fear the inevitable.
Lets look at what really happens when you’re obsessed with death.
When you think only about death and the fact that it might come any minute you think short term. You don’t plan, you don’t save, and you don’t expect anything because you might die any minute. Just look at any Democratic plan for this kind of short term thinking. In other words you have lost hope. People who supposedly “live in the moment” aren’t living in the moment, they’re trying to get every last thrill in before what they assume is a rather quick end. They see life as only a series of a few short thrills, a rather insignificant number of experiences to be experienced before the end; life as only a “bucket list” to be checked off and then there is nothing else.
Now let me ask you a question. Once I ask it you will know rationally which is the correct answer, but ask yourself if you look forward to life this way? The question is, if you had before you your own personal and extensive bucket list of all the things you would want to do and were given an option between the bucket list and then death or a reasonably loving marriage, good kids, and a reasonably fulfilling career for a lifetime that was at least 80 years, which would you take? Rationally we would say we would take the longer more meaningful life because rationally we know a whole lot of good experiences are better than a few great experiences. We know that one dive out of a plane, one sight of a famous painting, one moment standing at a famous monument will not compare to years of happiness, even if those years never quite reach the momentary high of those single moments.
However, because we have no hope that we can attain that lasting true happiness, because we are afraid that death can come any moment we don’t strive for it. We make our lives a series of meaningless moments that may in of themselves constitute a momentary high, but sadly have a sum total of zero (or less).
I’m not saying that this society is nothing but a society of base hedonists (although we are close), but how many people are stuck doing a job they hate and don’t take the risks necessary to better themselves to do better. How many of us view the thing we look forward to all week is our favorite show on TV and not our friends. …. Or how many in this country are wiling to vote for the person who promises the quickest fix with the most immediate gratification over a politician who has real plans? Long-term thinking is a reflection of hope. Now does that mean someone who thinks long term should just live by themself and never engage in any of those short-term pleasures? No. Any full life has a balance of experiences.
Now you may criticize me as a hypocrite. Don’t you practice that Buddhist meditation of envisioning your death? Aren’t you focused on death more so than the rest of us? Yes to the first, no to the second. The Buddhists teach to constantly meditate on your death not to be focused on death, but to prepare your mind for the inevitable so it won’t be too shocked by the crossing over and thus will be able to make it back here as quickly as possible. …Again long-term thinking coupled with an obsession with the quality life.
But how does this obsession with death relate to politics? Only too directly. What do you think drives this call for healthcare? Think we’re talking about insurance? Something that isn’t needed for the vast majority of humanity. Yeah we all use our dental insurance on a yearly basis, and if we have glasses we use the Vision insurance…but the medical insurance. I mean honestly now, most of us can go years without going to see a doctor if we take care of ourselves. But that’s not what the argument is over, the argument is over health care, at least from the side of the people advocating for it centers around when we need a doctor not as a precautionary checkup but when we’re dying and need massive medical care! Again why we should all prefer to live, why should the thought of death push us to action? It’s going to happen to all of us. But some of these ways to die are terrible and painful! The cry goes. To which I respond so are the treatments that cost massive amounts of money (that’s partly why this is going to be so expensive) often painful in of themselves, and only buy you a few months, maybe a couple of useless years. I very much believe in fighting to live every last moment you can. But fighting for three more months in a hospitable bed isn’t life; it’s fear of death. Or worse you now see people fighting to keep brain dead husks on life support (possibly tying a soul to a useless body for years because they fear the idea of death so much…but please tell me of a better description of hell than being tied to a body you can nothing with for years perhaps decades? That certainly has nothing to do with the respecting the sanctity of life.) Nothing anything a liberal has argued in calling for universal healthcare is about the improvement of the quality of life, it’s about delaying death for as long as possible. (Because in fact basic economics tells us this will make healthcare far more inefficient and thus ruin the average person’s access to medical treatment).
The fear of death causes nothing but stupid decisions. And this culture needs to get over it.
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.