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OPINION

America Needs to Embrace Death

Lowering health care costs means cutting unnecessary end-of-life treatment

By Drew Nelles| Posted Sep 13, 09 1:26 PM CDT|

(Newser) – Nobody wants to talk about rationing health care, but “the need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate,” Evan Thomas writes in Newsweek. To expand coverage and lower costs, Americans must overcome their urge to extend life at any price, and “learn to contemplate death as more than a scientific challenge to be overcome.”

There are concrete American success stories that show the way: a Massachusetts hospital keeps elderly patients in constant contact with nurses to drive down costly doctors’ visits, while a Wisconsin program encourages patients to make early decisions about end-of-life treatment to cut unwanted procedures. Thomas’ mother, for example, was over-treated until she finally insisted on dying in a hospice. “My mother wanted to die,” he writes, “but the doctors wouldn't let her.”

A clinic at St. Paul's Hospital in Vancouver, BC allows health care specialists to coordinate the treatment of patients with complex chronic illnesses to improve the quality of care and reduce costs. (AP Photo/The Canadian Press, Darryl Dyck)

Dee Jollie, a resident of Greenspring retirement community, discusses her thoughts on health care reform at the retirement community in Springfield, Va. Tuesday, Aug. 25, 2009. (AP Photo/Gerald Herbert)

Roberta Crawford, 89, wears a sticker in support of single payer health care during the Florida Alliance for Retired Americans fifth annual town hall meeting on health care reform. (AP Photo/Lynne Sladky)

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54 comments

VIEWING:

Citrixguy
Sep 13, 09 1:58 PM CDT

Basically...hey old people, die will ya?? please? Reply

-7

IN RESPONSE:

paul123
Sep 13, 09 2:12 PM CDT

Pretty please?

-9

IN RESPONSE:

emptycalm
Sep 13, 09 2:14 PM CDT

No, not at all. But there is no sense in spending so much money to keep these people alive who should usually be dying of natural causes. Isn't trying to keep people from dying an attempted act of "God"? Doesn't that go against yr far right agenda?

IN RESPONSE:

SilenceDogood
Sep 13, 09 2:29 PM CDT

I am not old, but the answer would be, Hell no I won't go.

IN RESPONSE:

Collusive
Sep 13, 09 2:55 PM CDT

I mean my question is, as scientific advancements are made, what will the cut off be? 115? 150? We can't afford the resources and we can't afford the social security. Its part of the balance of nature, and although no one wants to admit it, one day there will be rationing for one reason or another.

IN RESPONSE:

DontLikeYou
Sep 13, 09 2:56 PM CDT

Obamacare = less health care for all, especially for those the government deems "unworthy" of healthcare. Reminds me of how the Nazis handled things back in the 30's and 40's.

-16

IN RESPONSE:

Collusive
Sep 13, 09 2:59 PM CDT

Yea there was a massive extermination of the Jewish population, I have trouble seeing any connections.

IN RESPONSE:

Timinator2K
Sep 13, 09 3:17 PM CDT

"America Needs to Embrace Obama Death Panels."

-15

IN RESPONSE:

UrUndertaker
Sep 13, 09 3:47 PM CDT

This comment has been removed by Newser’s community. You must be logged in to view this comment.

-8

IN RESPONSE:

paul123
Sep 13, 09 5:27 PM CDT

@emptycalm: No it doesnt.

-2

IN RESPONSE:

fancygapva
Sep 13, 09 7:26 PM CDT

@collusive. I don't think we're at the unwilling euthenasia point yet. Health, quality of life, ability to regain quality of life after serious illness. Those are personal and family considerations best considered before the fact, not in the drama of the moment.

IN RESPONSE:

OWLWOMANXXXX
Sep 13, 09 7:44 PM CDT

look young-un...you embrace death...this old gal wants to live as long as she can....

IN RESPONSE:

Spudsy
Sep 13, 09 7:58 PM CDT

“My mother wanted to die,” he writes, “but the doctors wouldn't let her.” - I have seen that personally and it is not pretty. But since the GOP has no empathy for anything other than power and money, it won't matter in the debate.

IN RESPONSE:

rtl
Sep 13, 09 8:15 PM CDT

OWLWOMANXXX - Do you have a problem with someone calling you "old fogey"? Because, even though I'm not old or young (46), I find your "young-un" disrespectful and think you would know better. If you want respect, show respect. Being old doesn't make someone wise - but being civil goes a long way.

IN RESPONSE:

emptycalm
Sep 13, 09 8:55 PM CDT

@paul123 ok maybe try explaining why?

IN RESPONSE:

OWLWOMANXXXX
Sep 13, 09 9:08 PM CDT

and I am offended by citi's statement that all old people should die RTL

IN RESPONSE:

NewserScooter
Sep 13, 09 10:12 PM CDT

Collusive, the argument forwarded by the Nazis was the same. That the Jews did not have lives worth living, because of the cost to society. They were not Human enough. Therefore their lives were expendable. Ageism is an ism like racism etc. I have many patients who are more functional and with it at 95 then some 45 year olds. Who should denied care? Who should die? Sounds like Palin called this one on the nose.

-1

IN RESPONSE:

emptycalm
Sep 13, 09 10:31 PM CDT

Where did anyone say there was any intent to kill healthy old people? Some of you read way too much into things. What they're talking about is not wasting tax payer money on hooking up some old person to a machine so they can live longer than nature "intended" as they say.

IN RESPONSE:

paul123
Sep 14, 09 6:58 AM CDT

@empty: By your logic, we should never even eat a meal then as well. Eating is just an act of preserving our body and prolonging our lives. Twisted logic.

-2

IN RESPONSE:

ronimaca
Sep 14, 09 10:46 AM CDT

do you hate your parents? To bad they didn't abort you.

IN RESPONSE:

Berzelius
Sep 24, 09 9:40 PM CDT

Silence dogood. that is because your a pussy with delusions of grandeur

| 0 minutes ago

SilenceDogood
Sep 13, 09 2:28 PM CDT

Maybe this is what the whole argument is about. White people, old black people, frail you children with leukemia, bikers that are smashed up by a bad accident, a pregnant woman with severe delivery issues that is worrying about her unborn child; they all have he same right to live. Who are we as a society to place one group or person above the other? Reply

IN RESPONSE:

SilenceDogood
Sep 13, 09 2:28 PM CDT

you = young

-1

IN RESPONSE:

westonism
Sep 13, 09 3:52 PM CDT

One with limited resources and a history of leaders more concerned about looking good than of improving the quality of life of the people they represent?

IN RESPONSE:

Toon
Sep 13, 09 9:39 PM CDT

Say rather that they should all have the right to control their destiny. The law should give people personal choice to continue trying or to decide enough is enough.

| 0 minutes ago

SilenceDogood
Sep 13, 09 2:37 PM CDT

Another point, what this whole argument boils down to is rationing, we as a nation can only afford so much. The Liberals all claim how tough it is to be without healthcare, The Conservatives agree but want monetary common sense, the old people whom worked their lifetimes for a pension, sometimes healthcare coverage and a social security check are scared shitless they will be abandoned. Big Pharma argues that they develop life saving drugs that cost billions in R&D and need to make a profit, the trail attorneys that are getting rich suing doctors and hospitals claim they are just trying to help the little guy. We need reform, buy why kill the old people to pay Big Pharma and the trial attorneys? Reply

-5

IN RESPONSE:

rtl
Sep 13, 09 8:02 PM CDT

My Grandmother has gotten more back than she ever put into the system. No one is killing off old people - but rational minds MUST make the decisions NOT scare tactics. Health care is already rationed. Anyone who thinks it isn't has never had coverage denied by the insurance companies.

IN RESPONSE:

freethemall
Sep 13, 09 9:53 PM CDT

You post was making abundant sense until you got to the last sentence: ...."but why kill old people...". You know (or should know) God damn well that nobody, by any stretch of the imagination, advocates killing old people. Why do you lower yourself to advance such a damnable lie?

| 0 minutes ago

passinthru
Sep 13, 09 3:03 PM CDT

stop wasting the taxpayers money on the terminally ill and just kill em off already.. biggest fucking joke ive ever heard. its so hypocritical to think that these people are people that make decisions for millions of Americans and theyre worried about money when it comes to saving someones life. if thats the case WTF is the point of living life if youre not trying to preserve it? better yet, who gets to say what the cost of someones life is? pretty shitty deal for those who dont believe in a man in the clouds. Reply

-5

IN RESPONSE:

freethemall
Sep 13, 09 10:22 PM CDT

Who gets to say what the cost of someone's life is? They (the person whose life or death is in question) gets to say. duh! I know one thing for damn sure, I would NOT want tens of thousands of dollars spent to prolong my life by a day or two. But that should be my choice, one way or the other. If you force me to stay alive, when I would rather die, you are not prolonging my life, you're prolonging my death. The proposed end of life councils are not meant to encourage people who want to go on living, to give up and die. That's a damnable lie. They are meant to let people know what their options are. But the powers that be, who want to defeat reform, know this canard about death panels is a huge red herring.

| 0 minutes ago

Wills
Sep 13, 09 3:21 PM CDT

I personally feel like even this article is too short sighted. Some reform is needed in the short run, but the world is ageing, and unless we figure out a "cure" for that, or find a way to make ourselves age more gracefully and less expensively, the problem will only get worse. But I think the just shows once again how the healthcare debate highlights the lack of economic literacy in the general populace. "Rationing" is the word everyone hates and fears, but the central insights of economics are into how we allocate things which we do not have enough of. Which is called rationing. Healthcare is a scarce resource. Its a convenient fiction for the far left to think we have plenty of it and its only market fundementalism and Big Pharma/law/govt/etc that's preventing us from saving all the poor orphans. If you think along those lines, I'd kindly ask you to leave the entire conversation alone until you take off your rose colored glasses. Up until this point, medical care has been allocated (rationed) by insurance companies for the most part. Medicare is one of many exceptions, for the most part it's been private. The current administration, as well as much of the american public, sees errors in this. And there certainly are many. Allowing people to get any medical care they might want paid for by insurance (if they have it), which America does better than anywhere else, creates a system of perverse incentives that leads people and doctors to choose costly procedures of dubious real value because the doctors are paid and the patients aren't paying. But what do we do? Is it better to have the government choose how we allocate (again, don't forget this means ration) healthcare or the private sector? I really, really am not sure. I can see lots of good arguments for both. And I, and we as a country, are trying to figure it out. But lots of people either do not understand the choice, like passinthru above me, or deliberately try to obscure it, like some vested interests in the pharmaceutical industry. I'm not going to ask the obscurers to stop, because they've got money riding on this and they don't care what the public thinks. But everyone else needs to stop unintentionally confusing the issue, or we're never going to find a good solution. Reply

IN RESPONSE:

westonism
Sep 13, 09 3:57 PM CDT

I can think of one solution. "Logan's Run".

IN RESPONSE:

fancygapva
Sep 13, 09 6:03 PM CDT

Thoughtful. Thanks

| 0 minutes ago

youngblood
Sep 13, 09 4:07 PM CDT

We as a 'compassionate' society are getting weirder and weirder as the years go by. Reply

IN RESPONSE:

newzjunkie
Sep 13, 09 6:10 PM CDT

I agree yb... and at what age does "end of life" begin? To all of you who want the "old" to just go away or die, have any of your parents faced end of life yet, or have you watched them die?

| 0 minutes ago

fancygapva
Sep 13, 09 5:51 PM CDT

The pharmaceutical companies and the medical profession promote the idea that we can always fix whatever is wrong, always live over it. We can't. We shouldn't. Flowers don't bloom year round. In summer they fruit, in fall they go to seed and in winter they die. So so we. When life no longer has positive quality, we should be ready to go. My blind, deaf 84 year old aunt periodically quites taking her meds because she can no longer do the things she wants, and has enjoyed. Her lungs and heart are fine, but there is no joy in her life. Should she be hooked up to tubes against her will so that her daughter will feel guilt free and the docs and drug pushers and hospitals get rich? If there's any justice, if my living will and durable health care power of attorney mean anything, I will not live one instant longer than I am able to enjoy my life, at least 50% worth. I can't imagine who would want to live with chronic pain and sensory deficits to say nothing of endless procedures, difficulty breathing, enjoying food, sex, etc. You guys who are saying live at any cost, you are very, very young. Enjoy yourselves now. Let it go when you're not having fun anymore. Reply

IN RESPONSE:

NewserScooter
Sep 13, 09 10:13 PM CDT

So your saying we should not treat depression?

-2

IN RESPONSE:

fancygapva
Sep 13, 09 10:44 PM CDT

I'm in the mental health profession and I'll tell you a secret. Everyone I know on anti-depressants, consumers, friends, relatives--is still depressed to some extent. No shit. Yes, treat chronic depression. But it's a fact of life that some things are NOT happy things, they are there in one's path and a pill won't cure it. I believe those things, those life obstacles that wake us up in a cold sweat or won't let us sleep, I believe those things are learning opportunities and if they are struggled with and lived through, either alone or with the help of family, friends, professionals and in severe cases, temporarily, pharmaceuticals, life is richer. But depression is also a natural phase of grief, and part of old age is grieving loss of health, friends, mates, mobility, independence, sensory and mental acuteness. In other words, NATURAL and we've been sold a bill of goods that we can be effortlessly "undepressed" via pharmaceuticals.

| 0 minutes ago

rtl
Sep 13, 09 7:31 PM CDT

Health care is already rationed. "Claim denied", "Coverage denied", whatever they want to call it, it amounts to the same thing. PLUS we pay for all the ER visits by people that are destitute and without insurance anyway. Reply

IN RESPONSE:

Doctor_Zaius
Sep 13, 09 9:42 PM CDT

The real life "Norma Rae" just died of cancer because her health insurance denied her medication for 2 months before granting it but it was too late.

| 0 minutes ago

SPH
Sep 13, 09 8:32 PM CDT

"life , .liberty, and the pursuit of happiness" this applies to elderly people as well...What don't you conservatives understand here?.... Reply

| 0 minutes ago

Dr.Y.Dino
Sep 13, 09 9:08 PM CDT

I wonder if Evan Thomas will feel the same when he, his wife, or child do want to live a little longer and are denied treatment. Reply

| 0 minutes ago

Doctor_Zaius
Sep 13, 09 9:41 PM CDT

You want to keep me alive forever, fine. Just figure out a way to make me 25 again and bring on the chicks. Reply

| 0 minutes ago

jagerhans
Sep 14, 09 5:34 AM CDT

did someone here know something about the Eluana Englaro affair and end - of life polemics about that horror story ? Reply

| 0 minutes ago

cochiserocks
Sep 14, 09 5:55 AM CDT

It is the duty of a doctor to prolong life. It is not his duty to prolong death... -Thomas Horder Reply

| 0 minutes ago

oldgoat
Sep 14, 09 6:31 AM CDT

For me I want the option of ending life if I want. I've seen family member waste away while waiting for death to come. In the meantime they become a job for someone to change their diapers, bathe, feed and lift in and out of the bed. Quality of life has to figure in here somewheren. I think the whole thing boils down to the old realizing sometimes that existing isn't that great especially for them and their loved ones. One of these days maybe medicine will catch up with what drugs can do, but I don't believe that we are there yet. Reply

| 0 minutes ago

rtl
Sep 14, 09 6:36 AM CDT

OWLWOMANXXXX - I "get" that you were offended. Citi has that effect on a lot of us here. BUT how do you know he's young? And young-un seems condescending. Age (young or old) has nothing to do with common sense. That was my point. This whole debate is fed on fear and the GOP circus machine. Let's get it back to being INFORMATIONAL instead of confrontational. Reply

| 0 minutes ago

mikech
Sep 14, 09 8:03 AM CDT

This is another slippery sloopoe. What we will wind up with two tiers. The wealthy will receive life extending treatments and the middle class will be forced into these choices. Taken to a SiFi conclusion, we will wind up with a class of immortals. But today's SiFi is tomorrows science. Reply

IN RESPONSE:

freethemall
Sep 14, 09 10:56 AM CDT

What part of the word "choice" do you not understand? It should be a choice by the individual whether tens of thousands of dollars should be spent to prolong his or her life. I hate to hit the caps lock but here goes: NO ONE HAS PROPOSED THAT ANYONE SHOULD BE DENIED CARE DUE TO ADVANCED AGE. THAT'S A DAMNABLE LIE, AND A RED HERRING BY THOSE WHO WANT TO DEFEAT HEALTH CARE REFORM.

| 0 minutes ago

Zorro
Sep 14, 09 9:27 AM CDT

Many great, rational comments here from both sides - thanks for educating me on this issue! Just one point to add - I don't know the reform proposal well enough to conclude that ageism is being treated as another "ism" - where the old will receive sub-par treatment - but it seems clear that today we have money-ism (or wealth-ism, or whatever its called) - the more money you have, the better health care you get. You can argue that these people worked hard for health care - but that's not always the case. I don't have a stand on this, just another point to complicate the issue. Reply

| 0 minutes ago

ronimaca
Sep 14, 09 10:44 AM CDT

There are death panels, they are the for profit health insurence companies. get real people the government is trying to protect us. Reply

IN RESPONSE:

PhillytoWinnetka
Sep 14, 09 5:19 PM CDT

you need to get real...and look out for yourself first and not wait around expecting the gov't to "protect" you. Do you remember what happened w/ Hurricane Katrina? Those folks right or wrong..should have made plans to protect themselves first, rather than hope the gov't(as if) could do it as effectively.

| 0 minutes ago

kansas1946
Sep 14, 09 9:39 PM CDT

I am 63 and I think this is right on. Too many times, patients have treatments forced on them by either over zealous doctors or loved ones who just can't let go. It makes no sense to extend the life of an elderly patients by machines and feeding tubes if there is no quality left to their life. Older Americans need to talk to someone about these end of life issues and get papers drawn up ahead of time. You don't want it to end up in the hands of the court or a bunch of zealots like poor Terri Schivo. Every person has the right to die as they wish and when they wish. This is the most important and personal decision that any of us have to make. Our bodies belong to us and no one else. I have never talked to one older person that wants to be kept alive on machines. Reply

| 0 minutes ago

radnip
Sep 25, 09 3:37 AM CDT

Let's see: Ration care for elderly so everyone can get care. Or ration care for everyone so the few executives can get pooled premiums in the millions of dollars. Which do you think we have now? Reply

| 0 minutes ago

View all 54 comments »

health care • health care costs • death • rationing • health care reform • death panel • end-of-life care

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x

America Needs to Embrace Death

Lowering health care costs means cutting unnecessary end-of-life treatment

We Must
Reduce Health Care Costs*

*But please don't
touch mine, no
matter how wasteful

MORE ABOUT:
health care • health care costs • breast cancer • prostate cancer • rationing • mammogram • health care reform • U.S. Preventive Services Task Force • Eugene Robinson

Mammogram Backdown
Hurts Health Reform

Sebelius played politics, missed chance to show leadership

MORE ABOUT:
health care • breast cancer • mammogram • health care reform • Kathleen Sebelius

CBO Estimate: Senate
Health Bill Costs $849B

Figure clears the way for Reid to get measure rolling

MORE ABOUT:
health care • Senate • Harry Reid • Congressional Budget Office • health care reform

health care • health care costs • death • rationing • health care reform • death panel • end-of-life care

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America Needs to Embrace Death

Lowering health care costs means cutting unnecessary end-of-life treatment

Related Newser Stories

Eugene Robinson

We Must Reduce Health Care Costs*

*But please don't touch mine, no matter how wasteful

MORE ABOUT: health care • health care costs • breast cancer • prostate cancer • rationing • mammogram • health care reform • U.S. Preventive Services Task Force • Eugene Robinson

OPINION

Mammogram Backdown Hurts Health Reform

Sebelius played politics, missed chance to show leadership

MORE ABOUT: health care • breast cancer • mammogram • health care reform • Kathleen Sebelius

CBO Estimate: Senate Health Bill Costs $849B

Figure clears the way for Reid to get measure rolling

MORE ABOUT: health care • Senate • Harry Reid • Congressional Budget Office • health care reform

health care • health care costs • death • rationing • health care reform • death panel • end-of-life care

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We Must
Reduce Health Care Costs*

*But please don't
touch mine, no
matter how wasteful

MORE ABOUT:
health care • health care costs • breast cancer • prostate cancer • rationing • mammogram • health care reform • U.S. Preventive Services Task Force • Eugene Robinson

Mammogram Backdown
Hurts Health Reform

MORE ABOUT:
health care • breast cancer • mammogram • health care reform • Kathleen Sebelius

CBO Estimate: Senate
Health Bill Costs $849B

MORE ABOUT:
health care • Senate • Harry Reid • Congressional Budget Office • health care reform