November 11, 2011

AN EMAIL I RECEIVED: Meeting at the Corner of Health and Money! What's Your Reaction?

On Wednesday, I received an email in response to something I'd posted. I asked the sender if I could "publish" it, with her name. She declined to be identified -- I respect that wish -- but she gave me permission to post her thought-provoking note anonymously. And I thought that this would be a good time to remind you that you, too, can send me an email at the address I publicize here: jschappi@gmail. If you'd prefer to correspond via email -- as this person did -- that's great! I'd love to hear from you.

Of course, you are always welcome to leave comments right here on the blog where others will automatically see them. Remember, you can post comments without disclosing your identity, if you prefer. What matters to me is this, and this only: I love getting responses and opinions, however they arrive, and whatever they say. If you disagree with something I've written... even better. Just let me know!

I admit: I soft-pedal my strong views on political issues on this blog, and I despise the slash-and-burn attacks we see too often on TV. IMHO, much of our current political paralysis results from excessive attention given to the crazies at both ends of our political spectrum.

We need to hear more thoughts from sensible people somewhere in the middle, like the author of this email who reminds us that -- healthcare reform politics aside -- we're dealing with human beings struggling with end-of-life choices that make real sense -- personally and financially.

Hope to hear from more of you in the "silent majority." 


You've generated several conversations lately in one of the scariest parts of town: the intersection of Health and Money. We pause there – under the shade of the Discomfort Tree – throw around some quick ideas, and usually get the hell out of there as quickly as we can.
We need to linger. Honestly, I know of no other place where we need to spend more time -- if we care about our children’s and grandchildren’s futures… and our country’s frightening deficit.
We met at the Intersection just yesterday, when you railed against AARP for threatening elected officials with removal from office if they DARE touch our precious entitlement programs, like Social Security and Medicare. “Reduce spending, sure. But don’t even THINK about touching MY stuff!”
You brought us together there last week, too, when you wrote “The Best Way to Die.” I loved that piece, and it brought back lots of memories -- wonderful and horrible -- of my father's last days ten years ago. Most of us want simple, painless, dignified deaths at home or in hospice (thank God, my Dad's last days in hospice were -- oddly -- pretty happy for him and for us). Tragically – in a way that is fiscally unconscionable, as well as contrary to our most earnest (and usually unexpressed) wishes – we will instead die in hospitals, plugged into machines that aren’t helping us. All the while, the meter is RUNNING. It makes me crazy!
You wrote about healthcare costs two weeks ago, too, as part of the debate about PSA tests and other procedures, too.
If it’s the patient’s own money to spend on these procedures, and if she has discussed her wishes carefully with her family and doctors, so be it. Not the choice I’d make, but still -- all best wishes.
In most cases, though, it is NOT the patient’s money – it’s ours… yours and mine – and she did NOT specify clearly and rationally in advance that she even wanted the extraordinary measures being taken to prolong her life, such as it is. “Her life is worth all the money in the world!” Chances are, we’ve all felt that way. I felt that way about both my parents. Still, the only inevitability about life is death. And all the money in the world cannot keep the Grim Reaper from his rounds.
I recently saw an old taped segment from the CBS show "60 Minutes," for which I later found a kind of transcript. In that show about death, a Dr. Ira Byock said: “Families cannot imagine there could be anything worse than their loved one dying. But in fact, there are worst things. Most generally, it’s having someone you love die badly…. Dying suffering. Dying connected to machines. I mean, denial of death at some point becomes a delusion, and we start acting in ways that make no sense whatsoever. And I think that’s collectively what we’re doing."
I agree with him, John. I think this is JUST what we're doing.
The pool of money funding these often needless, useless procedures is not bottomless, though we act as if it were. That’s not all. Healthcare is about the only arena I know where the consumer – the patient – does not typically end up paying for the goods and services received. WE do. Isn’t that strange? If I want a new computer, or a massage, or a trip to Costa Rica, I consider first if I can afford it. If I can’t, I do without, or I buy something I CAN afford.
I’m not suggesting that only those people who can afford medical services should receive them. Far from it. Medicare, in fact, pays for practically anything, shelling out countless millions of dollars every year for tests and procedures that do not help patients, and even cause harm. Do those procedures have any positive effect? Well, to be sure, they create revenue for hospitals and healthcare workers… revenue for which taxpayers foot the bill.
I am so proud of my father, may he rest in peace, for making the choices he did, and for insisting we honor them.
If you were the CEO of Medicare, John – pondering the limited pool of precious resources so often squandered – would you run the company this way? Guess what? As a taxpayer, you ARE Medicare’s CEO. We all are. Should we stand quietly by and watch our company go to hell in a hand basket?
I'm grateful to you for writing about this difficult subject. More of us need to talk about this gigantic issue. We need to DO something about it. No question: it isn’t fun hanging out -- and talking -- at the scary intersection of Health and Money. But do you know of a more important place for us these days?
Please, keep talking. Keep writing!
>name withheld by request<

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