Take a look at my apricot tree. We planted it shortly after moving in so it's now over 20 years old. A few years ago we noticed several dead branches and the tree was leaking giant globs of sap. It didn't look good. I visited our local nursery and talked to their arborist. He told me that apricot trees don't live more than 10-15 years in our harsh desert and recommended not spending any money trying to fix the tree. "Take it out. Time to replace it," he advised.
Not being ones to give up so easily we trimmed out the dead wood, fed it some sulfur and stuff and said, "Let's see how it does." That was more than three years ago.
There are many reasons I am opposed to the current Health Care Reform legislation. Outcome based health care is one. (You can look at House Bill 3200; Section 1162; subsection (ii) Establishment of Outcome Based Measures pages 335-339.) It is part of the payment section. In short, this subsection says that the government will mandate the establishment of "outcome based measures." I can't help but look at this and believe that this type of plan will move us from a health care doctor/patient relationship (with limitations by my chosen insurance plan) into a doctor/patient/advisor relationship. It appears that these mandates will add statisticians to the table.
I don't look at these advisor's as a "death panel", well, at least not in the sense that the patient will find himself standing in a circular room surrounded by black hooded robed "specialists" who can give life a thumbs up or down. But it does sound like the advisors will be able to overstep my doctor as to whether a test or procedure or even surgery would be covered based an individual's health, age or the "predicted" prognosis. What will be the criteria used to make these decisions? Must one be a "productive member of society"--and how do we decide what that means? You might have read elsewhere about seniors who are concerned that they will be denied services because they have already outlived their statistical life. These concerns become particularly worrisome if funds become limited or the plan overpopulated--did you not ever watch Logan's Run???
This change worries me greatly and here's my real life example. Our son, Matthew, was diagnosed years ago as having Cerebral Palsy. He also fits the criteria for Autism. Perhaps now that Matthew is 26 I could make an argument that he doesn't really have CP or that it is such a mild case that the statistics of mortality wouldn't fit him. You'd probably agree watching Matthew as he appears quite healthy. But I've been told for years, "Once Diagnosed; Always Diagnosed." In other words once you have been diagnosed by an "expert" you have this disease until you can find another "expert" to retract it.
Okay, let's take CP out of the picture and just look at Autism. You'll see many places where it state that people with Autism are expected to have normal lifespan. Yet there are studies (lifeexpectancy.com) that show autistic people have a reduced life expectancy. What if Matthew gets cancer? Would he be treated as aggressively if someone gives him a higher mortality rate? Would he be denied therapy because he's not a productive member of society? And who gets to make those decisions?
The other day I read about a young girl born with Down's Syndrome in the UK. Like a whole lot of "normal" infants she had some complications. Unfortunately, during treatment she was given too much antibiotics and down the road her kidneys were in failure. At that point she was a good candidate for a transplant as she was in otherwise good health. But the advisors with the National Health Service in England said that she was not eligible because she would not be able to care for herself and take the medications as needed. It is a tragic story that I have trouble even retelling it because I can't help but think of children I know with Down's or other special needs.
Looking at the proposed health care reform plans it's obvious we must be a voice for those, like Matthew, who can't talk. If his doctor, my husband and I agree on a treatment plan for any given ailment we do not want a government bureaucrat to come in with a "thumbs up" or "thumbs down." Like my apricot tree's continue growth, statistics don't always hold out.
It's something to think about as we sit under its shade and watch the birds in their nest.
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