Wednesday, July 30, 2008

Soylent Green in Oregon?

James Taranto's Best of the Web has this subarticle, that I have reproduced in its entirety:
Great Moments in Socialized Medicine
Oregon is, according to an editorial in the Oregonian newspaper, "the only state that both allows assisted suicide and tries to ration health care." This embarrassed the state when 64-year-old Barbara Wagner got sick with lung cancer and the state essentially said to her, Have you considered suicide, lady?:

After her oncologist prescribed a cancer drug that would cost $4,000 a month, the newspaper reported, "Wagner was notified that the Oregon Health Plan wouldn't cover the treatment, but that it would cover palliative, or comfort, care, including, if she chose, doctor-assisted suicide."

The Oregonian editorial explains that the decision to deny coverage for the drug was based on a policy of disapproving payment "for treatment that doesn't provide at least a 5 percent chance of survival after five years." The paper does not fault the state for this decision:

In Wagner's case, administrators of the Oregon Health Plan had to make a difficult call. But that's what they do every day in performing the tough, thankless job of rationing government-paid health care to the needy.

What's unacceptable, however, is that Wagner's rejection letter included the offer of payment for doctor-assisted death. Such notification creates at least the appearance of an ethical conflict: state encouragement of dying as a cost-saving measure.

The editorial notes that, the rejection of the $4,000-a-month drug notwithstanding, taxpayers have "paid thousands of dollars over the years for Wagner's cancer care, and . . . will continue to do so."

Unless, of course, she chooses suicide instead--an option that would still be open to her whether the state made the point explicitly or not. The Oregonian is troubled by the "appearance of an ethical conflict" when the state spells out the offer, but it seems not to mind the actual ethical conflict posed by the underlying assisted-suicide policy.

Yeah, government run health care will be soooo much better for us. Accountants determining what care you get just sends a shiver down my leg.


Andy B. Hammond said...

Good Lord...

Anonymous said...

LOL! Oh, wait...

Anonymous said...

I understand that you want to take pot shots at me, as you don't debate well otherwise. But that was weak sauce. Weak ...

You're missing the point, again. (sighs) We ration health care here in this country, but we do it based on who has the most money. It's frightfully inefficient and expensive. If the Oregon woman had money or a blue chip insurance policy, she would have gotten the drugs, no questions asked, even though they are expensive and don't work. The drugs are a placebo.

The only difference between the US and other industrialized countries is the manner in which we choose to ration health care. Here we do it based on bank account. In other countries, it's based on need. That's why they do it so much better, and why our system is so overwrought with petty insurance bureaucrats rationing our care.

Steve said...

I agree Mark that it is difficult to debate you, since you make up most of your "facts" and blithely ignore every time that you are shown to be full of it. Your persistence in your belief that the government is always better blinds you to obvious truths.
But you ignore in this argument the problem with any system that is run by the government: Someone is always going to say that your life is not worth saving because it costs too much.
Compassionate accountants may just be as oxymoronic as it comes. The accountant has a duty to the bottom line. And while the 87% of the population who have health insurance amy not be all that satisfied with it, it is still better than the system in Canada, where they have programmed into the system the number of people who will die while waiting for MRIs, CAT scans and other needed treatment.
The other issue not addressed in the article, where is the Medicare Part D plan in all of this? Since we are spending a huge amount to make meds affordable, how is $4000 a month supposed to be considered affordable? And that is a government run program that you idolize so much.
Your problem is that you look at an imperfect system and presume that the government can make it better. My problem is that I look at an imperfect system and know that the government can make it worse.
If you were right, great! If I am right, even less health care coverage than we have now.
I am not willing to gamble on people's lives just because you have an agenda for greater governmental control of our lives.

Anonymous said...

The Canadians, who do not have the best of systems (though it is far better than ours), are mostly happy with their system. You accuse me of making up facts - you're far better at broadcasting manufactured data than I. And our system being bested by that of Canada, Great Britain, France, Australia, Japan, Taiwan, West Germany, and of course the Scandinavia countries, is fact. People there live longer, live birth rates are higher, and their costs are much lower by a factor of at least 50%. We run by far the most expensive system in the world, yet 47 million of us have no insurance, millions more are underinsured, and economic insecurity is simply a fact of life here. Any one of us can be wiped out at any time by medical costs.

The US is now 42nd in terms of life expactancy, down from 11th just twenty years ago.

Round and round we go - your horse follows your car. You presume to know that markets always offer the best solutions, and therefore look at our system and force it, in your mind, to be the best of all possible worlds.

Truth is, markets don't always work well, and that there are some things that governments do better. One is health care. The testimony of the rest of the world is in your face, but you cannot see it. You are blinded by ideology.

Steve said...

Mark, I admire your tenacity in either making up data, or in relying on other people's made up data. The WHO ranking is based on the skewing of what determines rankings and how they are to be measured. But again, you uncritically rely on the DNC talking points.
But don't worry, you are not alone in being manipulated in that regard. In fact, there is an excellent review of the flaws in the methodology right here.
I am sure that this doesn't comport with your desire to see this country as an abject failure, unless the government steps in to correct what the market is doing. I however, find that there is absolutely no example where government intervention to the extent that you are talking about has ever worked.

Anonymous said...

Good grief - talk about subjective - the two articles you refer to are remarkably so. And where I rely on WHO, you send me to a fricking blogger. I'll stick with WHO, thanks.

Example: The measure of health care does indeed include delivery of care to people, and the US is notably deficient in that regard. So your blogger tells me that's a subjective measurement. I can't think of anything more relevant. Cost of service is indeed another fair measurement, and cost of service is indeed lower in other industrialized countries, by a factor of 50% or so. So you want to jettison that measurement too.

Yes, it is true that taxes are how they pay for it - but if you compare their taxes against our private and tax expenditures in total, we suck.

You mentioned before that 87% of Americans have insurance. I'm sure you're proud of that figure. But it's distressingly low. Other countries are doing more like, say ... 100%? And you don't say how many of that 87% are covered by government health care systems in this country - you know - the ones the private sector jettisoned (they were sick - the private sector doesnt' like sick people. They're too expensive). Tell me how much of our population is covered by private health care - remove VA, Medicare and Medicaid from your calculation, and you'll find that the government is already doing a good deal of our health care. Not because anyone asked them to - by default. The private sector failed us miserably. The only reason seniors are covered by Medicare is that there was no coverage available to them in the private sector if they were actually sick.

Good grief - you don't like the results of objective measurements, attack those who do the measuring. By any standard a system that leaves 47 million of its citizens uninsured, millions others underinsured, and still costs twice as much as other countries is a failed system. Period.

Anonymous said...

BTW - you mentioned Medicare D above - as if somehow we are responsible for this boondoggle. It's an industry-sponsored program designed to benefit industry (yet another subsidy)that has ano cost control measures built in. Big Pharma has been feeding at this trough for several years now.

With prescription drugs other countries manage to control costs quite well by, well, controlling them. And since government in this country does most R&D for drugs, there's no reason not to put caps on costs.

Anonymous said...

You might enjoythis. You might not.