Afraid to Let Go- Health Costs Skyrocket

He was afraid to let go.  Afraid to say no more.

“Do everything,” he said.

So his wife, an 87 year old woman from a nursing home laid in bed day after day.  Racked by a multitude of severe medical problems:  kidney failure, alzheimers, a weakened heart muscle, and severe emphysema.

She had no mind.  No coherent thoughts flowed inside her.  Just jibberish.  “My tube, my tube, my tube.”

The nasogastric tube bothered her nose.  She tried over and over to pull it out.  A severe infection raged through her body.  Numerous expensive antibiotics were given.   She developed a racing heart from her infection and low blood pressure.  Her chances of survival were extremely low.

Her husband, devoted and loving, was afraid to let her go.  So we pressed on.  Medications, tests, and more medications- the scene above isn’t unusual.  It is common, way to common.

Even when the inevitable is staring us in the face, loved ones have trouble letting go.  It’s normal.  It’s natural to think someone will live forever, should live forever.  But they don’t.  Everyone dies.

The health care debate has been raging itself over the last 2 years.  Republicans (mostly) ask- where will we find the money to pay for this new health care plan?   Recently Allan Greenspan suggested that if the Congressional Budget Office is wrong we could be in a whole lot of trouble: (http://blogs.abcnews.com/politicalpunch/2010/04/greenspan-on-heath-care-costs-severe-consequences-if-cbo-is-wrong.html)

If we want to solve the health care crisis we have to come to a consensus on when to let go?   As a society we have to determine what is the limit?  It’s not an easy answer.  Emotions run very, very high. But the money to pay for health care can be found within this debate.

Other societies have come to terms with this.  They have formed a consensus about who should receive heroic treatments.   For example, in America, kidney dialysis ($35,000-60,000/year) is offered to people at any age, in any physical condition.  In other countries, they limit dialysis.  Bypass surgery, expensive heart treatments, cancer treatment for incurable cancers, orthopedic surgery for people who don’t walk-  the list of very expensive treatments that are limited in other cultures goes on and on.

In America we need to start looking at this.    I’m not saying I have the answer to such sticky questions.  But anyone who works in medicine knows that you can’t pay for health care without finding a consensus regarding these issues.

A discussion at least would be helpful.

So I’m starting one.  I welcome your comments.