The cycle of life and spiralling health care costs

[Urbane]

This George Jonas column raises some unpleasant aspects of life and death as they relate to the spiralling costs of health care:

George Jonas: “Free” health care will see me and my friends bankrupt Canada

George Jonas Apr 23, 2011


Geriatric medicine has been trying to accomplish something that goes against our blueprint. As living beings, we’re designed to be born, mature, age, sicken and die. That’s the cycle of life. Existence is a process in which every condition is its own cure and every cure its own condition. Maturity is a remedy for childhood, and so on. Death heals the disease of life and birth heals the disease of death.

It’s simple and elegant — and we don’t like it. Never did. We didn’t in the Garden of Eden, and we don’t in Canada. Back then, we figured an apple a day might keep the doctor away, but we never made it to the Tree of Life. Evicted by an indignant Creator for sneaking a taste of Knowledge, we’ve been trying to recreate Paradise on Earth ever since.

Modern medicine and universal health care are manifestations of this urge. Our quest is to die in perfectly good health. It’s a contradiction in terms, but never mind. That’s only our small problem. Our big problem isn’t what we can’t achieve, but what we can.

The 17th-century poet Angelus Silesius hasn’t been part of the health-care debate, but he was among the first to note the paradox. A doctor by occupation and a mystic by preoccupation, known as Johann Scheffler in his day job as court physician to Habsburg emperor Leopold I, Silesius foresaw that the healing profession might fail by succeeding. One of his couplets ran: “No ends, only beginnings. Grim midwife, / Death is renewal. Death’s birth. Death brings life.”

One needs to remember that declining and dying aren’t enemies of the organic process, but its natural components. Delaying them isn’t only artificial and costly, but runs counter to life’s purpose. What goes up, must come down. Gestation and growth are spontaneous. The wheel of existence rolls by its own geometry. Trying to slow or stop morbidity or mortality in mature organisms is sticking a crowbar in the spokes of a wheel. Modern medicine is an act of hostility to life.

At one time, we saw this clearly. One day, we may see it again.

The forbidden fruit we managed to liberate from the Tree of Knowledge proved nutritious, but at an ever escalating cost. In 1846, Dr. Ignaz Semmelweis made medical history when he eradicated puerperal fever by washing his hands between attending the morgue and visiting the maternity ward in Vienna’s General Hospital. A hundred years later, Hermann J. Muller needed to produce mutations by irradiation to make medical history. The cost of Muller’s discovery, for which he received the Nobel Prize in medicine in 1946, was to Semmelweis’ cost what an X-ray machine is to a bar of soap.

While doctors could do little, they made house calls for a couple of eggs. When they could do much, patients lined up in front of their surgeries carrying chickens. By the time doctors could save patients, patients could no longer afford doctors. Society’s eggs needed to be pooled, and the question became whether to put all the eggs into the government’s basket. Canadians said yes. Today, many have second thoughts.

Why are costs going through the roof?

One obvious cause is medical sophistication. We transplant organs; use million-dollar diagnostic machines; we re-attach limbs we used to amputate. Re-attaching a limb is a more satisfactory result than cutting it off, but it’s infinitely more expensive.

Another cause is entitlement. If people purchased medical services the way they buy food, clothes or transportation, limiting themselves to what they can afford, prices would come down. But illness in our culture removes economic constraints. Few feel entitled to drinking Champagne, but most feel entitled to having low cholesterol and normal blood sugar. People expect to have all available therapies or drugs at their disposal whether they can afford them or not. Insurance, whether private or public, inflates considerably what “the market will bear.” If consumers bought caviar on “lifestyle” insurance, a milligram might cost what 10 grams cost today.

The biggest economic burden comes from post-productive longevity. Medicine extending people’s lives beyond their productive years carries a huge price tag. It’s one thing for doctors to patch up a current contributor to the economy, and quite another to spend health-care dollars on a retiree soaking up resources like a light bulb in an empty room. We all love Gramps, but he’s an economic menace. My contemporaries and I drooling on park benches in sufficient numbers, feeding pigeons and drawing pensions for 20-30 years after retirement, can bankrupt Canada without any assistance from anybody.

Easy to fix, someone might counter. If medical science can keep people fit, Gramps and Granny don’t have to retire. No pigeons, no pensions. Let the old folk stay productive until they’re 100.

That’s a really bright idea. It means Junior can have a starter job as soon as he turns 60. The kid will be okay until then. We’ll give him Grandpa’s pension as an allowance.

Houston, we have a problem. Health care is making us sick. Silesius wouldn’t be surprised.

National Post

[NAB]

Christie Blatchford:

With the great mass of Baby Boomers getting old, we too will grow frail and fall upon the mercies of the badly faltering health-care system

Read More: http://fullcomment.nationalpost.com/201 ... re-system/

[steven lloyd]

We need to get rid of the bureaucracies - but obviously (and unfortunately), that would have to be a bureaucratic decision.



Just a little “health fact":

Research from the Mayo Clinic...

Did you know that in the human body there is a nerve
that connects the eyeball to the anus? It's called the
Anal Optic Nerve, and it is responsible for giving
people a poopy outlook on life.

If you don't believe it, pull a hair from your ass and
see if it doesn't bring a tear to your eyes.


My public service is done for the day.

[Glacier]

Perhaps one of the main reason we have such spiraling health care costs is because of how die.

I think there is a subtle philosophical difference between the older generation and the newer (and likewise between North America and Europe) when it comes to death and health care treatment. I say subtle because the same treatments are utilized and available across the pond, but Europeans are more likely to conduct cost-benefit analysis. In modern day North America we hold the philosophy that life must be extended at all costs. I say extend because modern science does not save life, it merely extends it because every last one of us will die.

A couple of personal examples:

Relative #1 went in for a hip replacement a couple years ago, at which point they discovered he had lung cancer (the number one cancer killer for both men and woman). Lung cancer is almost always fatal, but the medical establishment spared no expense fighting his cancer. Within 6 months of being cured, they discovered that it had spread to his brain. Again they fought it, but it was a losing battle he ended up losing a few months later.

Relative #2 was diagnosed with an extremely aggressive and fast growing breast cancer last Spring. After a couple of months of cancer treatments, she went home "cured." The cancer came back in the fall (this time in the liver), and she was going to go through the chemo if she has been given more than a week to live.

By contrast, how do doctors die? Hint: It's not like the rest of us, but it should be...

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently. [1]

References:
[1] http://zocalopublicsquare.org/thepublic ... ead/nexus/
[2] http://www.cbc.ca/thecurrent/episode/20 ... uidelines/

[steven lloyd]

Modern science does not save life, it merely extended it because every last one of us will die.

Great point Glacier, and something I really think we need to re-think. I liked this example:

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

I have an uncle in his mid eighties who has been diagnosed with cancer. He’s been offered the choices of chemo and radiation therapy but refused both. For him it is about quality of life – and quality of what life he has remaining. I think I can really appreciate that. I work fairly hard at staying in the best physical shape as I possibly can for a middle-aged guy, but that is about quality of life ( being able to enjoy life, travel and golf, etc. ). There are no guarantees regarding longevity ( anything can happen - accident or disease ), and when that time comes I do not want to be a burden on anyone – loved ones or society as a whole. Just give me what I need to make me comfortable and let me say my goodbyes and go.