
{"id":16678,"date":"2011-03-17T11:06:37","date_gmt":"2011-03-17T15:06:37","guid":{"rendered":"http:\/\/www.carrborocitizen.com\/main\/?p=16678"},"modified":"2011-03-17T11:06:37","modified_gmt":"2011-03-17T15:06:37","slug":"the-waste-we-cant-talk-about","status":"publish","type":"post","link":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/2011\/03\/17\/the-waste-we-cant-talk-about\/","title":{"rendered":"The waste we can&#8217;t talk about"},"content":{"rendered":"<p><strong>Vicky Dickson<br \/>\n<\/strong><br \/>\nIt doesn\u00e2\u20ac\u2122t make sense to me. Our representatives in Washington, in a panic over the effects of current spending levels on the country\u00e2\u20ac\u2122s long-term future, are proposing deep cuts in health and social programs. But they\u00e2\u20ac\u2122re leaving one of the fastest-growing of those programs, Medicare, alone, despite a Congressional Budget Office projection that Medicare and Medicaid expenses will nearly double their share of the GDP in the next 25 years. If lawmakers are so concerned about our future, you\u00e2\u20ac\u2122d think they\u00e2\u20ac\u2122d be worried about that growth, and also about the negative effects that cutting programs like Head Start and WIC could have on the ability of our children to earn the money that will be needed to keep Medicare benefits coming.<\/p>\n<p>Since cuts are often justified by the claim that they\u00e2\u20ac\u2122ll merely root out waste, there\u00e2\u20ac\u2122s further irony in the fact that Medicare spends about $50 billion a year on medical care for people in their last two months of life. Not all of that money is wasted, of course, but there\u00e2\u20ac\u2122s no question that a significant amount is spent on futile operations and procedures for patients who are dying. And it\u00e2\u20ac\u2122s not just the money that matters; too many people are ending their lives in painful, traumatic ways they\u00e2\u20ac\u2122d never choose if they were able to think clearly about all their options.<\/p>\n<p>End-of-life counseling can enable that kind of clear thinking. But the hornet\u00e2\u20ac\u2122s nest Sarah Palin stirred up when she equated such counseling with \u00e2\u20ac\u0153death panels\u00e2\u20ac\u009d has apparently made lawmakers loathe to consider funding anything of the kind. So, since our leaders have abdicated their responsibility for ensuring that Medicare funds aren\u00e2\u20ac\u2122t wasted on operations and procedures that are harming us, we need to take that responsibility upon ourselves.<\/p>\n<p>This became clear to me when my 80-year-old father, suffering from both dementia and severe arthritis, was hospitalized for fainting spells. The spells were attributed to a faulty heart valve, which the doctor who saw him in the hospital told me could be fixed with an operation I would need to authorize. The doctor was shocked when I refused to do so.<\/p>\n<p>Not being my father\u00e2\u20ac\u2122s primary-care doctor, the attending physician didn\u00e2\u20ac\u2122t realize the extent of my dad\u00e2\u20ac\u2122s dementia. The conversation they\u00e2\u20ac\u2122d had hadn\u00e2\u20ac\u2122t lasted nearly long enough for the doctor to understand that his Princeton- and Harvard-educated patient could no longer read a book, remember what he\u00e2\u20ac\u2122d told you three or four times in the past ten minutes, or understand that he was in a hospital. The doctor also didn\u00e2\u20ac\u2122t know that we\u00e2\u20ac\u2122d decided against a recommended knee replacement for my father because his hip-replacement operation had been so traumatic that he had repeatedly asked his nurses to just let him die.<\/p>\n<p>I knew that the valve operation could kill my father, but was more worried that he would come out of it with increased dementia. (When pressed, the doctor admitted that being on the heart-lung machine the operation required often damaged a patient\u00e2\u20ac\u2122s memory.) My dad was a person who deeply prized his intellect, and I knew how much he suffered over its loss. More importantly, I knew he didn\u00e2\u20ac\u2122t want to undergo a major operation if he didn\u00e2\u20ac\u2122t have the capacity to decide for himself, because he&#8217;d already said so in his living will.<\/p>\n<p>It&#8217;s hard to go against a doctor&#8217;s recommendations, even when you\u00e2\u20ac\u2122re aware that those recommendations are based on incomplete information. The stress of being faced with a life-altering choice between options you can&#8217;t fully understand makes it all too easy to simply rely on a doctor&#8217;s opinion, or to go beyond that opinion by requesting that &#8220;everything&#8221; be done to try to save a loved one, even though &#8220;everything&#8221; may well include a highly risky and painful operation your loved one would never have chosen for himself.<\/p>\n<p>It&#8217;s therefore vital that we all choose ahead of time by making living wills and ensuring that our loved ones also make them. Living wills involve complicated choices, so we should demand that Medicare pay for medical consults that can help with those choices- regardless of whether such consults are labeled &#8220;end-of-life&#8221; counseling. <\/p>\n<p>In the process, we should make it clear to our elected representatives that we don\u00e2\u20ac\u2122t want them giving in to right-wing distortions and lies about our health care. And make it clear, as well, that we want them to reconsider the cuts they are proposing to children\u00e2\u20ac\u2122s programs, since the future the cuts impact belongs to all of us. <em><\/p>\n<p>Vicky Dickson is a columnist and co-owner of <\/em>The Carrboro Citizen.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>It doesn\u00e2\u20ac\u2122t make sense to me. Our representatives in Washington, in a panic over the effects of current spending levels on the country\u00e2\u20ac\u2122s long-term future, are proposing deep cuts in health and social programs. <\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-16678","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/16678","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/comments?post=16678"}],"version-history":[{"count":3,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/16678\/revisions"}],"predecessor-version":[{"id":16750,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/16678\/revisions\/16750"}],"wp:attachment":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/media?parent=16678"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/categories?post=16678"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/tags?post=16678"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}