Looking for a Place to Die
nytimes.com
nytimes.com
There are many levels of care available between intensive care and hospice and plenty of funding available to pay for almost all of them if you look hard enough. Sadly, OP mentions none of this. What an unhelpful article.
There is part-time home health care, full-time home health care, assisted living, nursing homes with multiple levels of appropriate care, and multiple levels of hospice care. (Six days to live or you're not accepted? Shame on them. What kind of thing is that to put caregivers through?)
There is also tons of "care for the caregiver" which is indispensable. I don't how I would have made it without that.
Most importantly, I can't say enough for all of the wonderful people who cared for my loved ones, in many ways much better than I ever could have. They're out there, dedicating their lives to make this inevitable transition better for everyone.
Theresa Brown, I suggest a follow-up "how to" article for caregivers. Unlike this piece, that would take a little research, but could be your contribution to this difficult, but easily addressed problem. You could make it the piece I wish I had read instead of figuring it out myself at the worst moment of my life. Please use the resources of the New York Times to finish the work you've barely started here.
Hospice doctors and nurses are trained in palliative medicine, and the hospices themselves are peaceful places, very different then hospitals. I have unfortunately spent significant time at two hospices this year, and had an old friend choose hospice care at home. It was a very humane way to go, with no suffering.
I think self-euthenasia should be allowed, but letting nature take its course has a certain clarity to it. Especially in cases like these, where disease progression impairs decision-making faculties.
I know that doesn't sound fun, and I know the holidays seem like the wrong time, but there's never a right time. Do it now.
I just went through the cancer-to-hospital-to-hospice transition this fall with my mom, and I am immensely grateful that we had all talked about what we wanted. And then put it in writing, with a living will and a durable power of attorney.
At some point a team of doctors may turn to the person you love best and say "What should we do?" Don't make them guess.
http://www.ted.com/talks/yoav_medan_ultrasound_surgery_heali...
http://www.phdcomics.com/comics.php?f=1162
Great strides have been made. E.g., one friend with leukemia just takes a daily pill. 40 years ago we would have buried him by now, but since he got cancer he's taken up doing triathlons. Go science!
"Switzerland's laws that prohibit killing continue to apply in full. Direct, active euthanasia (deliberate killing in order to end the suffering of another person) is therefore also forbidden. By contrast, both indirect, active euthanasia (the use of means having side-effects that may shorten life) and passive euthanasia (rejecting or discontinuing life-prolonging measures) – while not governed by any specific statutory provisions – are not treated as criminal offences provided certain conditions are fulfilled."
Source: http://www.bj.admin.ch/content/bj/en/home/themen/gesellschaf...
The biggest problem I see here is that unless the patient expresses a clear desire to end treatment (either in the moment or via legal documents prepared in advance) then medical professionals must continue to treat. I think the that's a fine way to run things, but it means Americans must be very clear about what they want if they are to avoid dramatic interventions that may do very little to help them and certainly are scarring for the family.
The bankruptcies are from living expenses, not medical expenses. Sick people can't work, so housing and so on become a problem. Free unlimited heathcare can't solve that problem.
> going uninsured,
All poor people in the US are eligible for medicaid. Many don't bother to sign up until they get sick. While they're technically uninsured until then, they're not actually uninsured.
> people dying because they can't pay for treatments,
Feel free to list any place that will do every possible treatment "for free". (And no "every approved procedure is free" isn't anywhere near "every possible procedure".)If you can't, we're merely arguing about where "for free" stops.
There's always a point where it comes out of your pocket. Yes, even under the nationalized system.
The point about medicaid is valid (most Europeans in flame wars like this don't know it exists), though eligibility is complicated and there are many people who need care who don't qualify. The $35k household above, for example, probably isn't poor enough.
And the final point is a ridiculous straw man (substituting "every possible treatment" for "treatments"). You should be ashamed of yourself. To be fair, the "people dying because they can't pay" was likewise a distortion though.
Why? The claim was that someone was dying because they couldn't afford a treatment. That's going to happen under any system that doesn't pay for every possible treatment.
Since all systems limit treatment, we're actually arguing about where the limits should be and it's dishonst to suggest otherwise.
Families can generally house other family members. They can't pay $90k medical bills.
All poor people in the US are eligible for medicaid. Many don't bother to sign up until they get sick.
How are poor people supposed to know this? I didn't know this. I went to the website and it wasn't the least bit clear. Discoverability is absolutely terrible.
The rest of your statements are just silly extrapolations. There will always be edge cases that cannot be fully served.
> Families can generally house other family members. They can't pay $90k medical bills.
The point is that they don't have to. However, living expenses must be either paid or borrowed from folks who are fairly insistent on being repaid. Hence the bankrupcies, and if you're going to file, you claim everything.
>> All poor people in the US are eligible for medicaid. Many don't bother to sign up until they get sick.
> How are poor people supposed to know this?
Poor people don't have to know it because health care professionals know it. It's how said health care professionals get paid for treating poor people.
Also, why do you think that you know what poor people know? When I was poor, I knew things that I don't know now.
How is "there are always treatments that won't be paid for" a silly extrapolation? You even (seem to) admit that it's true...
Like I said, most people have family they can move in with in an emergency. Most families, however, do not have $90k to cover a medical bill.
Also, why do you think that you know what poor people know?
1) I've been not poor.
2) I'm currently classified as poor.
3) I have vastly greater informational resources at my disposal than most poor people.
How is "there are always treatments that won't be paid for" a silly extrapolation?
Because it's an utterly pointless statement. Of course there will always be some portion of the populace that cannot be ideally treated. That is no argument whatsoever against doing something to improve the standing of the majority.
My wife was given a 30% chance in an ICU room earlier this year. Since then we have been through a month in hospital, multiple surgeries, and many doctors appointments. The total cost to date has been over $250,000. Even with insurance we have still paid $10,000 and covered another $10,000 while waiting for reimbursement. The new insurance calendar year starts on January 1st – so we will be paying another $10,000 for a surgery planned in early 2012.
Our household income is $30-40k above the US median and we have savings, but it’s amazing how quickly your savings start shrinking when your partner is unable to work and you need to take months of unpaid leave to attend appointments and sit in surgery waiting rooms.
Any politician that talks about fostering innovation and entrepreneurship but continues to support the status quo is a fraud. Surely removing the financial and administrative burden of healthcare for business is better than any tax cut congress could come up with?
Bingo. Heath insurance doesn't address those costs.
> Surely removing the financial and administrative burden of healthcare for business is better than any tax cut congress could come up with?
And you think that Congress knows how to do this?
Medicare fraud is probably close to $100B/year. How are you going to do better AND reduce costs?
I don't know what it will take for you to get this Christmas wish fulfilled. But it's a little more complicated than mere scientific/medical research.
Peace and happy holidays.
But the thing that the article misses is the proportion. If the suckiness of death and dying is normalized to -100, then having the hospice care feels somewhere south of 20, moving the experience from a -100 to at best -80.
As much as I dislike our insurance system, I'm not sure it's worth a lot of money for end-of-life help.