Commentary: Disability ‘not a death sentence’
August 14th, 2009Laura Hershey, writing in U.S. News & World Report, says the current debate over “end-of-life care” neglects to acknowledge the rich, vibrant lives lived by people with disabilities. She worries that health care rationing plans rely on discriminatory and erroneous views that ignore the experiences and value of people with disabilities.
An excerpt:
Tactless acquaintances have told me they would kill themselves if they became as disabled as me. More chillingly, the last time I was hospitalized for pneumonia, I had two different nurses ask if I had a DNR-a “do not resuscitate” order. I replied that I had come to the hospital to get better, not to die.
Unfortunately, that expectation of medical treatment can run up against physicians’ opposing views and hospitals’ rules.
… In this economic and social climate, we fear that medical practitioners will stop short of saving our lives. More and more, despite rhetoric about “patient autonomy,” the decision to withhold treatment is imposed upon patients. Especially vulnerable are those unable to communicate their wishes.
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August 18th, 2009 at 9:42 am
This is utter nonsense. There is nothing in any of the health reform bills regarding the provision of “end of life” care, merely one provision that allows Medicare to reimburse for a voluntary counseling session once every five years that helps families learn how to complete living wills, powers of attorney, etc. and educates them about less costly alternatives to nursing home and hospital care, such as hospice. How can this possibly be bad????
Nor does anything in any of the bills change how healthcare is provided or restrict your choice. There is nothing in HR 3200 or any bill that allows the government to dictate what private plans can cover, impose waiting lists for coverage, or otherwise restrict the services patients can receive from their doctors. The healthcare you receive remains the choice of you and your doctors.
Laura Hershey’s fears are far more realized under our current system. We already ration healthcare, as does every other country. The difference is abroad, they ration on medical need, whereas in the United States, we ration based on ability to pay. If you are on disability, you have to wait two years to get Medicare. If you need a new heart, liver, or kidney, you are placed on a waiting list where bureaucrats decide what candidate is most worthy. And bureaucrats and desk clerks instead of clinicians decide what treatment you get under managed care.
What is desperately needed are comprehensive reforms that limit government’s role to the financing of healthcare while giving physicians the freedom to do what they do best, practice medicine. The models in Germany, Switzerland, and the Netherlands are not the dreaded “single payer” models but strict regulation of private insurers that are already in place in this country under the popular federal employeees health plan and Medicare Part D. Expanding these programs to everyone would allow risk to be spread out among the healthy and sick populations, reduce premiums for persons with high-cost disabilities, and allow everyone to choose the health plan that best suits their medical needs without having to worry about being dropped or denied coverage because of their disability.
Supporting these badly needed reforms would be in the best interests of Laura Hershey and everyone with disabilities. These reforms may not go as far as needed or suit everyone’s political ideology, but they are immensely better than the Republican’s only proposed alternative, which is simply “don’t get sick”.
August 14th, 2009 at 7:21 pm
Laura Hershey wrote a wonderful article that captures perfectly what loved ones of the intellectually and physically challenged fear about healthcare now and later even if reformed. I hope we hear more of her voice as she is great at standing up for disabled individuals.