I’m promoting this from PNH’s Sidelights: The utter venality of the chattering-class “yes, but” stance (a blog post by Kevin Drum at Mother Jones which I recommend you all read, for it has many intelligent things to say). The story includes this two-paragraph quote from Charles Krauthammer:
So why get Medicare to pay the doctor to do the counseling? Because we know that if this white-coated authority whose chosen vocation is curing and healing is the one opening your mind to hospice and palliative care, we’ve nudged you ever so slightly toward letting go.I’m going to comment on this based on my perspective as a health-care professional who has seen more than one person die (in many ways, from relatively good, to bad, to horrible), and as a man who sat at his mother’s bedside for a month as she lay dying with cancer: Whether Charles Krauthammer likes it or not, we are all going to die. That “ghostly figure, scythe in hand,” is waiting at the end of every path.
It’s not an outrage. It’s surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it’s intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.
And on that day, I promise you, you, or your nearest and dearest and best beloved, are going to wish to God that you had taken the time to make some plans and communicate those plans to others.
Here’s another point that Charles Krauthammer may not have thought of: In health care, if insurance doesn’t pay for it, it doesn’t happen. So denying insurance payments for a discussion now is saying, “You’re going to have to make health care decisions in a rush, in emotional and physical distress, and possibly you won’t get what you wanted because you can’t communicate at all.”