Talking Heads ~ A Duty to Die?

[ANNIE]

Talking Heads #9

"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.

A two week  forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.

Our Ninth  Selection is: A Duty to Die

Is this what we've come to now?


Don't miss this very  provocative article titled  Higher Ed Can Lead to Lower  Values  in the  Columbus Dispatch on May 14, 2010,

http://www.dispatch.com/live/content/editorials/stories/2010/05/14/higher-ed-can-lead-to-lower-values.html

 and let's talk about some of these issues,  because there's a LOT here he covers, including escalating solutions for the elder generation, education, the virtues of poverty and a lot more!

Let's discuss!.

Pedl'n,
What a eye opener your article was for me.  I have a friend who after having hospice take care of her dying husband, took the nurse's advice of using a magnet to turn off her husband's pacemaker.  He died peacefully several hours afterward and his family were sitting with him through it all.

There are other things that dr's are dealing with when it comes to chronically ill elderly people.  For instance, at the age of 75,  I have two friends who have been told that they have polyps in their intestinal tracts.  They are both on Coumadin.  One's dr is insisting that she return for the surgery and the other's dr said that at her age, he doubted if her polyps would ever become cancerous.  So, what does one do at a time like that?   I think I would be asking for my colonoscopy pictures to have them evaluated by different drs.  What do you think?

Look at my husband who had a heart pump implanted last year and how good he feels now and tell me the drs shouldn't have done that at his age of 75/76.  We had to consider the possibility of him having a stroke.  But this is true for any surgery that he agrees to now.
 
He just had an abdominal aortic aneurysm treated by inserting a stent/wall graft inside the aneurysm so that it could deflate and not burst.  He is the first heart pump patient to have that done.  We call him "curious George" when he hears of new procedures that might help him live a better.  Its the engineer in him, I believe.  And hope is never ending in him.

  

[nlhome]

Adoannie, 75/76 is young now. Good for your husband.

[Steph]

Eloise,, Dont we all  want to die at our time and place?? I agree with you.. My sons and I had to make the decision on my husband. Thank heaven, he had made his wishes clear to all.. But it is hard.. no question.

[bellemere]

I think a lot of our comments are missing the mark, in terms of the article sited.  Sowll is not opposed to any individual decisions, just to the idea that the decisions are being made by "intellectuals" whose values are different from his.  We cede a great deal of our life decisions to experts of one kind or another, don't we? From teachers, to lawyers, we always seek the'best' advice. 
As Janet says, the governemt could do more in research to find real cures, notjust existence-extending technology.  The government already funds most medical research, through grants from the National Institutes of Health to academic institutions, etc.  The current administration increased their budget but not by a lot.  They do provide payment for doctors,usually primary care, who respond to thier patients requests for information about their options.  This requires more time than a 10 minute appointment, and doctors formerly coud not be reimbursed for the time - unless the disguised it somehow in the Medicare codes.
But i doubt if the public would support, with additional taxes, the amount of money needed to find all the cures.  and to give everybody everything they want. 
So how do we make a policy on health care that will provide the greatest good to the greatest number of people?  Should that be the criteria?
 
 

[Steph]

I think it would help if the government would clamp down on all of the hospitals who have to have the latest gadget no matter how many hospitals in the town already have them.. It  brings the cost of care up with all of the building and the latest nonsense. How about it when there are multiple hospitals in a town, that each is permitted certain specialties without all of them jumping in.. Its like,, dont put money into the young doctors who want all of the expensive specialties. Put the money in the family doctors instead..

[bellemere]

The "Determination of need " process was more or less set aside by the Reagan administration and never came back.  A local board of providers and consumers made recommendations on capital expenditures over a million dollars, based on whether the community judged it as a "need".  The recommendation was made to the state, which could then grant permission for the project to proceed.  Hospitals hated it.  It restricted their freedom in"marketing" and as a result of the law's ending, they were free to buy or build whatever they wanted.  They borrowed the  money with a state- insured loan.  To pay the interest and principal on the loan, they raised thier rates.  To pay the increased rates, the insurance companies raised their premiums. And on and on it went.  We used to joke that some of the rural hospitals in our state could not achieve 100 percent utilization of their MRI's without running cows through it. 
But today hospitals are all about "marketing" not meeting community need.

[bellemere]

In a Boston Globe Opinion article on the 21st, the president of the biotech research firms in Greater Boston noted the trend of pharmaceutical companies to acquire more members with busiiness experience.  These new ;members believe that the primary purpose of a pharmaceutical firm is to achieve an attractive return for shareholders.  I guess they are right. But accordingly, these board members are forcing companies to cut back on expensive research and development.  A new drug takes ten years to bring to market and can cost millions.  they want the companies to maximize profits on drugs already on the market = cut production costs and increase aggressive marketing. Get more people to take the stuff you see advertised incessantly on TV and forget about finding cures.
Doesn't sound good for us.
I would favor the gvt. giving the pharmaceutical companies a deduction on taxes for that portion of their profits that the devote to R and D for diseases that are a threat to the health of the public and I put drug and alcohol addiction and obesity up there.   What do you think?

[maryz]

We've always seemed to allot more money to treatments like "heroic measures" and end-of-life care, than for preventive care and quality-of-life things.  And those are certainly the more costly and "glamorous" things.  Better diet, exercise, life-style changes are not exciting and don't make headlines.

[Eloise]

Right MaryZ, It doesn't make headlines and it makes no profit.  

The younger generation will bear the brunt of elderly health care unless something is done. Prevention is not advertised enough but in the end the solution will eventually be raising the retirement age. France is already talking about it and the unions are flexing their muscles.

[Steph]

Life style changes are basic and not glamerous.. Its amazing sometimes in the excuses.. I have a friend who wont walk outside because it messes up her hair.. I was amazed at the excuse.. Told her that she keeps complaining about being out of breath.. She just needs to exercise.
When I was in rehab, my roommate was incredible. She regarded the rehab as a person excuse for laying in the bed. This was a class 1 rehab.. Therapy for four hours each morning, then lunch, a nap and back to the grind for several afternoon hours. anyone who was able was supposed to dress each morning and go down and have breakfast and other meals in the small dining room.. My roommate just sat in bed and whined.. Incredible.. She wanted to know where was the hairdresser.. ?? how about a massage?? The nurses finally broke the news that she needed an assisted living center or something of that type. This rehab was for getting people back on their feet... Now since she was on medicare like me, I know they paid the bills for someone who was being helped because she wouldnt.. Not a fair use of medicare money.

[maryz]

Amazing,Steph - but I guess I shouldn't be surprised.  How sad that you had to be stuck in the same room with her for weeks.  Yuck!

[Steph]

The therapest and nurses were fun and rescued me whenever they thought she was out of hand.. She actually asked a nurse to wash her false teeth.. Amazing woman. Only thing that drove me nuts, was because she refused to do anything and slept a good deal of the afternoon, she stayed up most of the night , kept her tv on and turned it to the loudest setting. Hard to rest and the nurses gave me sleeping pills because of the nightmares from the accident. My head therapist was so very kind to me. She came each morning when I was eating breakfast to check on me, sat with me at the table, noted I was not eating and gently tried to get me things I thought I might eat. The grief at that point was so overwhelming that eating was simply beyond me. They brought me things from the cafeteria,, and like the residents in the hospital when they discovered that I like
Dunking
Donuts coffee, stopped on the way in and brought me a cup.. which mostly sat and got cold.. Eating is hard at the beginning of grief, at least it was for me.

[Janet]

On June 22 bellemere said:

As Janet says, the government could do more in research to find real cures, notjust existence-extending technology.

No, no, no! I did not say that, and would never suggest that the government become involved in medical research. That is not the role of government. I accused the government of placing burdensome taxes and regulations on the pharmaceutical industry, making it difficult and extremely expensive for private corporations to do the research; but that did not imply that the government should take on the responsibility of research. I did also state that government could establish "policy that would encourage the expansion of medical research and production of equipment or pharmaceuticals, medical degree programs, or that would provide incentives for the medical industry to meet the medical needs of all." That could take the form of abolishing corporate taxes, examining all the nitpicking regulations to see where they can be eased in order to facilitate production yet still maintain safety, allowing pharmaceuticals, device manufacturers, medical schools, hospitals, doctors, etc., to make their own determinations of how to meet the needs and demands for health care. The last thing I want are government bureaucrats taking over yet another function of the private sector.

[nlhome]

Steph, someone in a nursing home on Medicare who refuses to participate in doctor-ordered rehab therapy will probably be told that Medicare will stop paying and would become private pay. I've seen that happen a lot.

From what I read, drug companies spend more on marketing than they do on research and development, and much of the innovative research is funded by the National Institute of Health. More of the "new" drugs that are developed these days are just small changes to existing drugs that will allow the drug companies to continue selling their brand drugs as the older drugs become generic.

If the companies are allowed to make "their own determinations of how to meet the needs and demands for health care" we will not have innovation, because the companies will produce what they can make the most money at, not necessarily what people need. As I understand it, also, more money is spent on marketing than on R&D.

[Steph]

I sold off all of my pharmacy stock since when I read the company reports, they all spend far more on advertising and what they call good will,etc. I want research. I have a policy of not wanting to take any drug that takes out full page ads in magazines.. My doctor laughs, but agrees with me..

[bellemere]

NIH is the largest source of funding for medical research in the world, creating hundreds of thousands of high-quality jobs by funding thousands of scientists in universities and research institutions in every state across America and around the globe.
I can't understand why anyone would want to do away with the National Institutes of Health.  Among the successes to which they have contributed is the extension of life expectancy to 77.7, and the decline in disability of those over 65 years of age.  It is a division of the United States Health and Human Services and it performs consistently well over the years.  Thank God for the dedicated scientists who are willing to work for probably far less money than they could earn in the private sector, making drugs for indigestion and erectile disfunction.
But we still are not adressing the contention of the Sowell article.  He believes that higher education produces lower moral values. 
The Ranters, Limbaugh and Beck seem to agree.  Their opposeion to Elena Kagan
s confirmation as a justice of the Supreme Court rest largely on her attendance at Harvard Law School and even her position as its Dean.  But Justice Antonin Scalia and Justice Kennedy also attended.  The retired Justice Souter had a double stigma, Harvard College and Harvard Law School.  They  have never been considered elitist. and liberal bacause of theri education . 
\A student whose parents make less than 60,000 pays nothing to attend and eighty percent of the sutdents are receiving some kind of financial aid. Their diversity is one of thei proudest achievments. The term "elite" does not apply  to most of the college students today, whether at Harvard or a state university.

[bellemere]

To Steph - You are one strong woman, going through grief and  rehab and having to listen to that airhead whiner in the next bed   I think I would have stuffed a sock down her throat.
To Janet - I think what we are is agreeing to disagee.  The tension between the role of government and the private sector is part and parcel of American economics.  I believe that the U. S.
Constitution enjoins on the government the duty to "promote the general welfare" - not insure it - and I think the two systems have served us well.  My sort of rule of thumb is: government for the "needs" and private enterprise for the "wants" . 

But is Elena Kagan a less moral person for having been raised in a big city and attending a private university?  If so, that would apply to an awful lot of Americans.  Is the value we place on education related only to the ability to earn more money or do we also want a more educated and thoughtful citizenry?

[Steph]

I guess that is what bothers me the most about this man and his writing. Why would moral only apply to the ill educated and poor.. Just not going to be that way. Moral is something that is or is not in all people. There are people who truly cannot see beyond t heir own needs and desires and others who always put others first..

[bellemere]

Just want to share some prize-winning personals parodies from  the New York Review of Books, although husband threw it out before I got them all.  Talk about people over 75 being liveley!  some of the actual ads were pretty funn, too [ - "foxy Manhattan cougar, 84, wants to meet open-minded gentleman..._  Cougar?
 or "West Palm hottie, can still drive at night, seeking lady friend....."  Well! 
One prize winner was "One-breasted woman seeks on-armed man"  Really!
And "Enjoy long walks from the parking lot to the doctor's office?" 
 and "Still have some teeth, hair , and ample supply of blue pills....."  I'm sure he means vitamins.
These people don't seem to grasp the duty to die, do they?

[bellemere]

Maybe they think they have a duty to enter their second childhood?

[Steph]

Some of the widows in my widow group are venturing a toe here and there in the internet dating pool. Their stories are pretty funny.. Alas, I am still too deep in grief to be interested in the other half of the world. Still long for the one who is gone way too much