Thursday, February 15, 2007

A Response on Medicare for All

The below comes in from long-time friend Bob Odean, now living in Ottawa, Ontario where his wife is employed at the United States Embassy. Bob’s career included the Christian ministry, Washington D.C. lobbying, and college administration.

Relative to Pete Geilich’s conclusion on how health care ought to be paid for: I am not significantly knowledgeable as to the merits of the Medicare Program to believe it deserves to be expanded into a universal program. I assume Geilich is speaking only to insiders who know better than I do, and is thus engaged in what we used to call “preaching to the choir.”

How would such a universal health care, payment system work? How much support is there for this proposal within the medical professions? Is this proposal under consideration as a serious political solution? What controls are involved, and by whom are they to be decided? Is this another “big brother” system? How are costs being controlled in this scheme of things?

For laymen, the argument favoring this proposal requires more than the claim that it is “well-managed and cost efficient.” I don’t see the connection between “clout” and “quality.” Ultimately, it is the layman who will be called on to make the political decisions involved. Geilich needs to make his case clearer.

Obviously, there are detractors and counter arguments; I would be interested in learning the problems and limitations in universalizing the Medicare Program’s payment system -- if that is the problem Geilich is addressing.

The first issue that caught my attention in Pete Geilich’s opinion piece was his concern about the high cost of “end of life care.” Using the example of his mother-in-law and her problem in maintaining “control of her basic bodily functions,” he gave credit to a “palliative MD” for her dying “comfortably.”

Since “palliative” is not a word in my normal vocabulary, I had to consult Webster for its meaning. “Palliate” is “to conceal, cloak,” “1) to lessen the pain or severity of without actually curing…” -- this is apparently the sense in which the word is being used.

Hopefully, reading between the lines, Geilich is not suggesting a means to cut costs by which we end the lives of those for whom there is no cure – and are ”miserable.” Rather, I would like to believe, he is arguing against “heroic” procedures to prolong life needlessly at exorbitant costs that offer no cure and ultimately make no sense.

I am assuming the “palliative MD” in the case of his mother-in-law, apparently provided the comfort of such drugs as to alleviate her suffering and allow unhindered the dying process.

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