Whatever my differences with Ted Kennedy – and when it came to personality and outlook on life to say nothing of politcs, there were many – I had to admire the guy during this past year. The guy lived quite a life – and, at 77, was still actuarially a tad young to go. And he probably knew it.
So he fought like hell. He attacked his illness head-on; he threw all of his resources – and, being a Boston Brahmin from a phenomenally wealthy family, he certainly had the resources to throw – at trying to push back his brain cancer. By all accounts, he fought like a lion, living his life to the best of his ability in the meantime.
I was about to write “let’s hope we can all be so lucky” – but of course, his colleagues in the Senate are waving Kennedy’s barely-cool body in front of the media and the people to ensure that you (but not, as it happens, they) can not:
“Ted Kennedy’s dream of quality health care for all Americans will be made real this year because of his leadership and his inspiration,” Democratic House Speaker Nancy Pelosi said in a statement.
Pelosi underlined that Kennedy’s death one year after the cancer-stricken liberal icon climbed on stage at the Democratic National Convention of August 2008 and declared health care reform “the cause of my life.”
“Today, we pick up the torch and recommit ourselves to health insurance reform,” said Democratic Representative Chris Van Hollen, who leads the party’s efforts to maintain or enlarge its majority in the 2010 mid-term elections.
Democratic Senator Robert Byrd, who like Kennedy has missed some votes this year due to illness, mourned “by best friend in the Senate” and called for the health overhaul legislation to be named for the late Massachusetts lawmaker.
“In his honor and as a tribute to his commitment to his ideals, let us stop the shouting and name calling and have a civilized debate on health care reform which I hope, when legislation has been signed into law, will bear his name for his commitment to insuring the health of every American,” said Byrd.
The contradiction that none of them mention; the treatment options for a 77 year old man with a long history of alcohol abuse would be much, much more restricted than they were for Kennedy.
“Heathcare Rationing” is practiced all over the American healthcare industry, in both the private and public sectors, today. HMOs adopted “Case Management” from their inception. “Case Management” is all about answering, for a given person with a given condition, the question “For a person of a given age and with a given medical history and in a given overall condition, what will be the most cost-effective treatment option, given the limits in the amount of resources available?” Of course, behind the scenes there is a formula – how many years will a treatment likely buy a patient – and, where resources are scarce, a question: to whom should a limited set of resources go?
For a seven year old girl who develops leukemia, it’s moderately simple: aggressive, intensive treatment – say, a bone marrow transplant and intensive chemo – the $200,000 worth of treatment will likely buy 70-75 years of life span; the procedures are becoming moderately common. Approved!
For a 65 year old overweight alcoholic and two pack a day smoker with terminal cirrhosis of the liver? He has uncontrolled high blood pressure and all sorts of alcohol-related pathologies? He might get the liver transplant, if there’s a liver of his type available - and if there’s not a 30 year old marathon-running father of four with a congenital liver condition who needs it first; a smoker with hypertension and alcohol-related kidney trouble and high cholesterol might have a life expectancy of seven more years, should he get the liver and the cool half mill in supportive care; the marathon runner could get you fifty years and change. Again – a simple choice; if there’s one liver that matches both, the 30 year old will live, and the Case Manager – or the team that manages the case, perhaps – will put the 65 year old on palliative care, and medication to try to coax the liver function along, and tell him they’ll try to find another liver but to get his affairs in order anyway.
By the way – you may not call the Case Manager or CM team a “Death Panel” – but if you’re the 65 year old in the example above, the difference is only rhetorical.
So how much money did Ted Kennedy spend to eke out this past 15 months or so? It’s his money, and it’s his life, and I won’t begrudge him a dollar or a day.
But if a 77 year old man with highly-advanced brain cancer, plenty of chronic conditions related to decades of heavy drinking, and a good 60 pounds overweight went into a doctor’s office in Sweden or the UK or Canada, what do you suppose the prognosis, course of treatment, or results would have been? Not just for any given 77 year old man, mind you, but 100 of them whose profiles match each other fairly closely?
Naming a health rationing system after a man whose struggle the system would have made impossible makes sense – in the curious little world of Democrat social policy.
Rest in peace, Ted Kennedy.
Die in pain, Obamacare.