Health reform Who lives? Who dies?

With all of the talk of health insurance reform where cuts need to be made, the quality of care, who pays for what, and what may have to be sacrificed there is a fundamental issue at its heart. How much medical care does a person deserve and what care and tests may be denied because they are too expensive? My mother died at 97. Her mind was sharp until her death. She enjoyed her life enough to want to live until she was 100. My sister and I questioned that desire because in the last two years of her life she was confined to a nursing home.

My mother worked hard all her life at one point being the sole cook for a restaurant she my father owned. But my mother had ailments, rarely life threatening but always painful and always ailments that could to a degree be fixed.

By the time my mother reached the nursing home she had outlived her savings; my sister and I were retired and we were living in a two-bedroom manufactured home. She had no money but we knew she could no longer care for herself.

A bad bout with pneumonia led to our decision to place her in a nursing home. She went kicking and screaming. She became a Medicaid patient. During the two years she was there and during the years just prior to that she had seven hospitalizations. She had a benign brain tumor, which had been preceded by a grand mal seizure. She had a heart attack, extreme vertigo, an infectious bowel disease, a hip replacement and pneumonia, a hemmroidectomy (which she said was as painful as the acute pain she suffered in her hip before the replacement). During this time she had numerous tests and surgeries. She recovered from each. In the weeks before her death she was hospitalized with an infectious bowel disease, and finally we learned she had pancreatic cancer, which had metastasized to her stomach and liver. With all the tests and hospitalized no doctor ever told us she had cancer which leads us to believe they didn’t know she did.

There are several questions inherent in her story. All of the tests were expensive and cost more than she ever contributed to Medicare or insurance coverage. She was a Medicaid patient so yes her care was being paid for by taxpayers. Neither my sister nor I both retired and living on limited income could support her. When do you say: “ No, you are old and these tests are more expensive than the insurance can afford”. Or do you say no? When a medicine, a procedure, a test, a surgery is developed that can cure a condition, does a patient have a right to it regardless of how much money the person can pay. Does an insurance company or the government have a right to say, “You are at the end of your life. This procedure may save your life but we can’t afford you access to it.” Then of course the question arises why after all these tests did no doctor realize my mother had cancer. Did they keep it from us, from her or was each doctor treating one condition without looking at her overall health. It was only after she learned she had cancer did my mother give up her will to live. Until then she was always waiting for the doctors to find out what was wrong so they could fix. And for years they did fix it. Cancer killed my mother but should some health professional have said at some point in her life.

“We know you are in pain. We could fix that but you can’t afford it.” Would you have let my mother suffer or die? As boomers age and the elderly population grows this question may arise many times. Would you let my mother die? What happens when your children stand at your bedside? Will they ask the same question? What is your answer? And then we have we have to look at what we are spending tax dollars on, bailouts, foreign aid, billions spent on a war that is not leaving a country very different than before we “Invaded”. If you think the violence will end when we leave Iraq I will sell you come swampland in south Florida. Who gets what? What projects and people are denied? What is your answer? What issues need to addressed if we are going to have health insurance reform?