Comments about ‘Cost of care an ethical debate’

Health care is a complicated issue. People with disabilities don't have a choice when health care is involved. Many of us can't walk enough to exercise to lose weight, although we still try to exercise. On disability, there is not enough money for much food or anything else for that matter, so we don't eat a lot. I am grateful for the disability check I receive. Yet, as things progress, I don't want to live when things get that bad. I want the right to die and save my family the expense of health care and medication. Diabetes is an illness health care needs to address also. Common sense needs to be exercised by people to help keep needless visits down, as this is very expensive too.

IT's an excellent idea to let legislators decide things like who needs and deserves heart surgery. Who needs medical school or even to know individuals involved? Seriously, is there nothing those people don't feel qualified to dictate?

Interesting questions indeed that reflects core values of our society MONEY... They all have an underlying debate, Money versus health and life?

I find it strange though that our economic model is not discussed. Why are Heath insurance making so much profit on our health? Why do we spend so much money on defense at the expense of health care?

I find it shameful that the wealthiest country in the world has decided not provide affordable healhcare to all its citizens. It is not the lack or money, nor the lack of skills; it is a choice of society, of public policy and of lobby interests.

A difficult decision for Mr. Liljenquist to be sure. Almost every life at some point comes up against a similar question.

It is worth noting however that the decision was made by someone with a stake in the outcome.

But do you really want the decision of whether the life of your child is worthwhile to be made by the state or anyone else who is rewarded on the basis of how much money he can save by denying services?

Having worked with people who choose to have comfort care rather than life extension care and their families, it is my humble opinion that transitioning from this life with dignity is perhaps the last great lesson we can learn. I feel it is up to the elders to set the example and to help their children and grandchildren realize that as amazing as living is, it is also amazing to move on.

When harsh diagnoses with limited prognoses are made, it may be better to welcome family home to say good bye while the individual is as comfortable as possible than to have them spend end days in endless trips to medical facilities while they feel worse and worse. Taking the opportunity to come together to celebrate their life with individual chats, family traditions such as prayer and singing, or reminiscing can take the fear out of it for everyone and put the love back in.

We weep for the time of missing them, but how much better to create transitions filled with laughter and love? To send them off with as much joy with which they were welcomed to this plane?

So often we are shifting deck chairs on the titanic...
Welcome to the beginning of socialized medicine.
In a way I'm excited to be able to say- we won't be trying to save your profoundly demented father who's having a heart attack, in renal failure and on a ventilator (because that is appropriate). The part I'm not excited about it the family of that person going crazy because we aren't "doing everything possible" (because doing that is inappropriate)

My concern with Medicaid has always been, where's the accountability? These people receive free health care, yet the ER at the hospital where I work as a physician is always full of people who have made poor lifestyle choices. These are the people who bring their 3 year-old to the ER at 11 PM because he has an earache, yet he does not have a fever, and is running around the room. These are the people who are on dialysis because of poorly controlled diabetes and do not take their prescribed medications, and Medicaid pays every penny without blinking an eye. These are they who have liver cirrhosis because they have been alcoholics, and now that he is vomiting blood, everything should be done to save him. Handouts. That's the solution to those who are poor and needy. Not accountability. There are plenty who use it wisely, but what about the accountability for those who abuse the system?

Medical care cannot and should not be reduced to terms of dollars and cents. I think that is the most unethical approach of all to value dollars and cents over peoples lives. It is a greed-driven approach and is at the basis of what is wrong with medicine today. Medicine should first and foremost be about healing people. Sometimes that means helping heal peoples spirits as they lay dying (see beautifully-written comment above by D Shields).

Any honest discussion of ethics must include all the reasons why healthcare costs are so astronomical. We never address the issue of GREED. The insurance industry makes huge profits accepting our premiums but often refuses to pay for care and/or medications ordered by healthcare providers. Where are the ethics? Where is the accountability?

I personally feel that we should get rid of insurance companies altogether and go to a concierge-type medical model where patients form pools (done on a state level, for instance) and have brokers working for us to negotiate reasonable prices with care providers and institutions (hospitals, pharmacies, etc), who would in turn be able to negotiate reasonable prices with their providers.

I think that there should be more publicity about people going to a doctor or pediatric clinic if they have a slight problem than going to the ER. And, I certainly don't want the state to have the option of deciding just who can have open heart surgery. This is for the person (if he is elderly) and the family to decide.

We are on Medicare, and it is not always cost saving either. My husband had a problem, as we thought he was getting pneumonia. As this was on a weekend, I took him to an Insta-Care Clinic who to me gave him excellent care, bloodwork and an X-ray, and they suggested admitting him to the hospital.

Then we ended up in ER WITH THE SAME TESTS and there's turned out differently, so he was just sent home with an antibiotic. My point is, both had to bill Medicare, which is a waste of money.

Something has to be done with co-ordination with the clinics, physicians, and hospitals. His PC doctor CANNOT admit him to a hospital without goring through the ER and this is a Medicare stipulation. It needs to be changed.

what the legislature decides--the decision was quietly tucked into the stimulus bill which just passed Congress--all Americans will have computerized records of all their health care and decisions will be made by a board which will determine whether the physician or hospital is operating the most COST-effectively!
I've been in England and talked to people who can't get care that is readily available here because they are "too old." Please, tell me, who should decide whether an old person's life has value--some government agency? Gosh, President Hinckley couldn't have had cancer surgery because he was in his 90's and it might not "cure" him. Or my friend who had stage four bowel cancer two years before retirement. No treatment since she wouldn't live long enough to be economically viable to the government? She's been treated agressively and has had four more years with her children and grandchildren and has great joy. We should rob her of that? Our Down Syndrome son who is a service missionary--should he be refused treatment since he is retarded?
Maybe we should save by denying free medical care to illegal aliens.

I doesnt matter what our personal feelings are ont he subject. The health system is broken and will break even more soon. Tough choices are going to have to be made. We have a greying population ( and I am one of them!) and we cant continue the way we are going. Real decisions must be made and soon or we may find we dont have much of a health care system left to complain and theorize about! Boy are people today without any common sense.

Dr. J's comments seem harsh. I hope I never have to deal with him as a patient.
The health care system in our country is a disaster...and getting worse. Talk, talk, talk. It seems the new focus is BLAME! Sure, we call it personal responsibility...but it is packaged now as a cost shifting blame game...your fat, you drink, you smoke, don't exercise...it's now going to cost you, and not just health wise. Fee wise. The legislature thinks "preventative health care" is new. No, I've heard about it since the 1960's through public service messages.
The Hippocratic oath is dead. Those of you fearing Socialized medicine...it arrived...as the article states...half of all dollars in health care come from government programs (medicaid, medicare,tricare, s-ship,PCN). Medicine is rationed in this country and about to get worse.

I am a working Pharmacist and have been for the past 30 years. I too have seen so much abuse of the system by people who make bad life choices and want the taxpayer to pay for it. A single prescription for an anti-aides drug can easily cost 1500 dollars per month, and most aids patients are on a coctail of medicines. They made their choices and we pay for it through our tax dollars to medicaid. People say we should not judge on money, but as I see it the only real choice is money and how to spend it. Consider how we could spend the same money we spend on aides patients, if we put it into an inter city clinic for the un or under insured children. We as taxpayers can not pay for everything for all people, and choices must be made. I for one do not want to be the person making the choices, but society must make some choices.

We all think it's horrible to even think about refusing treatment to a ninety-year-old, but we do have to be realistic that if there IS NO MONEY for it, then there is NO MONEY. News flash: money to pay for healthcare does not grow on trees, even money from the government. If government has a limited budget (and it should although politicians act like we don't), then decisions have to be made. If we want to put our money toward the care of a ninety-year-old, then that money has to come from somewhere else, whether from the care of a five-year-old child or from our education system or wherever.

THIS COUNTRY DOESN'T HAVE AN ENDLESS SUPPLY OF MONEY. As such, tough choices have to be made. The people who seem heartless enough to consider denying medical care to your grandmother are doing so only because they are trying to avoid saddling your children with trillions of dollars of debt they can't pay. Think about it.

somehow the fact that you do not know its AIDS not aides makes me doubt you are a pharmacist.

I know of a couple with a young child who ran to the ER for any sign of a cold or complaint just because they knew it was covered because they qualified for Medicaid. Later they were commiserating because with a new job, they will no longer qualify and will have to pay for their own insurance.
On the other hand, I know a couple (father is a student) who discovered that their first child had a brain tumor. He subsequently had surgery, had a seizure and then a stroke. He is receiving chemo treatments and undergoing therapy and quite possibly will have lasting effects that may limit his activities. The bills are being paid by Medicaid. So how to reconcile the needs and decide who is to judge who gets the care? Death and disabilities are both a part of life. We cannot fight the inevitable, but life is precious and we need to take care of those who are really in need.

As a true healtcare professional for more years then care to admit I somhow have to doubt the validity of Dr. J and right on Dr. J. I somehow doubt that either of you would last more then a few months in the healthcare field with such person prejudices and I would truley have concern for your patients well being. You are right about one thinf though you do not want to be the one making those tough chouces and as such maybe you should also withhold your judgements.

A few years ago, there was all kinds of uproar because Terri Schiavos husband wanted to take her off life support. The entire government of Florida got involved and the US Congress wanted to take a vote on it. Legislators were swearing up and down that there was brain activity. How many millions of dollars were spent on that fight?

Chronically ill patients want the right to end their lives when and how they see fit. Millions of dollars are spent every year to prevent this.

Women want to be able to choose whether or not to carry a pregnancy to term. Millions of dollars are spent every year arguing they should not have that right.

Pres. Obama is constantly slammed by the far right because he did not support a redundant bill to provide care for infants that survive late term abortions.

The attitude in this supposedly Christian nation seems to be that no expense should be spared to bring life into the world or prevent it from leaving when it is ready but every expense is too much in between.

Once you put the government in charge of healthcare it will be even more costly because of the massive bureaucracy that will be involved to determine who gets what healthcare. It is a sad road to see are country go down when a lot of medical costs can be attributed to greed of lawyers and lawsuits they create to obtain a living.

On what are you basing your presumption that AIDS patients don't deserve care? Do you feel that way about all AIDS patients or just those that got it from "icky" sex? What other diseases do you feel do not deserve care?

Do me a favor, if you are indeed a pharmacist, let me know where you work so I will know where not to shop.