Wednesday, January 5, 2011

Death Panels, Unplugged

It's not surprising that it was our own Representative Earl Blumenauer who was originally responsible for introducing the idea of Death Panels into the national conversation about health care. Oregon, after all, has long been known as the home of grey skies, rain, abject melancholy, and death. This is what makes us great. This is why we have thriving independent book stores, terrific beer and top-notch palliative care.

To be fair, he did not actually propose Death Panels per se. Or even per at all. Mr. Blumenauer merely observed that our modern way of death often reduces us to a carton of skin and pain, with a detectable electrical quiver. This is a condition that might be maintained for some time, at the expense of some other portion of the healthcare-consuming population. Medical and legal establishments have colluded to make this scenario mandatory if one has not had the foresight or opportunity to express one's wishes. He proposed allowing Medicare to reimburse doctors for their time discussing end-of-life care for anyone interested.

Opinions vary as to how much and what sort of care one might wish to sign up for. One member of my family made us swear we'd put a bullet in her head the day she needed her butt wiped for her. I, on the other hand, might opt for a host of medical interventions as long as I am still cheered by hearing Vladimir Horowitz play Stars and Stripes Forever, or thinking about ducks. For the record, I'm fine with any one of you wiping my butt.

If you don't understand and express your preferences, you run the risk of being escorted into the beyond mangled, miserable and late. Mr. Blumenauer wanted to make it easier for us to have that opportunity to make informed choices by talking to our doctors about our outlooks and options. It's a reasonable position that nevertheless seems ghoulish to that segment of society that would rather hurtle towards the abyss with their fingers plugged into their ears and everything else plugged into machinery.

Often as not, it's the very people who have their tickets to Heaven all punched who are most likely to want to postpone the trip for an extra couple weeks while they run their children's inheritance through some tubes to generate blips on a screen. It's not my choice, necessarily, but that's what all of this is about: choices.

So, what with the "death panel" thing and all, the idea never went anywhere at first. We haven't heard much hue and cry about the death panels lately. The hueys and criers got distracted when the Humane Society came out with a commitment to save all the dogs and inoculate them against disease, and they had to put out the word that there was an institution that puts puppies behind bars and shoots them.

But it turns out Mr. Blumenauer's regulation is alive and well after all. Some Democrats waited until the height of eggnog season and slipped the sucker back in the health bill, slick as a suppository. Everything was fine until a memo from Mr. Blumenauer's office surfaced that stated "the longer this goes unnoticed, the better our chances of keeping it."

Well, that always looks bad. It looks like there's something the Elites are trying to sneak past the American people, high-stepping past the American people's door with their elite Snidely Whiplash mustaches, and that's not true at all. They only want to sneak it past the Wacko-Americans.

I'm being unfair. The Wacko-Americans in question are well-meaning folks who truly do not want a situation in which we as a society decide who lives and who gets the axe. Because that's the job of the health insurance industry.

Personally, I hope Mr. Blumenauer's idea makes it this time, which it might if we're all very very quiet, but it's not something Dave and I are likely to need. We're realistic about death: we bought and used over 35 pounds of butter in December alone. We figure we might get to the end of our days sooner, but we're going to slide right out.

28 comments:

  1. Wonderful! If I remember correctly, it was the ever so intelligent Ms. Palin who first alerted the nation to the threat of "death panels." A fearful nation contemplated extermination by youth in Asia. Personally, I'm more frightened of former beauty queens in Alaska.

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  2. And don't forget that Arizona, that most Republican of states, actually does have death panels for those of their population who find themselves poor and on Medicaid. Remember Palin's outcry on that. Oops, forgot. There wasn't any. Perhaps it's OK when a Republican governor institutes it.

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  3. However it works, I'm all for very sick people finding an easier way out of this world -- if that's what they want.

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  4. And it will be a tasty, tasty slide!

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  5. I didn't know that Pootie graduated Medical School! I would have sent a card. Or is that Vet School? Looks like a small animal practice.

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  6. What did I do for fun before I discovered your blog? Pootie looks very professional, I'm reassured now. I have written down my directives and hope that if I can't take care of myself, I won't be lying in a bed wishing I could check out.

    BTW, new snowshoes don't feel like your description any more, funny as it was. I appreciate your comment!

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  7. "We haven't heard much hue and cry about the death panels lately. The hueys and criers got distracted when the Humane Society came out with a commitment to save all the dogs and inoculate them against disease, and they had to put out the word that there was an institution that puts puppies behind bars and shoots them." "we as a society decide who lives and who gets the axe. Because that's the job of the health insurance industry." Once again, Murr has hit the nail squarely on the head! If I wasn't laughing so hard, I'd cry. Elaine

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  8. The righteous chords, the towering butter, my word what a way to start the day!
    But you know, I think the stack of butter really needs a flag unfurled at the top to score a perfect ten.

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  9. Ah, Vladimir Horowitz, what a freaking genius! We once saw him on the Upper East Side with his companion. It was the only time, I think, in which I saw my father act like a true fan. Priceless.

    Oh, and a truly brilliant post, by the way.

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  10. Best post of the year! So far, and I'm sure your next posts will remain in the top ten.

    Reasonable people should be open to discussions with their doctors and their families about the end of their days. The insurance corporations should have NOTHING to say about it.

    Happy new year, Murr.

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  11. This comment has been removed by the author.

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  12. I'll never de-Murr...

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  13. I have to ask. . . what in the heck did you do with all that butter???

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  14. I worked in the health care field for 30 years, in pathology, no less. My profession did not shape my attitude toward death and dying. I came into health care because of, and with, my belief in man's worth and dignity, both in life and in death. But, these things must be taught when we are young.
    People need to be made aware of the choices they have in their way to die. Death not by assisted suicide, or by death panel decision, but, with compassionate care and an easing into the inevitable, with or without extraordinary means.
    You should have a living will, and have it in hand, when you have that attack or accident that leaves you lingering between two worlds. Living will, death panel, whatever..once you are placed on an artificial means of life support you will not be removed until you have been dead for some time. My advice is don't let anyone put you on a ventilator unless you know there is hope of ' a life ' after you are weaned off of of it.
    As for 'death panels', they have always been around, they are called, "Doctor". And, they do a darned good job ( with love and compassion ) when their hands are not tied by insurance companies, hospital administration, and government!
    These proposed death panels are straight from hell and should be fought tooth and nail. The government already kills and sanctions killing in and out hospitals everyday. I am speaking of both in and out patients under a physician's care.
    By the way, I was a lowly tech. I am not a physician or a pathologist.
    My advice is talk to your doctor, carry your living will at all times, and as long as you have breath fight against any more help in dieing!

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  15. Is there anything in the Death Panel rules about pumping our own gas? Because, dammit, I really think I am competent enough to pump my own gas into the tank like they do in the other 49 states, Guam, Puerto Rico and American Samoa.

    Apparently in Oregon I am competent enough to avail myself of Death with Dignity, as long as I don't have a right-wing Christian physician as my primary.

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  16. ME, you bet, get that living will. The so-called "death panels" will allow doctors to be reimbursed by Medicare for consultation on the subject. Nothing more. More information to the patient, more choice.

    And Robert, New Jersey doesn't have self-serve either! I love my inability to pump gas. I think of it as retaining a good choice. They say allowing self-serve gives us choice, but in reality, it gives us the choice of pumping our own or--nothing. I will happily sit in my car and watch the rain-soaked person attend to my car while I listen to the radio with the heat on. And know he/she has a job.

    Merrilymarylee, we had butter on or in every bit of Christmas dinner, but most of it went to Dave's Famous Almond Roca-athon. He's like Johnny RocaSeed. Bright tins of the stuff all over the nation, and the globe. If there is a heaven, this is what's going to get his ticket punched.

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  17. I am in full support of butter as a means of euthanasia. It takes a long time but it sure tastes good going down. And Robert, sure I'll let you pump your own gas. I do it all the time here in Kentucky....it's so much fun.

    As to end of life care, thanks for writing this funny and thought-provoking piece. Having worked in healthcare for over 20 years with about a quarter of that in oncology, I've seen enough to recognize what constitutes good palliative care. Believe me, anything that supports and enables that has to be a good thing. While I'm at it, let's clear up a common myth though. Once someone is put on life support (ie. a ventilator) it does not require an act of congress or court order to have it removed. It just requires a discussion between doctor and family about the realities of the patient's status and prognosis and agreement about a course of action. As you can see, this circles back to the need for discussing such matters in the first place.

    Blessed New Year, dear.

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  18. This just in: Obama is "pulling back the language" about voluntary doctor-patient discussions. Thanks again, Sarah P.! You're a valuable ass to the community.

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  19. From Karen's comment above:

    "And don't forget that Arizona, that most Republican of states, actually does have death panels for those of their population who find themselves poor and on Medicaid."

    Yesterday, 1/5/11, the second person awaiting a Medicaid transplant died. Our death panel is up and working.

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  20. Freakin' genius, my friend. Thanks for presenting this confusing topic in such an easy to get and fun way. And just for the record, I think the butt-wipe test is an excellent criteria. Flunk it and I'll be checking out happily.

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  21. Having lived in the NW (Seattle area) most of my life, I agree that all that rain can help one think about leaving this planet alright :)
    Maybe leave their 'Earthsuit' and go some place warm and sunny where they can have a say in how/when to make their exit from here. As a cancer survivor (8 yrs)I'd rather go quick with a heart attack than linger with cancer....so, I'm with you---pass me more butter please!

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  22. I have to ask. . . what in the heck did you do with all that butter???

    ReplyDelete
  23. I worked in the health care field for 30 years, in pathology, no less. My profession did not shape my attitude toward death and dying. I came into health care because of, and with, my belief in man's worth and dignity, both in life and in death. But, these things must be taught when we are young.
    People need to be made aware of the choices they have in their way to die. Death not by assisted suicide, or by death panel decision, but, with compassionate care and an easing into the inevitable, with or without extraordinary means.
    You should have a living will, and have it in hand, when you have that attack or accident that leaves you lingering between two worlds. Living will, death panel, whatever..once you are placed on an artificial means of life support you will not be removed until you have been dead for some time. My advice is don't let anyone put you on a ventilator unless you know there is hope of ' a life ' after you are weaned off of of it.
    As for 'death panels', they have always been around, they are called, "Doctor". And, they do a darned good job ( with love and compassion ) when their hands are not tied by insurance companies, hospital administration, and government!
    These proposed death panels are straight from hell and should be fought tooth and nail. The government already kills and sanctions killing in and out hospitals everyday. I am speaking of both in and out patients under a physician's care.
    By the way, I was a lowly tech. I am not a physician or a pathologist.
    My advice is talk to your doctor, carry your living will at all times, and as long as you have breath fight against any more help in dieing!

    ReplyDelete
  24. I didn't know that Pootie graduated Medical School! I would have sent a card. Or is that Vet School? Looks like a small animal practice.

    ReplyDelete
  25. And don't forget that Arizona, that most Republican of states, actually does have death panels for those of their population who find themselves poor and on Medicaid. Remember Palin's outcry on that. Oops, forgot. There wasn't any. Perhaps it's OK when a Republican governor institutes it.

    ReplyDelete