Comments on: NYT Encouraging Old Folks to Give up and Die

By: duck

duck — Tue, 21 Jul 2009 22:57:32 +0000

Who do you want to make life or death judgments on your life, a doctor or someone that just as well could work at the State Department of Motor Vehicle Registration. ??

Odds are with the government, there will be some faceless bureaucrat counting pennies instead of looking at a patient’s viability.

But, as with most things, as long as it is someone you don’t know, the outcome doesn’t matter….

By: Jack_Savage

Jack_Savage — Mon, 13 Jul 2009 20:56:04 +0000

“‘We’ need to change they way ‘we’ administer end of life care or ‘we’ will go bust.

“It’s hard. Just because ‘we’ can extend life a couple of months doesn’t mean ‘we’ should in all cases. The more ability ‘we’ have, the more is required of ‘us’.

If anything should be left to individuals and families, it is how end of life care is administered. Who is this “we” you are speaking of? A committee of nuns? Local doctors? My softball team?

Or government bureaucrats?

We all know the answer to that, and it is telling that if “we” decide “you” should make sacrifices, including the last few months (possibly – maybe more) of your life, well – that’s just what has to be done.

This slippery slope is one that the most incompetent organization among us – the federal government – is rushing toward, without the capacity or the interest in evaluating the ethical ramifications of their actions. In no way, shape or form am I about to cede the decisions that need to be made at the end of life to government.

“Fine” you will say, “Pay for it yourself”. The problem is that under ObamaCare, I HAVE paid for it – time and time again. Just like a auto warranty company that has bitten off more than it can chew, the government will simply cut service in order to attempt to make ends meet. And if the ends are too far apart, they will cut more, and more and more, until end of life care is gone, and near-end of life care is gone, and quality of life care is gone, and basic care is gone and then finally all care is gone.

Slip slidin’ away.

By: Scope

Scope — Mon, 13 Jul 2009 18:55:39 +0000

you may very well be right concerning having to go through a primary, before a specialist. Being the only caretaker of my elderly parents until their deaths meant many visits to the “regular doctor” for whatever ailed them. Most times the regular doctor was able to see to most ills. They were mine, and I had no problem with seeing to their nail trimming needs myself. I guess that was before the slip-and-fall, and, ambulance chaser lawyers came to town. My folks had whatever tests they needed to make diagnoses, without the necessity of having to have every test known to man done, so the doctor wasn’t sued. I had no intention of turning this into a “elderly foot care” thread. My last point on this is I cannot buy anyone using medicare dollars for a toe nail trim. It is up to your primary physician to see to all of your needs, and to send you to a specialist for medically necessary procedures and treatments.

By: aesthete

aesthete — Mon, 13 Jul 2009 17:05:27 +0000

Under private care, that would be a choice among many, and in many cases, an admirable choice to make. But under the NYT-suggested way to reduce costs in a federally administered program, some people *will* be forced to accept this “treatment” or just die–exactly what liberals argued happens in our current “broken” system. If that is the case, what is the point of a public or public-private system, if it doesn’t even have the one tenable benefit promoted by its supporters?

Of course, the NYT solution isn’t the only one, but make no mistake: rationing will become a part of the system. There’s no way around it from an economic perspective. Therefore, I’d rather have healthcare choices made by patients, than by an autocratic and unbendable system more beholden to politicians and special interests than consumers.

By: janis

janis — Mon, 13 Jul 2009 16:41:22 +0000

through HealthSpring and they must first have a referral to see a specialist. The referral comes from their primary care physician. Most Medicare plans that I know of are the same way.

By: Scope

Scope — Mon, 13 Jul 2009 16:36:24 +0000

Think about it this way, for all those who have HMO types of insurance, and, I am not saying it is the best, but, a large part of the population has HMO type plans. Those people would not be able to go directly to a “podiarist” even if they know they have an ingrown toenail. They go to their primary physician first, and then must get a referral for a specialist (in this case a podiatrist). In many cases, your primary physician can/does take care of the problem. I’m not saying that it is the best system, but, it is currently a widespead system. When an elderly, not so nimble person goes to their “primary physician” so to speak, I must believe that the physician does an overall assessment of the patient, and knows what elderly problems to check for, such as circulation problems, and anything else that can affect the limbs. At that point, the regular physician can recommend a visit to the podiatrist, if they feel it is necessary. With the current way the Medicare system works, I believe that any Medicare receipent can go to whomever they choose, including directly to a podiatrist, if they accept medicare patients/payments, and it is all paid for by the publics taxes. On the other hand, it is costing me over $400. per month to participae in an HMO healthcare plan, and my primary then decides if I need to see a specialist. I have no problem with anyone going to anyone they wish for whatever, however, I see the taxpayers as being on the hook for something as small as a toenail trim, as pushing it. BTW, my 88 year old friend sees her regular doctor at least once every 2/3 monrths. If a regular doctor cannot trim someones toe nails, then we are in deeper doo doo than I even thought.

By: Pomme

Pomme — Mon, 13 Jul 2009 16:30:53 +0000

why not “octogenarian?”

By: 6eorge Jetson

6eorge Jetson — Mon, 13 Jul 2009 16:04:26 +0000

"But I DON’T want my government making that decision for me."

By: Paul_In_Houston

Paul_In_Houston — Mon, 13 Jul 2009 15:57:51 +0000

Amazing how the word “KILL” has become the elephant in the room that no one wishes to acknowledge.

Such an “inconvenient” word; it should be purged from the dictionary.

In the Obama Newspeak dictionary, it probaly wont exist.

By: cars

cars — Mon, 13 Jul 2009 15:57:17 +0000

is that it’s more than a pedicure.

And I really don’t think that the average person in nail shop is qualified to accurately assess medical problems – nor should they be relied upon to do so.

By: mom2oneson

mom2oneson — Mon, 13 Jul 2009 15:54:39 +0000

Many times even a RN can’t even cut a patients toenails, Under the current system I have no problems with a physician or PA or podiatrist being paid to cut an 88 yo toenails and I think it’s great if they are getting preventative foot care. You equating to something like a luxury like we might get at the corner salon, this is not a luxury. That is not right that you think a nail tech or cosmotologist should do a medical assessment on someone. I’m sure you would not want your life or independence to depend on your nail techs assessment skills. Maybe your friend is confused about why it’s a dr doing this for her feet and she can’t get it for her hands but that doesn’t mean it’s wrong that a podiatrist is paid to do it.

(BTW I’m sure there have been MANY cosmotologist and nail teach and home health aides and nurses that have alerted people to problems and saved thier limbs. I am not discounting that but that does not mean they have the skills of a physician.)

By: johnt

johnt — Mon, 13 Jul 2009 15:45:56 +0000

No more need be said, I hope !

By: Scope

Scope — Mon, 13 Jul 2009 15:41:29 +0000

that there are plenty of people who do “pedicures” without charging the fees that a podiatrist does. I’m sure they would point out any ingrown toenail problems, or any other problems. Then it is time to see a podiatrist. I understand your point in 88 year olds not being very nimble, and I agree, but, if you believe that a “pedicure” is a medically necessary entitlement, then I guess my 88 year old friend is right in that medicare should be paying for “manicures” also. If you can afford a “manicure” then I believe you should take the personal responsibility to pay for “pedicures” also. Neither are medically necessary in any part of the country.

By: janis

janis — Mon, 13 Jul 2009 15:33:50 +0000

starting out on their own already know that they don’t stand much of a chance of success when it comes to opening their own freestanding practice. Instead, they have opted to work on a salary for a hospital where their paycheck is assured and they have no overhead.

In other words, free enterprise under this administration is a zero sum game right now.

By: mom2oneson

mom2oneson — Mon, 13 Jul 2009 15:11:58 +0000

By: mom2oneson

mom2oneson — Mon, 13 Jul 2009 15:11:33 +0000

hopsitalists and liberalism? I don’t get it.

By: johnt

johnt — Mon, 13 Jul 2009 15:03:00 +0000

as a moments reflection will recall. More so them in a demographic sense but rationing of care will be spread “liberally”.
Hospitals are already closing, young doctors starting out are not opening their own practices but are opting for full time work in hospitals, hospitallers as they are being called, the trends are there now.
Progressives, [that's what people who emulate the practices of Egyptian pharaoh's call themselves] will for a while think this is a good thing, but less the true statist elite they will awake sadly to the fact that the mess includes them as well as the normal people.

In any case Death and Decay are the provenience of this curse known as Liberalism, so we ought not to be surprised by their macabre desires, their ghoulish lusts.

By: cars

cars — Mon, 13 Jul 2009 14:28:11 +0000

The critique of this article strikes me as trying too hard to make a case here using an inappropriate example.

There are legitimate issues surround the way we treat elderly people at the ends of their lives. Too often a lot of medical intervention is going on to prevent the inevitable rather than just making people’s lives comfortable and giving them quality rather than quantity.

In a thread that is trying to make a point about reducing care for seniors being inappropriate or unjust – trying to link foot care for the elderly to abuse of the system is somewhat ironic.

I don’t know about you – but at 88 I’ll be darn lucky if I’m able to trim my toenails and properly care for my feet. That requires a level of fitness and flexibility that’s not common at that point in most people’s lives long before their late eighties.

A podiatrist – or anyone doing foot care for the elderly is doing more than just trimming toenails.

They are keeping an eye out for circulatory problems (especially with diabetics – since problems usually show up in the extremities first). They are preventing or addressing ingrown nails and fungal infections that can rapidly become much more serious issues. They may also be dealing with problems caused by bunions, heavy callouses etc. It’s not just a nice pedicure on someone else’s dime.

In my neck of the woods some of the local pharmacies run foot care clinics for the elderly for the reasons I’ve outlined. Keeping their feet in good shape can go a long way to keeping elderly people active and mobile. Becoming inactive and/or bedridden is often the start of an irreversible decline.

There are plenty of things to criticize – but this isn’t one of them.

By: Warner Todd Huston

Warner Todd Huston — Mon, 13 Jul 2009 14:25:20 +0000

That we may not necessarily want to extend life just because we can. But I DON’T want my government making that decision for me. With Obamacare it will.

By: DamnCat

DamnCat — Mon, 13 Jul 2009 14:15:39 +0000

“…that American black-and-white way of thinking: Either we have to throw everything we’ve got at keeping people alive or leave them on the sidewalk to die.”

Dr. Carstensen has it exactly backwards – it is the current system provides the true nuance and gray-area thinking.

Take for example the two sisters mentioned in the article who have different views of what steps should be taken to extend their lives. Each is allowed to pursue her own path according to her own conscience. It is the government system that would impose a rigid “black-and-white” regime on these two women.