Can we speak honestly about end-of-life care in America? Apparently not. In 2014, the National Academy of Sciences and its Institute of Medicine hired a 21-member panel of big shots and wrote a 507-page report called “Dying in America,” to state the incredibly obvious point that end-of-life care in America is completely broken.
You know this already if you have had a parent or grandparent enter the system and stay there until death. You also already know the scam. It’s all about extracting the last dime first from private wealth and then from the taxpayer through government programs, until all excuses run out and the patient is finally and mercifully allowed to die.
Not only has the system gradually turned into a gigantic financial racket that plays on people’s normal sense of wanting to prolong life as much as possible; it is the cause of wrecked families, massive heartache, and terrible suffering spread far and wide, not to mention pillaged family estates.
The new report steps very cautiously into raising some questions about this system. Very reasonably, it suggests that at-home care, pain management, and simpler technology would be more financially reasonable than the current system of storing millions of people in medical institutions that rob the aged until they are penniless.
The report is cautious because of the prevailing hysteria based on the long-running fear that socialized medicine will be characterized by governments cutting life short when it becomes too expensive. You find this theme in every dystopian novel, and it has become a common criticism of Obamacare (“death panels”). This is why the language is so judicious, why every expert on the panel has a high pedigree in the field, and why the report has come wrapped in so many official trappings.
The first quoted critic is from the National Right to Life Committee. “The report’s emphasis on cost-slashing will intensify, rather than calm, the well-founded fears of older people and those with disabilities … about pushing them to accept premature deaths.”
But, honestly, premature death is not the problem with end-of-life care in America. The system is indeed more centralized and socialized than ever, but that has not resulted in elites forcing family members to pull the plug. To be sure, it is not unreasonable to assume that the government wants to kill you. But in reality, governments and their connected private interests want something even more than your death: your money.
This is why the United States’ public-private system has become exploitative in the most perverse way. It urges you to live as long as possible provided you can keep feeding the greedy health-care machinery. It’s all about getting money from your bank account to theirs, and, when that runs out, tapping the taxpayer for as long as possible.
It’s striking how many people are blissfully unaware of how the system operates until that fateful moment when Mom, Dad, Grandpa, or Grandma faces a health crisis. The doctors take charge, along with the insurance companies and the institutions that house barely conscious people for a decade after all quality has drained from their lives.
The condition worsens, the feeding tube goes in, the machines are hooked up, and suddenly you find your loved one as part of a decaying throng of octogenarians living off technology while the bank account slowly and systematically drains from $1 million to $0 in the course of a miserable 10 years.
Who wins? The medical establishment. The nursing homes. Big pharma. Insurers. Bureaucrats. They are the new parasites living off barely alive flesh, and they are determined to do this at the expense of every one of us, making sure that we can never inherit nor pass on money to the next generation.
But what about morality and medical ethics? There’s no point in going into a long discussion of this unbelievably complicated topic. Suffice it to say that life is better than death, and we should all do what we can to prolong it. But when is “what we can” too much? The old standard was pretty clear: we should provide ordinary means like food and water, but we are under no moral obligation to provide extraordinary means that only modern technology makes possible.
This seems like a reasonable standard, one that needs to be revived. As for those who say that money should be no object when it comes to preserving the life of another, I say: false. Money is a proxy for property, which in turn is about quality of life. No one has a right to another’s fortune, even if it is confiscated in the interest of prolonging life as long as possible.
Ask yourself this question: Would you rather live an additional two years on this earth, in a state of near unconsciousness, hooked up and doted on by professionals, inconveniencing your entire family and spreading waves of maudlin suffering everywhere, or pass $500,000 on to your children so their children can have a head start in life?
It’s a pretty easy decision. The problem is that it won’t be up to you. The choice to keep you “alive” by machines will be the decision of others, namely your children. And they will probably be too fearful or too intimidated by experts -- and often the law itself intervenes -- to make the right choice to let you die naturally.
For some very strange reason — and even though death has been going on a very long time — the current generation can’t seem to come to terms with the fact that we will all die at some point. If we have the choice either to go gracefully and leave something for those who follow us, or to die grimly while imposing enormous costs on those around us, we should choose the former route.
Everything about the current system is designed to make our deaths as grim and expensive as possible. That really does need some rethinking.
This post originally appeared at Liberty.me.