Wednesday, November 16, 2011

The Passing of a Friend

I stopped by the hospice yesterday to see a man I have worked with for several years and count as friend. Ten months ago he was healthy, looking forward to a new semester of teaching and interested in life. He had come through many months of clinical depression that was treated using shock therapy and was well on the road to being productive. He started to put on large amounts of weight rapidly, like two pounds a day.

He was diagnosed with and inoperable tumor in the region of his heart involving a kidney and liver. Within weeks of diagnosis he ended up in the hospice last May where he has languished since.

When I was there yesterday it is obvious he is entering the final stages of the illness. He looks wasted to some degree, pale, weak and is disoriented. His speech is slurred and difficult to understand and his thought process is confused and not easy to follow. He is an engineer, a musician, and intellectual. He is well read, fascinated with the Civil War and those times in society. Yet here he is, his light is winking out. How helpless I feel and how frustrated it makes one to see this slow degradation of a fine person. Why him, how did nature pick him, what did he deserve to have this terrible disease visited upon him. I don't know, these are questions without answer, but the plague me.

Tuesday, November 15, 2011

Death Squads

I was schedule to begin a maintenance chemo plan yesterday, Monday, Nov. 14, 2011. It was postponed because the insurance company wanted to review the plan to see if they would pay for it. Today, the lady who is the case manager for the insurance administrator called and said my maintenance chemo plan was turned down for payment. She said I should wait until the Dr. reviews the decision and let him either appeal the decision or come up with a new plan that will meet with approval.

A year ago or so when the democrats pushed through a huge health plan a number of conservative leaders said if the administration of healthcare were turned over to the government we would have "death squads" who would be deciding who lived or died. Well guess what, they are in effect already in place in the private sector.

If I were in desperate straits health-wise I would be extremely upset. However, my prognosis for my condition is very good. There is a 95% chance of full recovery. However, because I had a recurrence of cancer I am also at increased risk for further recurrences. This maintenance program is aimed at reducing that risk.

I have a coworker and friend lying in a hospice in Jonesboro. Ten months ago he was the paragon of health until he started putting on about 2 lbs of weight per day. Within a two week period he went from healthy to deathly ill. They found a tumor had invaded his right kidney, was invading his liver and was in the venus cava area of his heart. It was judged to be inoperable and he was immediately sent home with a horrible diagnosis and no idea of any palliative  care that could be provided. He came home and immediately went to a hospice where he has lain since last May. The family Dr. was so upset with his condition that he contacted M.D. Anderson in Houston to see if they would take him and render a second opinion. The insurance company flat refused to pay. Could he have been saved? Who knows, in the meantime he lies in a bed in a comfortable setting waiting to die.

Seems like we owe ourselves more than just a one time shot. In my case, I'm not too upset. Something will probably be done because the insurance company also recommends maintenance therapy. However, we are betting my life on this. Suppose five years from now my cancer comes back and we find out that had I had this "gold standard" treatment it would not have come back. Then the death squad becomes that for real.


It was recently announced the Supreme Court will hear the case concerning the new healthcare bill next February or March. A decision will be rendered in June, just in time for the election. One of the main sticking points is the mandated insurance coverage where most Americans will have to have insurance or suffer some financial penalty.

The argument against the provision is we should not force people to have to carry insurance and impose a financial burden on those who do not want insurance. A good argument. 

However, when these people who opt out of insurance have an accident or are hit with a sudden illness they go to the emergency room and may not be refused treatment. So the cost of that treatment then falls on the rest of us in terms of increased premiums, or taxpayer involvement.

So what are out options? We could refuse medical treatment to those who do not have health insurance. Think about the enormous moral burden we would place on our healthcare providers. Plus we don't refuse people help in the country. This country was founded on independence, but people still came together to render aid when people were in times of crisis or need.

We could bill the person's receiving treatment. However collecting can be a problem prolonged by litigation, abandonment, bankruptcy, or other means of dodging one's responsibility.

Or we can share in the premium cost with everyone participating thus reducing the over all cost for everyone and people would then have assurance of care in times or need or injury. 

I opt for mandated participation. This is one area where I think people's self-serving decisions would hurt the common good of the people.