Thursday, September 24, 2009

More on the absurdities of end-of-life care

A note from Portland, Oregon:

But for reasons both cynical and clinical, the American political debate on health care treats end-of-life care like a contagion — an unspeakable one at that.

Nobody was more frustrated than John Kitzhaber as the health care debate got hijacked over the summer by shouters and misinformation specialists. And no politician is more battle-scarred on this issue. He looks, at 62, still the Western man, with his jeans, his shag of gray hair, the face weathered by days spent trying to lure steelhead to the surface in the Rogue River. It has been his life work to see if at least one part of the country could join the family of nations that offers universal coverage.

With his mother’s death in 2005, Kitzhaber lived the absurdities of the present system. Medicare would pay hundreds of thousands of dollars for endless hospital procedures and tests but would not pay $18 an hour for a non-hospice care giver to come into Annabel’s home and help her through her final days.

“The fundamental problem is that one percent of the population accounts for 35 percent of health care spending,” he said. “So the big question is not how we pay for health care, but what are we buying.”

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