10A113 Who Pulls the Plug? by Jim Davies, 12/28/2010    

"During the stormy debate over his healthcare plan," claims Newsmax, "President Barack Obama promised his program would not 'pull the plug on grandma' and Congress dropped plans for death panels and 'end of life' counseling that would encourage aged patients from partaking in costly medical procedures." Yet three days from today, according to the New York Times, his own Medicare regulation will do precisely that. What? You trusted a politician? Ha!

According to this report, "The elderly (age 65 and over) made up around 13 percent of the U.S. population in 2002, but they consumed 36 percent of total U.S. personal health care expenses."

No surprise here. As age advances, functions fail, it costs more to maintain each day of life. The nearer to death one gets, the nearer that daily cost approaches infinity. Since resources aren't infinite, the plug has to be pulled. Again though: who decides when, and who pays up to that point? Four possibilities:

  1. The physician in charge. Unfortunately, while his advice is vital, he's not disinterested. Intensive care and 24/7 residence bring serious money to him and his hospital. The longer it continues, the more can be billed.
  2. The insurer, if any, with whom the patient has a contract. This is not a bad option, for it means the patient pre-plans how much can be spent. He keeps the matter quite closely under his own control.
  3. The patient. This works okay for somebody well-off, who has saved resources earmarked to prolong the final few days of life. That's a form of self-insurance, but given the uncertainties involved it's not clear that many will want to afford it.
  4. Government, if it monopolizes health care and steals the means to fund it.

That fourth option is clearly the worst, for it takes all the decisions out of the hands of the patient, his family, his insurer and even his physician. There are no "good" options here - death is always the outcome - but this is the one least consistent with the self-ownership axiom. It takes away all a person's right to control his own life and destiny, and hands it to a bunch of politicians whose only motive is to win the next election.

However, that is what government always does; if it's allowed to do it during most of one's lifetime, why not also as death approaches? - or if not then, why allow it during the years of good health? - once again, there is no rational alternative to a zero government society.

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