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We’ve heard a great deal of sturm und drang regarding the supposed "evils" of a Health Care Plan that would pay for end-of-life palliative care in-home or in a hospice, in addition to its hospital counterpart.
I don’t know about most people, but I have direct family experience with both.
In the first instance, when my Grandmother had her final recurrence of ovarian cancer, she was able to return home under the care of her own family and died surrounded by love in familiar surroundings – the family members who were with her at the end said that she passed on smiling at them.
In the second case, my Sister died due to hepatitis (a former nurse, she contracted it when an unruly patient lurched and stabbed her with his contaminated needle). Even though there was nothing that could be done, and she was unconscious, she had to remain in the hospital because no in-home care was covered; she’d been on Disability for some time, her husband did not make a good salary, and their home (which they paid off after many years) was a humble trailer out in the country. Her husband could barely afford to have her cremated and buried her ashes in the back yard under a tall tree that she’d always loved – he had to declare bankruptcy and also take legal measures to be sure he didn’t lose their home. Nonetheless, he still had to pay medical bills that crippled him financially, and the rest of the family couldn’t afford to do much for him.
Recently, we've been hearing many people asserting (often with great volume and aggression) that having the option of spending one’s last days in one’s own home is somehow some sort of "death-squad denial of care"; we also hear that the very wise (and physician-encouraged) idea of end-of-life planning, also called a "living will", somehow falls into the same category. I can't fathom the logic of that, and I can’t help but wonder: How many of the people who opine that insurance coverage for these choices is equivalent to a "death panel", actually has had direct experience with palliative care, especially at-home? Do they seriously believe that it’s preferable to be forced to remain in a hospital (because that is all the insurance will cover, and at that, it certainly will not cover 100% of the costs), despite the likelihood that it will further burden a family with financial ruin? Even more to the point, do they seriously believe that a dying person is somehow comforted by knowing that their family is likely to end up being driven into bankruptcy or downright poverty by the inevitable medical bills? Many of these protesters speak as though it's somehow crass to do end-of-life planning and include finances as part of that process, but that seems to me to merely be a denial of both the inevitible, and of the fact that resources must be devoted to good care for the dying person, regardless of whether the individual chooses to remain at home, go to a hospice, or remain in a hospital. The only thing that's worse than death, it seems to me, would be to die knowing that your loved ones will be financially devastated by your final medical bills.
The main thing people should be worrying about, as I see it, is freedom of choice, which includes taking responsibility for handling their own end-of-life wishes. I don't want to think that rejection of that choice is based upon a mere refusal to take responsibilities inherent to any choice - but that refusal is, in the end, also a choice: a choice to leave the final decisions up to others.
The distressing fact is that we will all inevitably die, and I cannot comprehend why some people are so adamantly opposed to a legal provision that, if they have been paying into insurance, be it private or some form of public, this insurance will allow their family to both care for their loved one as that individual has chosen, and avoid financial ruin whichever choice the individual makes regarding his or her final days.
Of course, I am only an eggplant, so...
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