Government's culpability in the health care fiasco.

[Tungwagger]

I rarely like starting political threads. But two things have occured to make me ask this question.

My argument of the government being culpable in the percieved health care crisis, i.e. using taxdollars to pay for unneccessary procedures.

1.) My wife's grandmother is 87 years old. She has a bum ticker and a pacemaker. She is on Medicare and Medicaid. Each year the government pays for her to get a mammogram. Even if she is diagnosed with breast cancer, she wouldn't in all likelyhood survive the treatment and/or the surgery to remove her breast.

2.) A guy I work with has a girlfriend who has had one lung removed due to cancer. Two months ago she developed cancer in the other lung. She has been pronounced as "terminally ill". Last week they discovered she has breast cancer,and because she qualifies for free healthcare because of her income/disability, the hospital (which is a training hospital) wants to remove her breast because they know that it will provide training and be paid for by the government.

In the case of my wife's grandmother, perhaps it would be for informational purposes to know what she may/may not die from.

But in the second case, what purpose would be served?

Am I the only one that thinks that government has a responsibility to oversee the waste occuring in just this one area?

 

[peachykeen]

Didn't you just say that in the second case it would provide training opportunities?

 

[Tungwagger]

Didn't you just say that in the second case it would provide training opportunities?

Yes I did. But will it help the patient at all?

Therefore, it is an unneccessary procedure. And a waste of tax dollars.

They have cadavers in medical school to practice "techniques" on.

She is still alive. Luckily her common sense won out, and has decided she will be buried with "both" breasts.

 

[peachykeen]

I would agree with you if not for the fact that you mentioned specifically that the hospital is a training hospital. Therefore, that is what they do. Obviously they are not forcing the woman to have this procedure, it was her choice. I don't see the problem.

 

[Tungwagger]

I would agree with you if not for the fact that you mentioned specifically that the hospital is a training hospital. Therefore, that is what they do. Obviously they are not forcing the woman to have this procedure, it was her choice. I don't see the problem.

I guess it's the fact that the government is willing to pay for it. That's my problem with it. No oversight into the neccesity.

If the hospital was that eager to perform the procedure, then they should be willing to eat the cost of the training. I just see the possibility of abuse of taxpayer dollars for the sake of training.
I'm sure there will be plenty of cases where a woman who is diagnosed with breast cancer and that is the only malady.

 

[ksmybuttons]

Hospitals are paid by the government to train. Huge amounts. Then the hospitals charge the government for the procedure.

Health care rationing. Where whould it stop is the question. Who gets to decide what is done to a person? Only the person who is being done upon. They are given the options and they get to choose.

AND we all pay for Medicare. Every month. It is not government money. I just wish they saw it that way...

 

[bluespoke]

If the hospital, using the 'taxdollar', develops a revolutionary new treatment for breast cancer wouldn't you consider that money well spent?

 

[Tungwagger]

If the hospital, using the 'taxdollar', develops a revolutionary new treatment for breast cancer wouldn't you consider that money well spent?

With all due respect bluespoke, I think you're clouding the issue.

What would be gained by trying to convince this woman to have her breast removed? The doctor who wants to perform the procedure is doing nothing beneficial for the patient to improve her life. The government by agreeing to pay for the procedure is doing nothing to improve her life.

We're talking about a human life, not an object for "practice".


BTW, I didn't mention it earlier, but she was never approached about the proposed mastectomy in the interest of training.

I guess my opinion is that if it doesn't benefit the patient, why spend the money?

 

[Tungwagger]

Additionally, her breast cancer is a result of her lung cancer spreading. How many operations would the doctors and the government be willing to perform on her in the interest of "training" before they admit to themselves that there is nothing they can do which will save her life?

 

[Tungwagger]

Hospitals are paid by the government to train. Huge amounts. Then the hospitals charge the government for the procedure.

Health care rationing. Where whould it stop is the question. Who gets to decide what is done to a person? Only the person who is being done upon. They are given the options and they get to choose.

AND we all pay for Medicare. Every month. It is not government money. I just wish they saw it that way...

I agree it's not the "governments" money...That is my whole point.

I think perhaps my opinion is a bit skewed because it was never proposed to perform the surgery in the interest of training. The doctors approched it from the angle of "possibly" prolonging her life. But there was also the possibility she would die on the operating table because of the Chemo and Radiation treatments.

I also don't consider it rationing when someone approches it from the human aspect by asking a few questions. i.e. is it neccessary to save her life?

 

[peachykeen]

I agree that there are many areas where government spending in health care is bloated unneccesarily; however I think you are choosing a poor case to make your point. bluespoke is not off the mark at all in his comment.

Of course the woman involved is not an 'object' for practice. However she has the opportunity of making a sentient choice as to whether of not to have to procedure. She decided not to. However I could just as easily see someone who, knowing they were terminally ill already, might consent to do so if there is a chance that it will possibly do some good for others, either in research or in education for future surgeons.

 

[bluespoke]

In addtion, treating secondary cancers can enable the doctors to improve the treatment, palliative or not, that they give for the Primary cancer.

I would agree, however, that not informing the patient that the treatment was not totally for her benefit is ethically wrong.

Using cadavers for training is common practice but sadly there are procedures where the cadaver is of no use.

 

[Tungwagger]

I agree that there are many areas where government spending in health care is bloated unneccesarily; however I think you are choosing a poor case to make your point. bluespoke is not off the mark at all in his comment.

Of course the woman involved is not an 'object' for practice. However she has the opportunity of making a sentient choice as to whether of not to have to procedure. She decided not to. However I could just as easily see someone who, knowing they were terminally ill already, might consent to do so if there is a chance that it will possibly do some good for others, either in research or in education for future surgeons.

I don't think it's a poor choice at all. The fact that there is an ambitious doctor, eager to train the latest "whiz kid" is more wrapped up in the training aspect than he is in the "quality of life issue". Other than teaching a doctor in training how to remove a breast, there is very little that will be learned other than how to remove a breast. There is so much research in breast cancer now. Most of which is discovered in the biopsy stages in the lab. They did a biopsy of the tumor to reveal is was malignant.

She clearly stated to me that there was no mention of training at all, in fact the only thing that was mentioned was prolonging her life, and that was the reason they wanted to perform the operation. The system that exists in this case requires full disclosure, and a doctor who is willing to overlook the possibility of "can we?", and focus more on "should we?".

 

[christophe]

many patients do receive unecessary treatments including surgery...in most cases it is from the behest of the patients family...many dont wat to give up even when it is a hopeless situation. i think it is tragic to see a patient going thru surgery ( a major one) whose over all state of health is so poor they wont survive.

many cases we see a patient eg. that has cancer that would live relatively peacfully for the last 6-8 mos of thier life but now that they have surgery they will die in 2 months...and quite miserably.

there are situations when a surgery which i would consider ill advised is performed that has legitmate foundation vs. the consequence of its potential lethalithy....for those that provide relief of pain such as a bowel resection or setting a broken bone.

 

[peachykeen]

I concur that not telling the woman the main impetus for encouraging the removal of the breast was more for the benefit of another's education rather than for optimizing her health is unethical and improper. I stand by the rest of my statement, however.