Health care complexities are summed up in the fates of two Democrats, each stricken at one time with cancer, who now have their lives on the line.
One is Supreme Court Justice Ruth Bader Ginsburg, 76, and two-time cancer survivor, of colon cancer, for which she had surgery in the past decade, and pancreatic cancer, for which she had surgery early this year.
Pancreatic cancer is usually fatal, as it is without symptoms and is usually discovered only when it spreads widely, but with Ginsburg this wasn’t the case. Hers was caught early and almost by accident, in the course of treatment for another condition, and thus her chances for being cured are much higher than in most other cases, and it is not unlikely she will be in the court in her 80s, like some of her peers.
Her problem under Obamacare, which looks at life through the prism of “cost-versus-benefit questions” and is committed to paring down costs by paring down treatments for those in the “twilight,” is that a bureaucrat might look at her dossier, look at her age and her medical history, and decide that as a public investment she was not a good bet. It mightn’t be true, but the bureaucrat perhaps wouldn’t know it. How would she fare then? Not well.
Democrat No. 2 is Sen. Edward M. Kennedy, the father of health care reform in the Senate, whose knowledge of illness is both wide and deep. He helped to save the lives of two of his children when they were stricken with life-threatening cancers by insisting on aggressive and expensive treatment, and happily, both are alive.
Now 77, and stricken with an aggressive and terminal tumor, he is fighting it with the same all-out aggression, which — like the treatment given on his advice to columnist Robert Novak, who died last week of the very same illness — would be regarded as wasteful under the legislation he is trying to pass.
According to Politico, some of his drugs may cost $50,000 for one treatment, while the Obama plan relies on trimming back the expense and the scope of the end-of-life treatments given the elderly when they become very ill.
“The problem is that too many Americans avail themselves of expensive treatments that may extend lives at the margins but have low prospects of actually saving them,” as Politico’s Jeanne Cummings puts it.
“The uncomfortable truth … is that most concepts about lowering health care costs involve patients and caregivers becoming more disciplined by resisting the kinds of aggressive medical treatments Kennedy has pursued.”
The real danger is less in cutting off aggressive care to terminal cases, and more that pressures to cut back expenses on care of the elderly may reduce it in cases of people like Ginsburg, whose fates are not settled and whose prospects on paper may tend to look worse than they are.
All people age, but people age differently. Some become frail, while others are vigorous; some watch “Judge Judy,” while others are judges; some collapse on their couches, while George Bush the elder jumps out of planes.
Perhaps the terminal should not be given on the public dime costly treatments that extend their lives only in increments, but the vigorous old, the Bushes and Ginsburgs, should not be denied things that extend their lives and the quality of them because of the demographic in which they happen to fit.
One irony is that Kennedy may be fighting so hard to extend his own life because he feels driven to fight for the plan that would make getting his treatments for others that much more difficult, while Ginsburg, as a good liberal, may back the regime that would introduce those “cost-versus-benefit questions” that one day might judge her as a social investment, decide she has already had her fair share of livable hours and find her, like an unwanted fetus, not really up to the mark.
The opposition will come from the Right, which is pro-life and finds her life important. It will be up to the Right wing to save Justice Ginsburg. Whether she wants it or not.
