Wednesday, August 19, 2009

The Certain Reality of Life: Death

Japanese Admiral Isoroku Yamamoto is portrayed in the 1970 film, “Tora! Tora! Tora!”, as saying after his attack on Pearl Harbor, "I fear all we have done is to awaken a sleeping giant and fill him with a terrible resolve." Whether this was actually spoken by any Japanese admiral may be subject to historic speculation, but it is a reasonable assumption that an admiral would have been at least politically aware of the certain potential of a nation with such vast resources at its disposal and a history of national resolve when directly threatened.

Now this same “sleeping giant” battle cry is being used by town hall protesters as a warning to members of Congress who have, at least prior to the August recess, all but ignored the outcry such speculation about the various health care bills floating about in Congress has brought. Some seemed genuinely surprised by what has come about from these gatherings, which is not entirely unreasonable considering the majority that carried Obama to the White House. Even still, I applaud those members of Congress who continue to hold these town hall meetings while mindful of what is likely to come as a result.

It occurred to me earlier that this outcry, resulting primarily from so much misinformation, is not unlike the outcry that came as a result of President GW Bush’s Social Security privatization proposals. Republican members of the Congress were skittish about how such proposals would be received by American voters, and Democrats were gleeful as they virtually ran to AARP-sponsored meetings and retirement homes, thumping their chests, and telling Social Security-dependent persons that GWB was going to throw them into the streets and that “George Bush will take your Social Security OVER MY DEAD BODY”! In spite of GWB’s direct and unambiguous words and specific proposed exemptions, Democrats intentionally, effectively, and successfully twisted the president’s words and put a stop to even having a national discussion/debate on addressing the very real – and very serious – problems Social Security will face in a matter of a few short years. The problems still exist, the danger is very real, but now we don’t even want to talk about it. It is much easier to claim a victory and leave well enough alone.

It would be nice to say we learned a hard lesson, but the truth is we’ve learned nothing at all. There are those “sacred cows” we can never have serious discussions about because our elected officials lack the courage and the resolve to be serious about anything other than their own reelection campaigns, and we voters lack the wherewithal to be serious and hear the unvarnished truth. Congressional incumbents will do enough damage control over the course of the next few months and will be able to convince their constituents that the outcry was “heard” and responded to. These same constituents will then be lulled back into complacency, and those members of Congress will have again successfully manipulated the voters. And health care reform – which we all agree is badly in need of serious discussion and attention – will be only a pipe dream, thrown into the annals of “nice try” history and forgotten.

Now that I have successfully taken myself completely off task, allow me to go back to the matter at hand. “End of life counseling” (aka, “death panels”) under the various House proposals will be voluntary on the part of patients but would be mandated to be made available to these patients, and doctors will be reimbursed by Medicare. What all this means is that there is a certain reality we must all face. And if it is true what President Obama said about “how the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care costs” (Washington Times, July 9 editorial), then we need to be very serious about exactly what is being done against what is being proposed.

Bottom Line: voters do not trust the government to make such decisions or even be indirectly involved in such decisions. This lack of trust is being translated to “health care will be denied to the elderly” (it’s called “reading between the lines”) so as to save a few bucks. Indeed, try to call the US government, any agency, and see how hard it can be to get a knowledgeable human being on the line. And imagine such an overtaxed system such as a national health care office where decisions to fund or not will be made daily and, quite literally, thousands of times per day. But let us not allow the language to become inflammatory. It is not, as I understand it, a matter of deliberately choosing to end the life of an elderly person. Rather, the choice will be the usefulness of thousands of dollars worth of treatment that may not be effective. There is a huge difference.

Yet even as I have nothing to lose or gain politically from this discussion, I cannot bring myself to say what needs to be said: we humans will not – repeat, NOT – live forever. It is imminent; our lives will end, but we have an aversion to such a truth as this. And even though Americans are living longer, my guess is that such longevity is not exclusively attributable to “natural” (read “pills” … and lots of them) genetics or “good, clean living”. The tricky part is defining “toward the end of their lives”, as President Obama had put it in the July 9 Washington Times editorial/interview, because no one can know exactly when the “end” will be without taking definitive measures to deliberately terminate a life. And this is where too many Americans see the US government stepping in. The government may not “pull the plug on grandma”, as Obama so callously put it, but government may well decide whether grandma is plugged in in the first place. And this, I think, is the problem.
Incidentally, the “pull the plug” claim is no more or less ridiculous than “throw grandma into the street”, as congressional Democrats gleefully proclaimed during the Social Security debate-that-never-took-place” during President Bush’s last term. But again, I digress.

The issue of health care in America is as real and as serious now as Social Security was, and still is. Whether we accomplish anything of substance remains to be seen and will be contingent upon American voters’ insistence on knowing the truth (the sleeping giant awakened AND alert!) not only about what these proposals contain but exactly how much – or how little – their senators and representatives actually know. And this cannot be determined until we actually allow them to speak. But may we also be realistic about what is at stake, and putting a 25-year-old heart into an 85-year-old body is not realistic. Nor practical.

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