Old People aren't Cost Effective

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My nan has lived in an old peoples home for many years. We're very lucky that it's run by a friend of ours and she's very exacting so my nan and all the other residents have fantastic care.
My nan has dementia, she can't walk due to the last home she was in saying that she was getting physio after a hip replacement and not doing it, and she has glaucoma due to diabetes.
Anyway, two years ago (exactly now), the home called us and said nan was poorly, she wasn't eating or drinking and they were very worried that her blood sugar levels had dropped. They told us that if she didn't get any better in 24 hours then they were taking her to hospital. There was no improvement so she ended up in hospital.

After 2 days in hospital, she seemed to be getting worse. When we looked closely at her bed, we noticed the sheet was filthy so we thought maybe the staff hadn't changed her since lunch. On closer inspection though, we found the whole bed was filthy, her catheter was over-flowing and the staff hadn't fed her as they didn't believe that she wasn't strong enough to feed herself!

Shortly after this, nan went into a coma and was moved to a different ward. The staff on this ward were so appalled by the state she was in, they raised an official complaint alongside the one we had raised. We were told that nan only had 24 hours and we should call in the rest of the family.

Despite all this, nan rallied round and is now still doing well.

When we spoke to the doctor who had been in charge of her care he was full of excuses, the staff didn't have time to read all the patient notes fully so they didn't know she couldn't feed herself or walk or wash etc.
Then he cam out with the MOST annoying thing! He said that x-rays had shown that nan had a mass in her bladder, possibly cancer and they wanted to do a very invasive and painful proceedure to check it out. We asked what the treatment options would be once they found out what it was and he said 'There are none, she's 85 so really it's not beneficial cost-wise to treat her'.
We refused the proceedure, if they weren'y going to bother treating her then what was the point in hurting and upseting her?

My nan worked and paid taxes all her life, her husband fought in WW2 and she did a lot of church work to help out other people less fortunate.

It wasn't worth it, she's not cost-effective.

 

That is terrible. I wonder if the next ABC produced Obama broadcast about nationalized health care will feature this human interest story?

 

Doubt it hun, I'm English!

 

But silvery, you don't understand, Universal health care is all about the CHILDREN, the liberals don't care if you or i or our elders die, as long as it saves 1 child.
Now do you see why i dispise them so much?

 

How exactly are the elderly taken care of by the heavenly private health care system in the US? From what little I have heard unless you did really well in your life and managed to save up a huge private pension you are to put it bluntly "poop out of luck"? Is this a flawed perception that I have arrived at through watching "the liberal media" and talking to lying Americans or is it true?


Oh and Silvery sure it sounds callous when they say it is not cost effective to treat your nan but cancer treatments are draining, invasive, damaging and takes time. What would be the point of putting your nan through months or even years of treatment that might as well kill her to possibly save her from dying from cancer when a person her age generally has a long queue already bickering over what will get to kill her?

 

martaug,
you sound cranky. Maybe you ought to have a walk in the woods, have some fresh air or work out to relive all that pent up stress.

Joa,
this is about tribalist swagger, not reason. That's why one would say something like this:

It's his tribe vs. theirs. Cons good tribe because his tribe, Liberals bad tribe because other tribe. So whatever other tribe does, bad deed - indeed very black & white if you will.

Silvery,
I can understand you are angry. It does sound callous. That's what happens when technocrats make rational decisions about life or health under economic criteria - and that's a news flash for you martaug - that's precisely what a for profit private health insurer does. If you don't have the money to afford a cover-all insurance, tough for you. You're well advised to carefully read the fine print anyway, just in case, so you know what they don't cover.

 

Sorry to hear that, Silvery. My granddad is 88, and we have been told that at his age any serious procedure has a higher chance to do bad than good, but to hear she's not going to be getting something because it's not cost-effective is quite harsh.

Please, that's universal healthcare for children. Universal healthcare period is for everyone, but Obama has even lower chances of getting that... and I seriously doubt you would support him if he tried .

 

Very eloquent how Ragusa points out the hypocrisy in martaug's words.
It's all about who gets to live and who deserves to die in conservatives' eyes, and Silvery's nan didn't have the 'credentials' to qualify as a conservative in market-driven health care.

Silvery, it was really callous, what the doctor said. And probably not even correct either: If he had used the word 'practical' instead, it would have described the situation much better. The marginal chance of improvement just isn't worth putting your nan through the procedure. joacquin explains what the doctor meant better than the doctor could!

 

coineineagh,
well thanks for the 'eloquent'. Anyway, I fear I have to disappoint you. First, I think that 'disoriented' is more apt than 'hypocritical'. Second, I really didn't mean to imply the question to martaug whether he thinks the decision whether Silvery's nan deserves treatment hinges on whether she is a liberal or a conservative. I didn't see that one. You must be more evil that I am to read that. But now that you mention it, it is a very caustic question.

 

Silvery - I'm sorry about your nan. The thing you have to ask yourself is even if her entire treatment would be covered by the health care system, would you really want her to go through that? She's 85 and any treatment will be physically taxing, and seeing as how she's suffering from dementia, even if she is cured it's not like she will be adding good years to her life.

My last grandparent died about 3 years ago from pancreatic cancer. She was 86 when she was diagnosed. They said her chances of survival with either chemotherapy or radiation were low. She decided to forego the therapy and at least be fairly comfortable for the last few months of her life. If she had opted for chemo or radiation, it would unlikely have prolonged her life to any significant degree, and she would be suffering from the side effects of the treatment. She died 9 months later. I completely understood and agreed with her decision.

Ask yourself this - if your nan was of sound mind, would she want to be cured?

 

Actually, it entirely depends on what home they end up in. Sure, the mroe expensive it is the more likely it'll be better, but there are some very good ones that are cheap, and some terrible ones that are pricey. Plus, as for hospital care, if you can pay and/or have insurance, it doesn't matter how old you are.

This is exactly the attitude that's the problem. You could not give it to Silvery's nan and steal away a potential 20 years more life from her. Likewise, you could give it to a 20 year old, help him recover, and see him run down on the street two days after he's released. You can't base a decision on projected benefits because, quite simply, we don't know. We can make averages that are true over 50,000 cases, but when the decision being talked about is life and death, who are you, or the doctors for that matter, to say "Oh, it's not worth it, she won't benefit much from it."

Rags, honestly, you sound as "cranky" here as Martaug. You have no reason whatsoever to believe that this is the reason for Martaug's position, as opposed to actually hating them for their philosophical and political positions.

Coin, the problem is, this isn't market-driven health care. This is liberal-driven health care in the UK. The older you are, the less likely you are to be treated, regardless of past or current health.

All in all, Silvery's case is a bad example of the risks of this system, and the attrocities. I posted in another thread about my wife's grandmother in England. 20 years ago, she was healthy and hale at 60 years old, and very active. She needed a foot operation to correct a deformaty of some kind. They put her on a waiting list, halfway down, because she was 60 and "probably wouldn't live long enough to seriously benefit from it". Now, 20 years later, she's 80, can't walk because of the lack of surgory, and is otherwise still rather healthy, hale, and active. She lives indepenantly, not in a home, and manages her own life quite well. If she had had the operation, she'd probably be 100% self-sufficient today. Instead, she's bound to a wheelchair. Oh, and the operation? She's still on the waiting list, only now she's on the bottom.

 

I can't quite agree there, NOG. While the UK does have a universal health coverage, or at least something like it, the reason the doctor gave sounded perfectly market-oriented. If he had simply said they can only perform X operations this year, and they can't have the lady covered, then sure. As for old people less likely to be covered, I'm not sure that is a universal rule. I'm pretty sure that's not the case here (although I'd only wish we had the same system the UK does) - old people go to the doctors more often, and thus they tend to sometimes "crowd out" younger patients. Any healthcare system has to allocate limited resources, and old people tend to need such resources more often than younger ones.

 

Sorry rags, not cranky just tired of all the liberal BS. Right now we here in the usa don't have a bad liberal system like in the UK, which is why my grandmother was able to get a hip replacement at the rip old age of 86(this was 3 years ago, she was born in 1920). Since then she has been able to move from a nursing home to an elders apartment building. This is just like a standard apartment complex except they have an emergency button in each room in case they need help. The on-duty staff personal usually answer within 3 minutes.

Also Rags it's not tribal swagger just common sense, 99% of the libs i have met don't have the sense to come in out of the rain but think they can run everybody elses lives better then they can. F'em all.

No shaman you don't get it, to liberals EVERYTHING is about the children, except when they do things to impact children. Oh, obamas stupid spending bill is going to bankrupt our children & grandchildren?, well thats ok as it's for ther own good. Please get a F'n clue.

No coin, ALL elderly people should be taken care of, if not for them we wouldn't be here.

Nog, you are exactly right about the attitude thing.
Just ignore ragusa, i'm the type of american he hates(there is nothing wrong with that just how it is).

 

Martaug is correct. I for one do not think that the U.S. healthcare system is broken and am not looking forward to adopting the European model. My family and myself have never had any problem getting the care we need. We never have to wait and we have never had anything rationed. Now it is true that myself and most of the people I know (liberals and conservatives) have jobs and that could be the reason for our satisfaction. For poor people, they have the Emergency room at hospitals as there are laws that prohibit anyone from being turned away. Didn't anyone here ever watch ER?

 

I haven't looked up any specific numbers but I am fairly sure that the 60+ population takes up a vast majority of the resources of any country's healthcare system. Up to 80% wouldn't surprise me, to put it bluntly old people really are not cost effective. They are a huge drain on society and the current demographic prognosis shows that it will only get worse. All over the developed world we will soon have less people working to support the elderly than there are elderly.

I am a quite callous person I can freely admit this but whether you want to or not there is a time when you have to make calculations and cut your losses. Where you can't spend a large chunk of your very limited resources to possibly give some most probably very worthy 80 year old the possibility of maybe living another two years. I am all for dignified care and making sure everyone gets by as best as possible but spending more money on one procedure on a very old person than we do on an entire class of schoolchildren or any of the other things that we can spend money on is just not justifiable. We do not live in the best of worlds, we have limited resources and frankly there are betters ways to spend them on than for example on your grandmother's foot NOG.

How else would you allocate resources than on projected benefits? Betting on the 20 year old not getting run over and spending the next 40 years working and benefitting society or betting on the old lady suffering from dementia to not die from the treatment or any of the many other things that ails old people and at the very very best have another 15 years of sitting in a chair not knowing where she is and being forced to be washed and fed by overworked nurses.

Do I sound uncaring, callous or even imoral? Maybe because I am and maybe because that is how the world works.

 

No medicare system is perfect -- you can find horror stories in the free market system, you can find them in two-tier systems, and you can find them in the most socialist of systems. Couple that with the fact that doctors themselves cannot always cure our loved ones even at the best of times, and factor in the emotions involved, and you've got a recipe for tears.

To be honest, Silvery, your nan's treatment at the home is disgraceful. While I believe that many people who run and work at such homes are good people, the bottom line is I would hate to see my father placed there -- there are also many incompetant, vicious dirtbags working in such places. Some others are decent people but are stunningly overworked.

My mom knew a lady once at an old folks home. The staff nearly let the woman starve. They would drop off her salad, wrapped in cellophane. The woman couldn't unwrap it, but they didn't have the perceptionm to see that she really was hungry -- they'd just take the salad away, thinking she was not hungry. My mother was furious. She ended up going in and feeding the woman her lunch every day for several months. Maybe the staff was incompetant, maybe they were just overworked, but either way the old lady deserved better.

As for treatment, well, in a socialist system it's all a matter of the cost benefit analysis -- there's a finite amount of money and a certain percentage chance of successful treatment, and tough decisions have to be made. In a capitalist system, poor families cannot afford some treatments. Either way, the vulnerable in society tend to suffer. No one anywhere has managed to figure out how to solve this problem, and kudos to the people who are trying, but it's a tough nut to crack.

 

You correctly point out that the issue isn't so bad if you are someone who has health insurance. I would like to point out that not all of the 47 million uninsured Americans are unemployed. Some of them are children. Some of them are gainfully employed, but cannot get health care due to pre-existing conditions. (Note - this would generally only apply to the self-employed, as health insurance companies generally cannot exclude a single individual from a company provided insurance plan.)

Emergency rooms are definitely not cost effective. People who go to the emergency room for a serious condition who do not have insurance are generally there because they didn't go to a doctor when the condition wasn't nearly as serious and could have been treated for a fraction of the cost. People like you and me, Snook, pay for these people by way of higher insurance premiums.

The biggest complaint I have with the health care system is that we spend way more on care than anywhere else in the world, and yet Americans are far from the healthiest people of the world. In fact, we're not even close. Even after all that, I'm still willing to concede that maybe the problem isn't with health care - maybe it's with the insurance industry. The fact that we spend so much tells me that insurance may be way over-priced compared to the rest of the developed world, and perhaps if health care wasn't as expensive, more people would be insured...

I don't see you as any of those - I see it as practical. If I were 85 years old and suffering from dementia, I don't think I would want to be cured of a terminal illness if I were in fact able to think.