Health and Human Services Secretary Kathleen Sebelius said on Fox News Sunday …

“SEBELIUS: Well, the president won't sign a bill unless it lower costs for everyone. And he believes that the best way to lower costs is to have some competition in the marketplace, to make sure that we actually begin to bring down the overhead costs for providing insurance to everyone and change the payment system so that we don't continue to pay for things that don't work.”

Perhaps some of the most chilling words to be heard on the subject of healthcare.

Ethics …

First and foremost are questions regarding ethical considerations surrounding the medical treatment of human beings in our society; including the denial of care under given circumstances.

Questions surrounding the patient’s right to terminate their own lives if the quality of their life deteriorates beyond an acceptable point or to a point beyond the patient’s immediate control.

Questions regarding the artificial prolongation of life in circumstances when the patient clearly lacks a familial or societal support system to sustain the patient’s well-being in a post-procedure environment.

Questions regarding the allocation of scarce medical resources to those who may not be wealthy, powerful, politically connected or have some historical record of demonstrated achievement of benefit to society.

Questions of “line-jumping,” venue-shopping celebrities and others who are able to obtain vital medical services and organs by “gaming the system.”

Questions regarding age and the potential of the patient to continue to contribute to society before rendering advanced medical treatment or providing access to costly drugs.

If you think that the discussion of abortion is emotionally charged, consider the ethical implications of governmental intervention into the realm of healthcare; where clerks consult checklists and can override an individual doctor’s ability to render care to their patients.

Profits and Performance …

Second, consider the built-in conflict of interest in allowing the payor, be it the government operating in a single-payor environment or an insurance company, to earn a profit (plus executive bonuses) to reap the rewards for denying or curtailing patient care; perhaps to the point of causing death or additional health problems down the road.

Medicine is both an art and a science …

Because of the complexity of human organs and bodily dynamics, medicine is often more art than science; depending on the intuitive abilities of doctors to diagnose a multi-organ problems and to render effective assistance to the patience.

Most people who know me well know that I consider doctors, with very few exceptions, to be like any other consultants who render personal services. And medicine, as practiced by most of today’s doctors, to be akin to programming.

The doctor follows a flowchart or checklist (known in medical circles as protocols) to a logical conclusion; hoping that the patient recovers before running out of checklist items or the patient dies.

I have an intimate knowledge of both the medical and computer consequences of this course of action. To bureaucratically limit the amount of time a doctor can spend considering a patient’s problems or to restrict a multi-disciplinary approach to patient diagnostics and treatment because of cost considerations is, at least to me, highly suspect, questionable and, in some cases, unconscionable.

As an aside, I would like to mention the efforts of an unsung branch of medicine, gerontology, concerned with the treatment of senior citizens. Due to the compounding and often cascading nature of medical events as we age, today’s gerontologist must be a multi-disciplinarian and able to diagnose symptoms which may present in an atypical fashion in the elderly and/or deal with patients who may not be able to fully describe their own symptoms. My personal recommendation for an award as one of the best gerontologists in the nation is Dr. James W. Davis, Jr. of UCLA’s famed gerontology department.

“Best practices” or a code phrase for rationed healthcare?

There is no argument that we are facing the healthcare needs of an aging population. An aging population which may not respond well, statistically speaking, to certain types of medical procedures or medicines. Therefore, we need to ask ourselves, whether or not we, as a nation, can limit the payment of treatments to those procedures and medicines which positively affects a majority of patients while leaving others to face pain, suffering or a shortened life?

We need to determine if we will only allow the wealthy, the powerful and the politically connected to receive “experimental” or last-ditch procedures and medicines. To restrict powerful diagnostic tools to those who somehow are statistically identified as being younger, healthier or better able to contribute to society. To allow costly hip or organ replacements for younger, more medically fit, patients who may respond positively to such treatments.

What I do know …

It does not take a genius to observe that each layer of bureacracy and artificial treatment constraints placed between a doctor and their patients is to significantly alter the opportunity for a positive outcome.

It also does not take a genius to observe that our government’s intervention in healthcare has been responsible for the declining effectiveness of our medical delivery system and an escalation of costs.

Want to confront your legislator directly: simply as them why some of the billions of dollars sloshing through our financial bailout scheme was not used to subsidize the manufacture of more GE LightSpeed scanners (thus reducing their overall costs) or providing subsidies to smaller medical venues to allow for better care?  

And it certainly does not take a genius to observe that the current Administration’s attempt to manipulate the payment and delivery of healthcare is based on a political ideology of increased government dominance and the dependency of the average citizen on governmental largess.

What can YOU do?

Recognize that we have barely begun to deal with the ethical, legal and logistical requirements of healthcare systems before allowing an all-out government intervention into an area which is NOT CONSTITUTIONALLY MANDATED as a power of the federal government.

Recognize that the government is being manipulated by powerful industry trade groups and unions to secure their own advantages; often to the detriment of the American citizen.

It doesn’t matter what party you belong to or your current age: if we allow government to further interfere in the healthcare system for political purposes, we are doomed as individuals – and as a nation – from receiving first class healthcare by first class doctors.

I was, unfortunately, required to make a life or death decision that required me to consider the quality of life of the individual. While I believe that I made the right decision, I do not want this type of life-ending decision being made by a faceless non-medical bureaucrat that consults a mortality table and government guideline before deciding whether or not I will be left to die. This is a subject which affects us all and transcends politics.

We must act now. Throw the incumbent bastards, on both sides of the aisle, out of office and repeal their legislative initiatives before they ruin our nation and our health.

-- steve

A reminder from OneCitizenSpeaking.com: a large improvement can result from a small change…

The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane. -- Marcus Aurelius

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OneCitizenSpeaking: Saying out loud what you may be thinking …

Reference Links:

RealClearPolitics - Sebelius, McConnell, and Odierno on "Fox News Sunday"