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Health Care Rumors: Science Fiction Run Wild

The health care debate has had many of us laying awake at night. Personally, I have found it difficult to turn the news off and get to sleep. I've learned to resort to watching fluff just before bedtime. This is why I was so happy the other night when I found myself laying in bed watching a movie called Logan's Run. I saw the movie years ago, and I thought for certain this was the one; this was the flick that would take me to REM.

Boy was I wrong. If there was ever a movie relevant to our current health care crisis and debate it is the 1976 science fiction movie "Logan's Run". Logan's Run tells the story of a post-apocolyptic world in 1974. A recovered Utopian society is built within a dome, shielded from the outside world. Supplies and space are obviously scarce so the society develops one rule for this perfect world- no one can live past 30. Age-indicating chips, called life-clocks, are implanted into the hands of citizens. Once an individual reaches the ripe old age of 30 they are forced to participate in a ceremony where they are told they are "renewed". They are, in fact, incinerated.

There is one other option for the people of this domed paradise. They can decide to run. Rumors of a placed called "sanctuary" lure "runners" to flee. These people then become criminals. This is where the elite police force called "the sandmen" come in to play. Their job is to chase the runners and return them to their proper fate. When one of the sandmen, Logan, is given an undercover job as a runner his life-clock is bumped up a few years and he learns that he too must now run. I won't spoil the end of the movie for those of you now interested.

It's a brief synopsis, to be sure, but I watched it at three in the morning in an attempt to sleep. As I mentioned, the movie did not help lull me to dreamland because all I could think about was how close it came to so many of those outlandish rumors surrounding health care reform. Namely, I think about the misunderstanding regarding end of life care and I think about the frequent use of the word Nazi to describe supporters of health care reform legislation offering end of life counseling. "Logan's Run" was a sci-fi pic, something from the vivid imagination of authors William F. Nolan and George Clayton Johnson. Now it seems conservatives have drawn from this movie and made it their own, without perhaps even knowing it.

There is not currently, nor will there be in the future, "government encouraged euthanasia", as worded by two house GOP leaders. The reality behind the end of life issue is that the legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn't cover. Anyone who's ever had a loved one in hospice care can appreciate this. There are people who may not know or understand that when they are terminally ill they have the option to die peacefully, at home, with their loved ones. They have the option to be relieved of pain or suffering instead of fighting. The key word here being option. Option. Option. Option. I cannot stress it enough. No one is forcing the elderly to go before what Sarah Palin calls "a death panel". They are simply suggesting that medicare pay for an end of life consultation between patients and their doctor.

I think we have to beat the dead horse here. We have to spell out each and every word. Debates are becoming so loud that no one is being heard. Take the sentence apart piece by piece:

The legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn't cover.

The legislation would order medicare... Medicare would be ordered to pay for the consultations. Patients would not be required to have the consultations. Medicare is the one being ordered to do something here. No one is requiring patients to visit their doctor to discuss end of life issues. The patient can sit at home and grow old for the rest of their days. The patient can visit the doctor regarding any matter: their liver, their heart, their foot, without the slightest mention of end of life care. The idea is simply that the option for this particular meeting between a patient and their doctor should be covered.

...between patients and doctors... The consultations would take place between patients and their doctors; not bureaucrats, not politicians, not a death panel. Those opposed to health care reform should be pleased with this idea. After all, they are screaming (literally screaming) that doctors and patients should be making health care decisions. Scream no more. This legislation is an attempt to increase the chance that doctors and patients will be the making one of the most important health care decisions. This can be whether to pursue further treatment for terminal illness or to begin end of life care such as simply addressing pain and comfort for the dying.

...end of life care... People die. They shouldn't have their lives ended prematurely. They shouldn't be sent to an extermination ceremony at the age of 30, a la Logan's Run, but people do die. An "advanced directive" is used to tell health care providers what life-prolonging measures an individual may or may not want taken should they become ill. This can be something immediate like CPR or something long term like life support. These directives are important because they make a patients wishes known. This way a wife is not fighting when she tells a doctor that her husband never wanted to be on life support. She is supported by his authorization. The terminally ill cancer patient who has a heart attack can use his Do Not Resuscitate order (DNR) to let doctors know that he does not wish for his life to be prolonged.

Currently, only 40% of medicare patients have an advanced directive. 75% of seniors polled said they would interested in one, and felt such consultations with their doctor are important. How many seniors have had to undergo various medical procedures in their last year of life, not knowing that there were other options available to them?

These are personal decisions. However one may feel about life support and life-sustaining mechanisms, surely we can all agree that every patient deserves the right to make their wishes known and to discuss and explore their decisions with an experienced, knowledgeable, trained health care professional. Doctors have no motivation to encourage seniors to end their lives. This legislation offers no such incentive. It simply addresses the 60% of seniors who do no currently have advanced directives. It simply attempts to give them an option. There's that word again, option.

The decision to pursue life-prolonging care or hospice care is, by law, a patient's decision. The government does not make this decision. Doctors do not make this decision. This particular part of health care reform is simply a suggestion that medicare pay for the meeting in which this topic is discussed between a patient and their doctor. I have seen ad after ad claiming that we are disrespecting our elderly; forsaking them and all they have done to pull our nation through some of the most trying times we have known. The true disservice to our seniors is the current system, in which medicare does not pay for them to discuss options with their doctor. By not allowing them to make informed decisions about their illnesses and options we are taking away their rights. The current system is failing to allow our seniors to live with dignity or die with dignity. By not paying for these consultations we strip them of their right to decide if they want to continue with chemotherapy, breathing tubes, respirators and any other life-sustaining method or to pursue pain management and a comfortable death. Shouldn't we at least allow them the choice?

Option. Choice. Right. Opportunity. Decision. We are not merely tossing these words at one another but rather we are hurling them. They are being yelled at town hall meetings. They are being cried out at press conferences. They are no longer words but they are desperate pleas, and rightfully so. We are a nation founded on the word "right"; founded on the word "opportunity". This is why it is so confounding that we would even think twice about this particular aspect of health care reform. According to one ad, "our seniors deserve better". I agree. Our seniors do deserve better. They deserve to the right, the chance, the opportunity to sit down with their doctor and discuss all of their options. They deserve the right to make informed decisions regarding their lives.

Like Logan's Run, these ads and rumors opposing health care legislation can be entertaining. Who doesn't enjoy a good scare every now and then. This, however, is really happening to us and we must not confuse a fictional post-apocalyptic world with reality. We can't let baseless fear and paranoia govern our decisions. Let the movies put you to sleep. Enjoy the stories, but take them for what they are, science fiction, based on reality and steeped in fantasy. No need to start running.

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AFL-CIO NOW BLOG | Democratic Dialogue, Anyone?

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