Health Care Rationing or Common Sense?

[Anne]

I was reading about the little girl with Wolf-Hirschhorn syndrome being denied a kidney transplant. I looked the condition up and it seems this child has a fairly severe form of the condition. Is it right to deny the transplant or is it common sense to let someone with a better prognosis have a chance? Is it a moral issue? I will post my views later. Anyone have any thoughts on this?

[Locutus]

I don't think the whole story is out on that.  All we've heard is the mother's side.  The hospital can't present theirs due to HIPAA.  I doubt this is in any way a "rationing" of health care.

[me]

I agree with Locutus on this about not knowing all the circumstances.  Looking at it from a mother's point of view it would be extremely hard to understand if it were my child but from a practical point of view if the girl is in very poor health otherwise the operation alone could kill her.  I don't believe it's a moral issue it's a matter of making a very hard choice as to quality of life and longevity of the recipient.

[The Troll]

I agree with Locutus on this about not knowing all the circumstances.  Looking at it from a mother's point of view it would be extremely hard to understand if it were my child but from a practical point of view if the girl is in very poor health otherwise the operation alone could kill her.  I don't believe it's a moral issue it's a matter of making a very hard choice as to quality of life and longevity of the recipient.

  Are you growing a heart? 

[Locutus]

I agree with Locutus on this about not knowing all the circumstances.  Looking at it from a mother's point of view it would be extremely hard to understand if it were my child but from a practical point of view if the girl is in very poor health otherwise the operation alone could kill her.  I don't believe it's a moral issue it's a matter of making a very hard choice as to quality of life and longevity of the recipient.

Bingo. 

[me]

I've always had one you guy's just fail to read my posts properly most of the time.

[Anne]

One of the articles I read the mother said that the doctors mentioned quality of life in addition to her mental handicap. It also stated that the medications she would have to take would interfere with the medications she takes for other medical conditions causing the new kidney to fail in a short period of time. I think the kidney should go to the person who is likely to have the best outcome. Medical rationing has been going on for years and will continue indefinitely and not because of money or insurance. In 1971 my mother has heart bypass surgery at the Cleveland Clinic. They were one of the leading hospitals in this procedure at this time. They did 24 surgeries a day when the hospital in Indy was doing one a week. It took weeks to get on the list for the heart cath and four months to have the surger and she was not at the end of the list. They told her the criteria went something like this:1. men under 50 with children at home, 2. men under 50, 3. women under 50 with children at home, women under 50, 4. men over fifty, 5 women over fifty, 6 anyone who had other health problems in additon to the heart blockage. My mother was 50 years old and had no other health problems and had excellent insurance. I am/was not upset by this, I am presenting this as an example of rationing. It happens all the time, in triage situations, in natural disasters, in transplant situtations.

[Palehorse]

The only "rationing" taking place is that undertaken to accommodate a given hospital's staffing schedule. If staffed for 24/7 coverage any hospital properly qualified can perform the procedures 24/7. Most aren't unless they are located within a large metropolitan area.

It's called making a choice. Anyone presented with such a delay for a serious health condition can always choose to go to another facility that can better meet their personal time-line preferences surrounding their health care. The fact is most will not though. Most often due to restrictions placed upon their health coverage by draconian health insurance policies. . . (Yet another reason for across the board health care reform and regulation that most of our elected leadership will vote against because the health care Insurance industry pays them to stop it).

[Locutus]

I had an appendectomy at 4 o'clock in the morning at the Cleveland Clinic.  But then again, I live in a large metropolitan area. 

[followsthewolf]

Thought you were a Floridian.

[Anne]

The only "rationing" taking place is that undertaken to accommodate a given hospital's staffing schedule. If staffed for 24/7 coverage any hospital properly qualified can perform the procedures 24/7. Most aren't unless they are located within a large metropolitan area.

It's called making a choice. Anyone presented with such a delay for a serious health condition can always choose to go to another facility that can better meet their personal time-line preferences surrounding their health care. The fact is most will not though. Most often due to restrictions placed upon their health coverage by draconian health insurance policies. . . (Yet another reason for across the board health care reform and regulation that most of our elected leadership will vote against because the health care Insurance industry pays them to stop it).

The problem I see with that is there aren't enough people to do it. Back in 1972 when my mother had her heart surgery there weren't that many surgeons who could do the operation. IU, I believe, was the only hospital in Indiana doing that surgery at all. Both hospitals in Anderson (and probably any full service hospital) can and does have surgeons on call who can come in for an emergency. Finding doctors (surgeons) who are willing/able to work the night shift is probably difficult.

[Palehorse]

The problem I see with that is there aren't enough people to do it. Back in 1972 when my mother had her heart surgery there weren't that many surgeons who could do the operation. IU, I believe, was the only hospital in Indiana doing that surgery at all. Both hospitals in Anderson (and probably any full service hospital) can and does have surgeons on call who can come in for an emergency. Finding doctors (surgeons) who are willing/able to work the night shift is probably difficult.

In either case you quote, it still is not a case of "rationing".

[Anne]

Ok, what do you want to call it. Any time there is a shortage and what is available is proportioned out to people on a needed basis what is it if it isn't rationing?  At any rate the point of the thread is it right to deny someone medical treatment due to quality of life issues ot likely outcome? Should we give the kidney to the first person on the list who is compatable and so far into decline that they won't like live long or someone with a much better chance of living a long time? What about patients who are HIV positive, hace MS or some other debilitating disease? Do you have an opinion?

[Palehorse]

Ok, what do you want to call it.

As with any other business, it is scheduling. Capacity is the issue here, not "rationing". And as with most customers in the business world, there are choices that can be made to meet demands.

Any time there is a shortage and what is available is proportioned out to people on a needed basis what is it if it isn't rationing? 

See above

At any rate the point of the thread is it right to deny someone medical treatment due to quality of life issues ot likely outcome? Should we give the kidney to the first person on the list who is compatable and so far into decline that they won't like live long or someone with a much better chance of living a long time? What about patients who are HIV positive, hace MS or some other debilitating disease?

Just the fact that you now want to separate the numerous issues the topic first presented, after trying to shove them all into the singular "buzzword" category of "rationing", smacks of deceitful intent or ignorance.

There is a HUGE difference between making a decision based upon empirical evidence vetted in sound and validated medical science, and playing to the emotional turmoil elicited via the utilization of buzzwords and deceptive presentation of half-truths and the mixing of facts.

I see enough of this methodology within the media, the repugnican party, and ASPCA, PETA, etc., so when I see it within a venue that provides a means to provide rebuttal and feed-back surrounding its use, I choose to take advantage of it.

Do you have an opinion?

I do, although I am fairly certain you do not really want to read it. (However, it is in part contained within the above responses.)

[Palehorse]

As with any other business, it is scheduling. Capacity is the issue here, not "rationing". And as with most customers in the business world, there are choices that can be made to meet demands.
See above

Just the fact that you now want to separate the numerous issues the topic first presented, after trying to shove them all into the singular "buzzword" category of "rationing", smacks of deceitful intent or ignorance.

There is a HUGE difference between making a decision based upon empirical evidence vetted in sound and validated medical science, and playing to the emotional turmoil elicited via the utilization of buzzwords and deceptive presentation of half-truths and the mixing of facts.

I see enough of this methodology within the media, the repugnican party, and ASPCA, PETA, etc., so when I see it within a venue that provides a means to provide rebuttal and feed-back surrounding its use, I choose to take advantage of it.

I do, although I am fairly certain you do not really want to read it. (However, it is in part contained within the above responses.)

Another thought occurs to me; Aren't you the one who claims to have worked within a healthcare facility for a very long time? If so, why do you not already know the answers to your inquiries? To what end are you attempting to stir up an emotional debate surrounding validated medical practices, and doing so utilizing personal anecdotes that are 40 years passed? What possible validity can anyone draw in comparing the capacity issues of medical facilities from 40 years ago to today?