Health Care Dilemmas
By Arnold Kling
How Doctors Die, an essay by Ken Murray, has been making the rounds.
Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo.
If Murray is to be believed, what medicine needs is not so much the Hippocratic Oath as the Golden Rule. The essay strikes me as perhaps exaggerated and one-sided, but I have no evidence that it it is.
Speaking of exaggerated and one-sided, I was sent a review copy of a “graphic novel” by Jonathan Gruber, called Health Care Reform: What it is, Why it is necessary, How it Works.
Gruber played a leading role in the Massachusetts reforms and in the national health care reform design. The book, which is in comic book form (but it is not a novel), is
dedicated to my wonderful family…who convinced me to take on the project and who have been my biggest cheerleaders throughout its completion
It is the sort of exercise in self-justification that might mean a lot to Gruber’s family, but not as much to anyone else. I think if, during some of my most frustrating times dealing with internal corporate politics when I was with Freddie Mac, you had asked me to express myself in a graphic novel, I would have come up with something similar. Years, later, with more perspective, one has an easier time seeing where others may have honestly disagreed with you–and maybe even had a point or two.
Incidentally, my own health care book, Crisis of Abundance, has now been out for five years. My goal at the time was to produced a book that would stay relevant for ten years or more. It appears to me that I will succeed. Not that anyone will be buying copies of it in 2016. But if my family–or Gruber’s, for that matter–should come across it five years from now, it will still have educational value.