Matters of Life and Death - not much fun and games

[Griffin NoName]

I don't like the distinction between 'babies', 'adults' and 'elderly', that is, the same rules should apply in all cases both morally and practically.

My point was: they don't.

And another point was I have been in life-death situation and taken a drug to give me more years, and I am quite clear I would not do it for just a few more months. And to be perfectly honest, if I was offered a painless and 100% successful way out, I'd take it now as I don't rate my quality of life.

Cost is a very disagreeable factor, ...............particularly specialized treatment of a baby in cases that happen in < 0.00001% of the population seems like a waist today, but certainly the knowledge gained is likely going to improve more patients in the future. We may never know when and how but knowledge is only gained that way, and if the general attitude of physicians were that it is impossible to save someone in this or that case, most diseases wouldn't have treatments today. We may be here today because the physicians of the past two centuries figured out how to save those that couldn't be saved before.

But their experiment costs were not in the stratosphere that they are now. Nor was the cost of keeping people(babies) alive while they try everything in the book.

We can't avoid cost. There is not enough money to treat all equally unless we stop some of the more loony stuff.

[Aggie]

We can't avoid cost. There is not enough money to treat all equally unless we stop some of the more loony stuff.

This is a lie.  There isn't the political will to provide enough money.  The reason pretty much every Western country (can't speak for the booming parts such as Asia and the emerging markets) is crying poor is the globalization of the rich.  Businesses and the magnates that run them are willing and able to move to a better tax regime if one becomes available.  So, taxes keep getting cut for big business and the ultra rich.  Of course, cutting taxes for the upper tier becomes a political issue for the masses if they are being up-taxed to make up for this, so we get tax cuts across the board which require cuts to social programs to match. There does seem to be enough cash for bank bailouts...

Medicine is a special case to some degree, because the equipment that is driving on-the-ground medical advances keeps improving drastically as technology improves, but is also horrendously expensive to keep up with.  We will keep being able to do more for less people in the future, unless something gets rejigged. Technocrats at the top of the medical system of course want to have (or in the US, sometimes need, lest they be sued for not using the latest and greatest) cutting edge technology, but it's a resource sap from less dramatic everyday medicine.

[Roland Deschain]

It's a difficult subject to objectively comment on without direct experience, and with direct experience you'd necessarily be making a subjective comment. I think the issue isn't so much that X amount of money is being spent needlessly on patient Y, but that the money is being spent, maybe, in the wrong area to help patient Y. Prolonging life is all well and good, and I applaud those doing so, but without research into the causes and cures of a particular illness, and definitely into improvements to quality of life, it's all for naught.

I sincerely hope i'm never in any of the aforementioned situations. I have no children yet, although I hope to in future, but I have parents with many medical issues, some genetic/environmental, some caused by an accident. Their quality of life is ok so far, but far from perfect, and the treatments they have all help, including the myriad number of pills, but there will come a time when their health will deteriorate to a point where it will be time to wonder whether to continue or not. I dread that day more than most things, and hope it will come decades from now, but rationality tells me it will be far sooner than that.

Saying all this, in either the matter of my parents or theoretical children, I think I would want to know the full truth, no matter how hard it would be to take, although I do understand the viewpoint of the doctors in wanting to slowly get parents used to the idea that their beloved child is going to die.

It's certainly not a situation i'd want to be in, from either side, although I have experienced something very similar. When dad had his accident, it was thought that he wasn't going to survive, but through the skill of a number of surgeons and A&E staff, then later dedicated nurses and doctors, he made it through, although with a noticeably reduced quality of life. Knowing how that made me feel, I more than understand the reticence of doctors to be the bearers of bad news.

[Griffin NoName]

Basically this is me ranting about the way the elderly aare treated compared to newborns or tiny children. It's disgusting.

[Roland Deschain]

I understand that, Griffin, and I agree with you. Did you know that the number of complaints against care home staff has risen dramatically in the past few years? Having seen the odd exposé on TV about this, it brings your comments into focus somewhat. Provision of decent care for the sick and elderly, either in the home, the hospital, or the care home, should be a priority. These people spent their lives hopefully contributing to this country's success, and how do we treat them? As burdens to be disposed of as cheaply as possible.

I know that's not all carers and doctors, not by a long shot, but it's enough of them to make a statistically significant problem.

[Sibling Zono (anon1mat0)]

I finally found a reference of expenditures by age in the UK:

http://oheschools.org/ohech6pg7.html

While the expenditures are indeed high, notice that expenditures for the group above 84 is still higher, and if you add up from age 65, expenditures are more than double that amount.

Expenses likely don't print the whole picture and it is quite certain that some money is waisted (it happens here all the time) in overcharges or services not up to the actual price, but just judging by expenditures it looks like seniors are not being particularly targeted.

[Aggie]

Seems like the expenditures at birth are ridiculously high, as an average.  It's not surprising, with the degree that childbirth has been medicalised. Given those stats, you'd think there'd be a push to develop alternative childbirth programs in parallel to the medical system - for example, a midwife-staffed maternity ward in or adjacent to the hospital that allows a more natural birth (i.e. not in a surgical setting) but with doctors and equipment available should something go wrong.  This'd cut costs for the majority of healthy, normal births while keeping help nearby if and when it is required.

[Griffin NoName]

..........., a midwife-staffed maternity ward in or adjacent to the hospital that allows a more natural birth (i.e. not in a surgical setting) but with doctors and equipment available should something go wrong.  This'd cut costs for the majority of healthy, normal births while keeping help nearby if and when it is required.

Actually this is more or less what a maternity ward consists of over here.

I finally found a reference of expenditures by age in the UK:

Also on that page shows spending per person higher for birth

But no detailed indication of what is included in these figures. For example, NHS figures for the elderly get distorted by social care issues (eg bed blocking). Date of figures is 99/00 - so old.

~~~~~~~~~~~~~~~~~~~~

I am now officially "old". I got a letter from govt. department this morning inviting me to apply for "winter fuel allowance" - this is a non-means tested sum of money for all pensionable age citizens supposed to stop them freezing to death (the govt. looks bad when this happens). It's £200-£300. My fuel bill is over £1,000. (yes, covers not just heat but all electric) ... but I only heat one room.  So it's a gesture rather than a life saver. Means when people die the govt. is not responsible. Anyway, I got a shock to receive this letter.

[Roland Deschain]

It would be far more helpful if the numbers were broken down into their constituent parts, as it'd be helpful to see how much is spent on what per person. Then you'd have to break those numbers down further into areas of the UK to see if healthcare is better or worse in one area to another. That would be an interesting table to read through.

Griffin, is that just for the winter, your electricity bill? What period of time does it cover? It seems an awful lot.

[Griffin NoName]

The winter fuel bill covers one year for the winter fuel The £1,000 plus covers one year's electricity. I am all electric, but as I said, only heat one room. Yes, it is very expensive. Because I am home all the time. As are lots of elderly people NOT THAT I AM OLD.

[Roland Deschain]

Lol, Griffin. You're not old at all.

Friends of the family, many years ago now, used to have their large open-hearth fire burning in the winter, along with the electric heating, and a large Aga in the kitchen. That place was a furnace in winter, and reasonably hot in the summer, so I do understand how you feel the cold more as you age (gracefully).

My parents are similar now. I'm outside in a t-shirt feeling very comfortable, they're in their living room wanting the French doors closed because they're cold.

[Griffin NoName]

Lots of elderly are thin and thin people feel the cold more. I plan to be fat to cut my fuel bills

[pieces o nine]

** more on temperature differences in the generations **

Mom called tonight; they're off on a tour to Niagara Falls. She's wondering what to wear, claims the tour company they always use don't have any ideas. Will be wearing jeans and sweatshirts, not sure whether to take a coat, as it's not like they're going to be outside...


Also, they;'ll be taking a boat ride and she's heard they're to be given some kind of poncho or something, so maybe it'll be a bit damp...


You know, *I'm* not going to be the one to break it to her...

[Griffin NoName]

although I do sympathise as travelling anywhere in the UK one has to pack full winter and summer clothing options.

If they are going to the Falls I suggest raincoats.

[Bob in a quantum-state-of-faith]

Definitely: raincoats are a must, at Niagra.  Unless you don't plan to get out of the car/bus...  those ponchos are a poor substitute for really good rainwear.  They are of the "one size fits few" variety.