Florida mull how to ration ventilators

It doesn't take Health Care reform to make reforms in health care....who will want to sit on the panels to decide which patients get the vents? And what happens in an acute crisis - say, auto accident, or burns?
Yes, I do not believe in futile care - and every time there is a 'bad' diagnosis there should be a counselling 'intervention' with the pt and family. But who gets the ultimate say-so?
WOW!

Did the family pay the bills incurred after 60 days? If not, why not? I hate to be cold but insurance is a cold game. That's why insurance companies must be gotten out of the health care picture.

I also have issue with futile care after many years in critical care and most recently working in Chronic outpatient dialysis. I have seen too many times pts from nursing homes in fetal positions and unable to communicate recieving life saving renal dialysis 3-4 hours 3 times a week. We move them from a transport stretcher to an uncomfortable recliner that isnt able to accomadate thier distorted body. Then I see the administrator who insist this person be referred for a "transplant" workup!!! Although we know that patient is by no means a candidate but go ahead and put them through all the blood work and the referral that's an 2 hour trip to be evaluated. When questioned I'm told "it's not for us as medical professionals to decide" yet of course our numbers look great for showing we did this or that many # referrals for transplant listing on CMS. Talk about futile care. I took a master's level medical ethics course back when I was in my senior year of nursing school (1979) and remember our discussions related to ethic teams set up for deciding who would get an organ and who wouldnt. This situation just brings to mind how much in the media it is right now regarding the political parties accusing each other of wanting to "pull the plug on grandma" in relation to health reform. I agree vents should be for those who are expected to recover and have a long productive life but I fear there will be those who slip through the cracks also. It is going to be interesting as to how this plays out as I also live in Florida. Staffing has been cutback so severly in my area in the hospitals that I fear for patients if this H1N1 outbreak does become an overwhelming pandemic. They have already laid off here many of the support services such as CNA's etc and put the balance on the Nurses they have kept besides the 15% pay cut. I think if it does arise here the system will be so overwhelmed I can see so many mistakes and law suits coming up with alot of angry families who will be quick to talk to the ambulance chasers waiting in the wings.

JoPACURN - -I think we all 'know' that these decisions are made every day. The situation here will be different, and I am certain that this will happen. The scenarios will be regarding which patient may be more salvagable - - 55 yr old mother of three, or 17 yr old HS junior? 3 yr old or 6 yr old? And even when it seems futile, there may always be some family member who is not ready to say 'stop'.

Sixteen years ago, my grandmother was killed in a car accident. The driver had insurance which paid $100,00.00 for death. The insurance co offered my dad $10,000.00 because she was in her 80's, had no real income, etc. My dad countered with 'How much is your mother's/grandmother's life worth?' The check came in for $100,000.00. My grandmother, by the way, was killed just after she left a casino in NJ, playing (and winning!!) at the craps table.
So who gets to decide? If she had made it to the hospital alive would someone have said, 'Oh, she's 82, has no income, why bother?'

JoPACURN - -I think we all 'know' that these decisions are made every day. The situation here will be different, and I am certain that this will happen. The scenarios will be regarding which patient may be more salvagable - - 55 yr old mother of three, or 17 yr old HS junior? 3 yr old or 6 yr old? And even when it seems futile, there may always be some family member who is not ready to say 'stop'.

Sixteen years ago, my grandmother was killed in a car accident. The driver had insurance which paid $100,00.00 for death. The insurance co offered my dad $10,000.00 because she was in her 80's, had no real income, etc. My dad countered with 'How much is your mother's/grandmother's life worth?' The check came in for $100,000.00. My grandmother, by the way, was killed just after she left a casino in NJ, playing (and winning!!) at the craps table.
So who gets to decide? If she had made it to the hospital alive would someone have said, 'Oh, she's 82, has no income, why bother?'

Did the family pay the bills incurred after 60 days? If not, why not? I hate to be cold but insurance is a cold game. That's why insurance companies must be gotten out of the health care picture.

As for who gets scarce resources - who says vents are scarce? It is not anywhere possible for our great nation to be short of anything. Manufacture more. Import more. There are plenty of ventilators to go around.

That does raise the question as to why such hopeless cases are on vents in the first place. The problem is not what the news media would have us think, "they are going to unplug grandma". The problem is that grandma was put on the thing is in the first place.