Medicine: Have we gone too far? And, is our system ethical as a whole?

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Lovely_RN, MSN

1,122 Posts

Well I for one don't think that having blue eyes and blonde hair = perfection but I digress.

I think the issue is that many American's simply do not understand or accept death. The media plays a large role in this problem because the focus is rarely on the people who do die. The focus is usually on the miraculous recovery, the god-doctor who can save even the worst case and the one person out of a million who lives past their 100th birthday. Most people are simply in denial about the average human life-span and want to believe that it is common rather than rare to live past 80.

Not only do they expect to live past 80 they also expect to be in perfect health, with good looks, and enough money to provide all of the luxuries they want. People don't ever believe that they are the ones who will end up in a substandard nursing home. Despite the statistics that say that majority of us will die in a health care setting most people stubbornly want to believe that they will die at the age of 100 or more in their sleep or at home surrounded by loved ones so they don't want to deal with nasty things like living wills or advance directives.

A lot of it has to do with commercials for drugs that promise health and vigor well into your 70s and beyond; the television shows that portray doctors as being able to save anyone from any imaginable disease or health care issue. Have you ever seen a T.V show portraying someone who dies on a vent after lingering for 3 years in a nursing home? That would be considered boring T.V; unless the death is dramatic and unexpected it isn't sexy enough for television. Does T.V ever deal with the financial implications of all of the medical interventions of the god-doctor? What about the bill that runs into the hundreds of thousands or even millions of dollars? Nope, once miraculously cured the person leaves happy and content and no mention is made of who will pay the enormous debt incurred.

No wonder people expect miracles they need to be educated in the reality of illness, disability, and inevitable death.

Having national healthcare is not a cure-all for the problems of American health care. I recall a vacation to England in 1999, my friend got ill on our last night and we ended up in a London ER. It was a nightmare visit, 8 hours in the ER waiting area before she was triaged by the RN. We finally left after the RN told her that if she could stand it she was better off flying back to the States the next day because it was likely she wouldn't be seen by a doctor anytime soon. We also had a conversation with the wife of a man who had been waiting 11 hours to be seen by a doctor after leaving another London ER and waiting for a full 24 hours and never being seen by a doctor.

National healthcare isn't all it's cracked up to be.

There are solutions to our healthcare problems but they aren't nice or very fair solutions and that is the problem. We are going to have to eventually deal with the issues of who gets what because our healthcare system cannot keep hemorrhaging money and remain functional. It's going to be very interesting to see what happens to the baby boomers as they continue to age. I have a feeling some very tough decisions are going to have to be made in healthcare during the next 30 or so years.

Things are about to get very ugly for healthcare in the U.S.

GardenDove

962 Posts

Interesting post,with many good points. You're right on the mark, I think, in your assessment of the media portrayal of medical miracles and the publics unrealistic expectations of immortality delivered.

Cattitude

696 Posts

Specializes in Lie detection.

there are solutions to our healthcare problems but they aren't nice or very fair solutions and that is the problem. we are going to have to eventually deal with the issues of who gets what because our healthcare system cannot keep hemorrhaging money and remain functional. it's going to be very interesting to see what happens to the baby boomers as they continue to age. i have a feeling some very tough decisions are going to have to be made in healthcare during the next 30 or so years.

things are about to get very ugly for healthcare in the u.s.

you are so right and just wanted to touch upon this one point. i know a few people get somewhat sensitive in regards to "everyone deserves healthcare no matter what" and in theory that's a very warm and fuzzy idea. it would be great. but unfortunately reality is going to hit at some point. the system is breaking.

as part of my job, i do medicaid budgets for my pt's. even trying to keep costs down, each pt averages between 3,000-6,000 per month. our pt's stay on this program for years until death or hospitalization.

we are just one tiny speck of sand in the desert. i can't even begin to imagine how many trillions are spent in the entire u.s.

i do believe this. i need to plan well for myself because soc.sec. and medicare will probably be gone when i retire,if i make it that long:lol2: .

GardenDove

962 Posts

The babyboomers are starting to be retirement age right now and have incredible clout, economically and in the ballotbox. I think that generation, of which I'm a part of, will break the bank.

Lovely_RN, MSN

1,122 Posts

The babyboomers are starting to be retirement age right now and have incredible clout, economically and in the ballotbox. I think that generation, of which I'm a part of, will break the bank.

Yes, it will certainly be interesting. Especially since for the most part baby boomers have grew up in the culture of expectation (no offense.) They expect to have it all and will expect to continue to have it all right until the very end.

Btw, was I the only one who saw Hugh Hefner dancing it up at a party with the Playboy bunnies on ET (or was it Access) last week? Prime example given to people: even octogenarians are still getting their groove on! :monkeydance:

Or be like Tony Randall and have your first child at 76!

What can I say? If they like it I LOVE it and I don't believe in ageism but a lot of people really do seem to believe that they will live forever.

Me personally? I plan on living to be 120 so I will worry about making out my will sometime around my 99th b-day as I sit on the beach in my bikini sipping a mai tai.

Specializes in Tele, ICU, ER.

Working in a county hosp ER, I see a lot of the abuse that goes on. Just this AM, as I was leaving, a lady who'd been discharged for sinusitis with abx and motrin was signing back in one hour later, decided she "wanted a cat scan".

Umm.. I can't help but believe that if she was paying $100 co-pay or if her insurance didn't pay for non-emergencies, maybe this wouldn't happen. As it is, WE are the ones paying for HER opinion of what she wants. And you know what? In this CYA medical world, she probably got what she wanted for fear of litigation.

Are there hard-working people who just can't get insurance? Absolutely! I have family members in that position, and I believe that's an appropriate use of our medicaid dollars - but not for the ones that use it as their primary care physician for something they've had for 4 weeks but couldn't be bothered to go to the clinic until they "couldn't take it anymore" while presenting with symptoms I've had for 4 days and have been self-medicating with OTC meds in order to show up to work.

Can ya tell I was in triage last night?

Simplepleasures

1,355 Posts

as part of my job, i do medicaid budgets for my pt's. even trying to keep costs down, each pt averages between 3,000-6,000 per month. our pt's stay on this program for years until death or hospitalization.

we are just one tiny speck of sand in the desert. i can't even begin to imagine how many trillions are spent in the entire u.s.

i do believe this. i need to plan well for myself because soc.sec. and medicare will probably be gone when i retire,if i make it that long:lol2: .

just think, what if the trillions spent in iraq could have been used toward improving our national healthcare....

DeLySh

76 Posts

Specializes in NICU.

Then you could also bring up the topic that some couple go through million dollars worth of treatment to produce a baby when there are thousands of kids in the foster care system that need a good home. They may not be perfect blond haired blue eyed infants ( but who of us is perfect).

Please be careful when making statements such as these unless you have walked a mile in the shoes of an infertile couple. You never know whose heart you might be breaking.

:o

Specializes in Emergency.

I just did a big project on euthanasia, and end of life issues. I read alot of comments/posts talking about how assisting someone to have a peaceful death on their own terms was "playing God", but sometimes I wonder how prolonging a 95 y/o on a vent, tons of drips/lines, tubes, etc. isn't playing God. Yes, I understand the value we place on life, and rightfully so. But, I also think our system is screwed up to assume that Quantity of Life should be placed over Quality....

AliRae

421 Posts

Specializes in PICU, surgical post-op.

Just to throw another piece into the puzzle here ...

There's been much talk on this thread of prevention and care in older populations. What about the pediatric population facing congenital defects? There's, for the most part, nothing that could have been done to have changed the fact that these kids were born with various anomalies, and yet here they are! They live in and out of hospitals and MD's offices, and they cost millions of dollars. What's the point, really? I'm not calloused, and I'm not a "mean old PICU nurse." I just lost one my favourite baby ever. He died after living in hospital for nine and a half months. He was never home, and his cardiac condition was inoperable from day one. Why did we code him 6 or 7 times? Why did we spend millions of taxpayer dollars for a kiddo we KNEW wasn't going to preschool? I think it's a huge ethical issue. (In this particular case, my view of things is biased by the fact that I loved him, and would give any amount of money to have him back.) But still, the question remains- how far is too far? We push these kids to survive with what kind of quality of life?!

I'm finished rambling now.

Huscarl73

45 Posts

A previous poster hit the nail on the head. The bank is empty, all the money that's supposed to be in it is gone. We have an entire generation, and even part of another one that spent that money. The spent it on everything but what it was it was supposed to be for.

This contract with the generations was a good idea and it would have worked but the baby boomers broke the contract. The did more than break it they pissed all over it. This money is gone and just like my checking account they don't get to spend it twice.

I see no reason that my generation should feel any obligation to break ourselves supporting their retirements, I see absolutely no reason why my children (5, 8 and 10) should be saddled with the huge amount of debt that they've already accrued and the tens of trillions more that are going to be added to it over the next 2-3 decades if this status quo somehow remains.

This system, our system, teeters on the edge of an abyss. Just a few short years ago this edge was estimated to be sometime in the 2020's. If you've been paying attention to the astronomical deficits we've run up over the last 6 years or so you know that we've brought this quite a bit closer.

What the ultimate solution is going to be, I don't know. But IMO that is going to include ten's of trillions of fake dollars that they've printed up coming home to roost. By any historical standard this should be causing double digit inflation, yearly. It's coming...

Indy, LPN, LVN

1,444 Posts

Specializes in ICU, telemetry, LTAC.

Well then, us 30somethings should definitely be voting... however, our generation is very much outnumbered by the baby boomers. They're going to be in LTC with a nursing shortage... they're going to be taken care of by overworked, understaffed nurses who can't afford their own insurance, let alone anything resembling retirement.

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