What Sarah Palin Is Fighting: Dispatches from the Health Care Front

As the ABC News website tells the story (HT: commenter William Collins),

The news from Barbara Wagner's doctor was bad, but the rejection letter from her insurance company was crushing.

The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.

What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.

"It was horrible," Wagner told ABCNews.com. "I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won't give you the medication to live."

Barbara Wagner is not alone in this experience.

"It's been tough," said her daughter, Susie May, who burst into tears while talking to ABCNews.com. "I was the first person my mom called when she got the letter," said May, 42. "While I was telling her, 'Mom, it will be ok,' I was crying, but trying to stay brave for her."

"I've talked to so many people who have gone through the same problems with the Oregon Health Plan," she said.

Indeed, Randy Stroup, a 53-year-old Dexter resident with terminal prostate cancer, learned recently that his doctor's request for the drug mitoxantrone had been rejected. The treatment, while not a cure, could ease Stroup's pain and extend his life by six months.

"What is six months of life worth?" he asked in a report in the Eugene Register-Guard. "To me it's worth a lot. This is my life they're playing with."

The thing is, though, to the state of Oregon, six months of these people's lives isn't worth much of anything—and it's the state of Oregon that's paying the bills. The inevitable result of this, as Gov. Palin has been pointing out, is that a dollar value is placed on human life; if the cost of keeping someone alive is higher than that dollar value, then their life is judged "not worth living." The logical thing to do in that case is to maximize savings and simplify the situation by encouraging the patient to accept euthanasia. This time, euthanasia advocates apologized for this in the case of Barbara Wagner—not because they believed they were wrong, but because the encouragement was offered with "insensitivity," without "the human touch." Next time? Who knows?

There's a reason that in her first Facebook note on this subject, Gov. Palin's thoughts went immediately to her son Trig: this sort of attitude is already dominant in the medical response to Down Syndrome babies. There's a reason why over 90% of such babies are aborted, and it isn't all about what the parents think or want, let me tell you. Or, better, let Gretchen tell you, from her post "Remembering" on the group blog Beautiful Work (HT: Jared Wilson):

It was 2 years ago this month that I was sitting in a chair looking at my unborn baby in 4D. She was precious! We had previously found out that our baby had several “markers” for down syndrome and had enlarged kidneys which may have required surgery upon birth. Thus we were monitored more carefully and had a ton more ultrasound shots at a hospital. This was the first level 3 ultrasound with this pregnancy (I had had one with my 3rd with no problems). I got to gaze upon my baby for almost a full hour—it was wonderful! I was there alone as my husband was out of town. The specialist doctor called me in after the ultrasound to go over the findings. The first words out of his mouth to me were “Well you will have to come in tomorrow for your abortion because of how far along you are.” I was utterly shocked and devastated. All I could do was mutter “What??????” He then proceeded to tell me that my baby had more “markers” for down syndrome and it didn’t look good. I was more shocked that his automatic assumption was that I would abort my baby. I almost couldn’t comprehend what he was telling me in that office. All I wanted to do was run as far away from that man as possible.

Read the whole post—it's well worth it. Like the Palins, Gretchen and her husband opted to have the baby. The irony of their story is that their baby was born two years ago . . . without Down Syndrome, and in fact with no medical issues whatsoever. The automatic reflex of the medical system would have aborted a perfectly healthy little girl.

In all this, I think the reactions of Wagner's ex-husband Dennis, on the one hand, and euthanasia advocate Derek Humphry, on the other (both quoted in the ABC News article), are telling. Here's Humphry:

People cling to life and look for every sort of crazy cure to keep alive and usually they are better off not to have done it.

In other words, Humphry believes, people are better off dying than fighting to live. By contrast, here's Dennis Wagner:

My reaction is pretty typical. I am sick and tired of the dollar being the bottom line of everything. We need to put human life above the dollar.

As it happens, I do believe his reaction is pretty typical among most folks; and in my experience, Humphry's attitude is usually lurking in there among advocates of euthanasia, even if most of them can't afford to be as blunt about it as the founder of the Hemlock Society, a man who has already "assisted" one wife into the grave. This really is the line between the sides here.

Now, at this point, you might be thinking that this doesn't affect you all that much, because the concept of euthanasia doesn't really bother you that much. What you need to understand, though, is that assigning dollar values to human lives corrupts the whole system—the extent to which that already happens with our private insurance bureaucracy is part of the problem with our health care system—and that when it's the government doing the assigning, there's no way to counterbalance that corruption, so it spreads unchecked. As is always the way with consequences propagating through a complex system, that produces changes beyond those which we have already thought to expect.

For instance, in that same first Facebook note, Gov. Palin pointed out a very important point made by Thomas Sowell: "Government health care will not reduce the cost; it will simply refuse to pay the cost." She went on from there, as most critics have, to point out that this will inevitably result in the rationing of health care—and so it will, as it always does. But that will not be the only effect of this new reality if Obamacare goes into effect. Our own Doug Brady has also pointed out that the US health care system drives most of the world's medical innovation, including the creation of new drugs, and that government price controls will bring an end to most of that innovation. This too is true, and important; but it too is only part of the cost of price controls. It's not merely that price controls will limit who receives medical care, or that they will depress the future potential of that care; they will also, over time, reduce the present value of that care.

To illustrate this, I want to take you inside a world which I hope is unfamiliar to most of you: that of the neo-natal intensive care unit, or NICU (pronounced "nick-you"). Specifically, I want to tell you a couple stories from the Canadian NICU experience. One, highlighted by Mark Steyn a couple months ago, comes from Hamilton, Ontario:

Hamilton's neonatal intensive care unit (NICU) was full when Ava Isabella Stinson was born 14 weeks premature at St. Joseph's Hospital Thursday at 12:24 p.m.

A provincewide search for an open NICU bed came up empty, leaving no choice but to send the two-pound, four-ounce preemie to Buffalo that evening.

Steyn comments,

Well, it would be unreasonable to expect Hamilton, a city of half-a-million people just down the road from Canada's largest city (Greater Toronto Area, 5.5 million) in the most densely populated part of Canada's most populous province (Ontario, 13 million people) to be able to offer the same level of neonatal care as Buffalo, a post-industrial ruin in steep population decline for half a century.

Unfortunately, as Steyn goes on to point out, whenever the Canadian government starts outsourcing its health care to the US, that creates additional complications:

When a decrepit and incompetent Canadian health bureaucracy meets a boneheaded and inhuman American border "security" bureaucracy, you'll be getting a birth experience you'll treasure forever:

Her parents, Natalie Paquette and Richard Stinson, couldn't follow their baby because as of June 1, a passport is required to cross the border into the United States. They're having to approve medical procedures over the phone and are terrified something will happen to their baby before they get there.

Once Buffalo enjoys the benefits of Hamilton-level health care, I wonder where Ontario will be shipping the preemies to. Costa Rica?

The other story I want to tell you is my own. Our oldest daughter has dual US/Canadian citizenship by virtue of having been born in Vancouver, BC; I was a student in the country at the time, so we spent five years as net beneficiaries of the Canadian health care system. I'm not going to demonize it or try to deny its virtues; combined with the medical benefits my wife received for her job, she was without question our cheapest baby despite spending the first two weeks of her life in the NICU. Yet, as I wrote last summer, there were some enormous downsides to the system as well.

We had some truly brilliant doctors, and some wonderful nurses, and the staff at BC Children's Hospital were beyond superb; they cared deeply about their tiny patients and were past masters at making bricks without straw. The thing is, they had to be.

The equipment was junk—they finally gave up on the blood-oxygen monitor on my little baby and took it off when it reported a heart rate of 24 and a blood-oxygen level of 0 (or the other way around—it's been a few years now); while we were there, the provincial government tried to donate some of its used medical equipment, and no one would take it. The Sun quoted one veterinarian as saying the ultrasound they wanted to give him wasn't good enough to use on his horses. Meanwhile, the doctors kept taking "reduced activity days," or RADs (which is to say, they took scheduled one-day strikes without calling them strikes), to protest their contract. I was actually up at St. Paul's in Vancouver for a scan one of those days; the techs were there, obviously, but no doctors. A hospital with no doctors is a very strange place.

I could also tell you about the time we took our daughter to the ER (different hospital) at midnight; there were only a few patients there at the time, but it still took them three hours just to get us into a room, and another hour to see us. It was 5am before we walked out the front door. At that, we were the lucky ones—there were a couple folks still waiting to be seen who'd been waiting when we got there.

Nor was our experience unusual, or even extreme; we prayed for people's friends or family members dealing with serious illness, not just that they would get better, but simply that they would get treatment before they died. Sometimes they didn't. That's why (as I noted in that post) there's an increasing movement against national health care in Canada and elsewhere (though not, as far as I understand, in Britain). That's the kind of thing that happens when the dollar, not human life, is the bottom line of the health care system. We already have too much of that in our country as it is; what Sarah Palin understands, and why she's leading the charge against Obamacare, is that letting the government run the system will only make it worse, not better. Yes, we need change; but for that change to bring actual hope, it needs to be change for the better. Obamacare is the wrong prescription.

(Cross-posted at The Spyglass)