Row 2 Seat 4 quotes President Obama during his Colorado Stump Stop for Health care as saying, “I just lost my grandmother last year. I know what its like to watch somebody you love who’s ageing (sic), deteriorate and have to struggle with that,” said Obama. “So the notion that I somehow – I ran for office, that public members of congress are in this so they can go around pulling the plug on grandma. I mean when you start making arguments like that, that’s simply dishonest.”

I don’t believe President Obama or any member of Congress is specifically going around building a case to pull the plug on anyone’s grandma. I do believe that your grandma and your grandma and your grandma and all the other grandmas out there get aggregated into one big number of thousands of people who, at some point, will never get well and who will inevitably die. When all those numbers come rolling into a health care review panel deciding where to allocate scarce resources, somebody’s grandma is gonna lose, because at that point she isn’t someone’s grandma, she’s a huge resource drain with no chance for a positive result. Inevitably, there’s a significant chance that no matter how hard people on the panel try to remember, “Hey, this is someone’s grandma,” they are going to see a never-ending line of large expenditures. And they’re going to have to weigh someone’s grandma who’s never going to get well against someone’s little boy or little girl who just might be able to make it and find the cure for global warming** if they could get the same amount of money we’ve been allocating for grandma so she can remain a near comatose vegetable in a nursing home where you don’t visit her any more than necessary. Responsible health care panel members will make the tough decision and opt to fund treatment for that little girl or boy and deny treatment for grandma. The first few times it will be with a heavy heart. Then they will steel themselves and block that area off in their mind, and the decisions will get easier.

But really, some of those decisions should never reach that point. At some point it becomes selfish and irresponsible to maintain someone with no hope on life support just so you don’t feel guilty for pulling the plug — no matter what age the person is. These battles rage in courts and hospital rooms all the time. They can be very divisive for families. Making the call to pull the plug is tough — it means you’ve given up hope, and no matter how hopeless the situation is, some people will always wonder if they prevented miracle by not waiting long enough. For these people, the health care panels will ease that guilt. I’m sure the altruistic goal of the end-of-life counseling which has caused such furor is to allow the elderly person to document their wishes to make that decision easier for family members. Health care directives and living wills are designed so your loved ones can carry out your wishes with less guilt and fear that they are making the wrong decision. Every five years or when a major health change takes place is not an unreasonable time to update these directives. However, improperly implemented or implemented with a different spirit than what I’ve described, it could be a terrifying harassment time used to browbeat seniors at a vulnerable time into adopting a less aggressive treatment than they might have ordinarily have done. That would be bad, and that’s what people are afraid of — there is a significant lack of trust in the President, Congress, and the government bureaucracy at large. And that lack of trust has been earned through years of bureaucratic screw-ups that have cost people their lives or livelihoods. These decisions are too important to turn over to to a hastily scrawled, pork-filled, power hungry piece of legislation where the goal to stamp “Done” appears more important to our elected officials than actually thoughtfully producing reform that works.

For that reason, this legislation needs to be dropped. If reform is to be developed, it needs to be accomplished carefully, with precision, incorporating as much of the usable structure we already have. Either build an administrative patch to allow non government employees to opt into one of the hundreds of government employee plans out there (impossible now because without being a government employee, they don’t have access to the system, but if the administrative database segment could be developed to all the vital information to be entered and maintained, this could be done with minimal difficulty) or legislate the reform in segments. Begin with overarching goals and timelines, then fill in the pieces are they are vetted and hammered out in ways that make sense and are ensured as little government involvement as possible while still ensuring access to care for those who need and want it.

* Posted earlier today on my Facebook Notes page.

** yes, in case you were wondering, that is sarcasm.