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NCallahan said on June 25th, 2009 at 8:01 am

There’s should be a big internet database of plucky, bullheaded patients who flew in the face of doctor’s know-it-all orders and then, like, died.

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mygif

If Obama were bitter and heartless, I would have liked to hear him say “Yeah, massively expensive and risky surgery so that your billion-year-old mother could spend five more years living off the government and complaining about modern music. Great investment. What, do you work for AIG?”

Then Biden would jump out and yell “Ohhhh! Sick burn!” then go for a high-five but Obama would totally leave him hanging.

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mygif

As a U.S. citizen, I get really fed up with how people like That Idiot Woman can get press with Stupid Inflammatory Rhetorical Smart-Ass Questions To Make Themselves Look Good On T.V. She knows the President she’s being disrespectful to on T.V. can’t say what he really thinks without massive backlash from the press.
Oh, and the fact that my tax dollars pay for the billion-year-old grandma to live, when I don’t have any access to the same benefits.
I’m not bitter, either.

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candlejack said on June 25th, 2009 at 11:25 am

I’m really uncomfortable with the idea of tax dollars being spent on procedures that doctors advise against. It just seems…well, stupid. Because for every person who gets fucking lucky, like this lady’s mother, there’s at least ten or twenty who don’t get lucky, like my grandmother (who had surgery to repair a minor heart defect she’d lived with all her life, and died after her intestines went necrotic during the long operation).

Doctors *should* play a big role in determining what risks are acceptable, and which just aren’t worth the possible gains. And neither tax dollars nor malpractice insurance should have to pay for people who go against their advice.

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mygif

If Obama were bitter and heartless, I would have liked to hear him say “Yeah, massively expensive and risky surgery so that your billion-year-old mother could spend five more years living off the government and complaining about modern music. Great investment. What, do you work for AIG?”

Wow, ageist much? Really, if all old people did what you apparently want them to and just died without a fuss rather than having the gall to want to extend their lives and not have to work in their old age, who would you mock and stereotype?

But seriously…

I’m really uncomfortable with the idea of tax dollars being spent on procedures that doctors advise against. It just seems…well, stupid. Because for every person who gets fucking lucky, like this lady’s mother, there’s at least ten or twenty who don’t get lucky,

The demographic that’s being overlooked here is “people who are aware of their needs and are, unfortunately, getting substandard care, or medical advice that doesn’t suit those specific needs”. Like my own mother, who, when she was diagnosed with endometriosis, was told repeatedly that advanced treatment was NOT necessary because endo is “a fertility issue” and being a lady of a certain age, she wasn’t planning on giving birth ever again. She repeatedly requested treatment and was repeatedly told “it’s not necessary”, until we were on a road trip through the Prairies one summer and she started bleeding internally in a Best Western hotel room and almost died.

Scary stuff. And I bristle at the idea that because it’s not super common for people to have to deal with crises like that, that it doesn’t matter enough for policy to try and prevent it.

So the example the interviewer on TV gave was a bad one, and quite often, even usually, doctors do know what they are talking about. But sometimes their idea of what a patient needs is quite legitimately wrong, and patients shouldn’t be penalized for wanting to have a say in their own care. Between cases like candlejack’s grandmother and cases like my mother, I’d prefer for policies set up to protect patients to err on the side of caution.

As to the whole “wahh my taxpayer dollars” thing – well, taxpayer dollars go towards upholding a lot shittier things than trying to protect the interests of vulnerable people in an imperfect system. Like wars! And the prison industrial complex! Perhaps if less taxpayer dollars were spent on THOSE things, spending taxpayer dollars on the relatively small number of medical procedures that take place against doctors’ advice would seem like not such a huge deal.

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mygif

Sure, sometimes doctors are wrong, but they’re wrong a lot less often than patients with zero medical training and a whole lot of irrational mistrust of the medical establishment that supports crap like homeopathy and faith healing.

Private insurance companies won’t fund treatments that are “against medical advice” either, FYI, and may in fact try very, very hard to funnel sick patients to doctors they know will support “cheap” diagnoses.

Putting in some right to a second opinion for patients is a good idea, but urging people to overconsume medical care is not.

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mygif

Wow, ageist much? Really, if all old people did what you apparently want them to and just died without a fuss rather than having the gall to want to extend their lives and not have to work in their old age, who would you mock and stereotype?

Concern trolls?

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mygif

I’m not ageist…at least that’s what I think, but then again any bigot says they’re not one, so putting that aside for the moment…

So to be clear, your proposal is that we make it government policy that if you think your doctor is wrong they are required to do what you say?

The point that you’re missing is that doctors erring on the side of caution is the precise reason the issue is coming up (aside from Candlejack’s g-ma, which was still almost certainly deemed a low risk that unfortunately came to be). I’m sure most doctors are aware that heart surgery on elderly is an extreme risk. I’m fairly certain that the treatment for endometriosis is more risky than going untreated in cases like your mother’s, and evidence suggests that her doctor agreed.

I’m very sorry that you and your mother experienced such a dangerous situation. And I truly hope that no one ever goes through that again. But telling people that it’s ok to ignore medical advice because they may just be that 1% whose paranoia is right is pure lunacy. (I wish I could make a clever footnote to Jenny McCarthy and stats on the number of people who would die if not for vaccinations but I’m not that nifty so I’ll make a passive-aggressive parenthetical notation).

And closing with ‘there are worse things to spend money on than old people’ takes away some of the punch your ‘ageist’ finger pointing.

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Sorry for the spam. After this I’m done. I just thought an actual statement about my personal thoughts on the policy might help assay further debate.

I believe the policy should be risk based, but give less weight to cost than insurance companies do now in their ‘risk’ assessments. Base the risk on dangers to the patient. Allow for second/third opinions when necessary, but don’t make that the default. Outside of that there should be an appeal process for those times you really don’t agree with the diagnosis but it shouldn’t be easy enough that everyone can appeal and bog down the system. This appeal process should include special treatment for emergency appeals as I believe the medical/hospital boards have now…at least if House, M.D. is to be believed. :)

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candlejack said on June 26th, 2009 at 1:48 pm

I guess I’ve just been lucky in my doctors–I’ve never had one that was flat-out stupid, and I’ve never had one that adjusted my treatment plan based on what I could afford. So I didn’t think to clarify that when I say doctors and realistic risk assessment should be part of the process, I really mean *good* doctors and *non-financially-based* risk assessment should be part of the process.

People should, definitely, get second (and even third or fourth) opinions if they aren’t sure their doctors are doing right by them. But if you see three doctors and they all agree you’re more likely to die on the table than you are to get a significant benefit from a surgery, I think that you maybe should have to finance that operation yourself if you still insist on having it.

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acabaca said on July 1st, 2009 at 2:10 pm

Isn’t it? I thought the entire point of the left-wing politics was that people would get more chances to be lucky.

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