I will begin with end-of-life counseling. The name is a bit of a misnomer; such counseling should not occur only at the end of life, nor even only when elderly. Ideally, this counseling is a meeting between a patient (of any age) and a doctor/lawyer/professional wherein the patient decides to what lengths they are prepared to go to stay alive (among other things). This can be anything from merely nutrition and hydration all the way to the most extreme measures (example: “iron lung” assisted breathing). Unfortunately, this type of conversation doesn’t occur as regularly as it should; hospitals frequently receive unconscious persons in highly critical condition without any stated policy about what procedures they are willing to undergo. In such cases the hospital and doctors must err on the side of caution and go to every length to resuscitate the patient. Such practices can often be unnecessary (if the patient would have refused the treatment) and, in a nutshell, costly to the system. Thus, it only makes sense to provide and promote this service for the public. Can it be subject to abuse? Perhaps; but under the current proposal, I doubt it.

One additional comment: rationing. This word has been bandied around of late as a dirty and repulsive product of government meddling in healthcare. The unfortunate truth is that rationing occurs in any healthcare system. In our current model, cost is the effective rationer: only the wealthy can afford the best of everything; the rest of us are forced to pick and choose which procedures are worth our meager resources, to say nothing of those who get locked out of the system due to a lack of any resources. Yes, money is the current key to our healthcare system; Obama merely proposes to take this rationing process out of the hands of merciless market forces (for what is capitalism if not competition; well, I’m being slightly facetious here. My apologies) and place it into the hands of intelligent, well-meaning government officials. Thus one hopes that, with planning and good management of resources, these government officials can maximize the availability of effective treatments while reducing the cost across the board. Yes, this may be a bit naive and idealistic, but perhaps that’s what we need at this juncture.

One more note on rationing: as long as some vestige of our current healthcare system survives the healthcare reform, the wealthy need not worry about rationing. It is my hope that a balance can be struck: governmental healthcare providing a blanket of effective and necessary treatment while doctors and hospitals continue to offer the auxiliary treatments on the side, for those willing to pay a premium. Such a system would be, to my mind at least, ideal; whether or not the current proposal will lead to such a system, only time will tell. I remain hopeful.

And, by the way, it is interesting that the person who finds all this ominous language in the bill, Betsy McCaughey, sits on the board of one of the country’s biggest manufacturer of medical devices. But I’m sure there is no conflict of interest there.

The elderly are not the only people who deal with end of life decisions–and before you are on Medicare, you can bet that an insurance company is going to play a role in those decisions. The purchase of supplemental plans to Medicare only defeats the argument of a public option putting private insurance out of business. There will always be people who will wish to supplement their public plan.

Thank you, however, for bringing this other bill to our attention, since a cursory reading of the bill also brings up the limitation on nutrition and hydration, which, as I mentioned, the Catholic way of life, informed by the teachings of our Church, regards as ordinary, not extraordinary, care. This appears to be a “slippery slope” bill, and pro-life Catholics (and others) need to watch it carefully as well.

BTW, what do Medicare (a public option, if there ever was one) and insurance companies “telling you how you will die” have to do with each other? People buy Medicare supplements to cover what Medicare won’t pay for, not the other way around. Medicare not only limits what is covered, but what percentage of the normal cost they will pay for. That is why many doctors limit the number of Medicare patients they will accept: they can’t afford to eat the costs.

At least insurance companies don’t have the police or IRS under their direction…

The end of life provision is a bipartisan entry into Medicare reform. In fact, there are two Republican cosponsors in the House Bill (HR 1898), one of them a doctor. It is not mandatory. The doctor that you have chosen may bring up the subject, but you are free to reject it out of hand. And there is no requirement to force you to talk about it every five years. If you don’t like your doctor, you can change your doctor.

I can assure you that both my parents, rejecting extraordinary measures to stay alive, are resting peacefully in their heaven. They died with dignity, with loving people around them. We had conversations about these issues before they were ill, and they both had Living Wills. They loved God and are with Him now.

Nothing in this legislation tells you how to die. In fact, it frees you from insurance companies telling you how you will die. Now, that’s scary.

According to Catholic teaching, nutrition and hydration–explicitly mentioned in this bill–are not extraordinary, but ordinary, care.

**”There is nothing “mandatory” in this legislation.”

That is debatable–and needs to be debated before it is passed.

**”It is cosponsored by democrats and republicans.”

Not true, All nine sponsors are Democrats. The first outright lie (not just a matter of interpretation or spin) in this post.

**”It simply allows you to consult with your doctor and the government pays for the consultation.”

So it has been said, but Medicare does not forbid your doctor from asking these questions now, but it also does not specifically schedule an appointment to force the patient into the discussion.

**”You can say you wish to have every means available put to the purpose of keeping you alive, or you don’t.”

If you are repeatedly asked the same questions, doesn’t it appear they are wanting you to change the answers?

**”This is a scare tactic used to scuttle health care reform and it will not work.”

Ad hominem attack, not argument.

**”Most people want some kind of public option, most people would like to have a say in how they die. To me, this is the essence of the “pursuit of happiness.”

You have every option to tell how you want to die–within the limits of the law–now. Talk to your attorney. He or she will be happy to help you. There is no necessity to write legislation to tell others how they should die.

Note that George Soros, the infamous multibilionaire funds much of this propaganda, disguised as “Mary and Joe Catholic” simply posting their views. http://www.discoverthenetworks.org/individualProfile.asp?indid=977

If something seems to smell, dig deeper, you may have found a cesspool.

PRI is a small not-for-profit organization. As with similar prolife, Christian organizations, like Priests For Life, what do they have to gain by educating us through articles such as this one? There is no money/power trail leading back to folks getting richer and more powerful with each tick of the clock and click of the mouse. The only thing prolife organizations hope to gain, is the treasure of your soul for Jesus Christ.

You wrote, “Most people want some kind of public option, most people would like to have a say in how they die. To me, this is the essence of the ‘pursuit of happiness.’”

As Catholics, is this truly our focus? Control over how we die is pursuing happiness? What happened to submitting to the Lord in all things? What about sacrificial suffering, as it comes? As I read this article, it seems to me that the public option will be controlled by the government:

” In a February 9th Bloomberg piece, she reported on a little-known insertion to the stimulus bill that said that “one new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446).” As McCaughey points out, these types of provisions are nearly always code for health-care rationing for seniors.”

I have older relatives who have made decisions regarding this with which I am morally uncomfortable. In fact, I won’t be part of their decision (withholding food and hydration), but at least I know they made it–perhaps coerced by their lawyer, perhaps not–by themselves. I guess I am grateful that there is no official “threshhold of treatment”–yet–but I don’t think my generation (I’m 42) will have options.