So, I’m sitting at home today not feeling well and bored out of my mind so I was just perusing some websites to kill some time. I came across a link on aol.com that caught my attention… a link to an article titled Why Does the U.S. Overspend on Health Care? One Simple Reason. (Here’s the link to the article should you want to read it yourself: http://www.dailyfinance.com/2013/10/19/health-care-why-america-overspends/) As a nurse, I am interested in different observations and opinions about our health care system. So, of course, I wanted to read the article. And it was definitely interesting. In a nutshell, the author theorizes that the amount of money we spend on end of life care, trying to buy a patient more time when they are going to die in a matter of a short time anyway, is how and why we’re overspending on health care. He writes “The U.K.’s National Health Service, for instance, is known to practice “denials of costly treatments for life-threatening diseases” toward the end of patient lifespans — a decision necessitated by “resource constraints.” But that’s not necessarily a bad thing.” I’ve worked with dying cancer patients, dying patients who’ve had terribly debilitating strokes. And yes, sometimes the aggressive treatment the medical community uses to prolong their lives is futile. They are going to die with or without the treatment; it’s just a matter of how soon. And sometimes that probably isn’t the best use of our resources and health care dollars. Sure, it’s easy for me to sit here saying that as it’s not my family member or loved one we’re talking about. I guess I’m saying, in theory, I understand and even agree with what the author of the article is saying. But I’m admitting I may very well feel differently if it were my family member or loved one we were discussing treating aggressively. I think the ethical problem that comes into play is already touched on when it comes to organ transplants. We only have so many resources to go around and who exactly gets to make the decisions about how those resources are allocated? Who gets to make the final decision about when a patient should be denied costly/aggressive treatments towards the end of their life? (That’s provided we know the patient’s wishes and they would want the treatment, of course. Otherwise it’s a moot point.) Those are the kinds of decisions that are incredibly delicate ethically speaking and letting the wrong people make them could be a very slippery slope. But who, exactly, are the “right” people? Not an easy question to answer at all.
In speaking to a friend (a U.K. citizen) about this article I was informed that the U.K. National Health Care System is very focused on preventative medicine and treatment of diseases rather than maintenance. That focus makes sense on many levels. First of all, it makes fiscal sense. It’s much cheaper in the long run to prevent a disease than to treat, cure, or manage it. And it just makes for a healthier society to prevent diseases so they’re not spread through the society. I don’t necessarily know if I think a national health care system is the right answer for the U.S.; but I do think there are some positive things about having one in place.