In Sweden medical care is free. I can fight as long as I want without them getting in trouble. I also suspect I should fight so hard as if the illnes is truly terminal I will end sooner in flames, not later.
I want all the tubing. I want the cracked ribs and surgeons transform me to a piece of blubber and then anlyze the hell out of it so anyone else don't have to go through the same thing.
Telling people to give up because of money or some sort of gentleness to yourself or your family is alien to me. Maybe it's our harsh climate uphere. Swedes seems very in tune with our suffering.
It's not free. It's free to you, but it is placing additional costs on the Swedish medical system, which somebody is ultimately paying for. You don't have to internalize the costs of your decision.
I'm not arguing whether or not you're a making a good or bad decision, or whether or not "free" medical care is a good thing. I'm just pointing out that providing such a system skews decision making.
It's worth noting that the US health model isn't a free-market system - the state links health care to employment, which distorts the market away from individual private health ownership, and creates patterns that make it easy for costs to creep up. The US health care model is a disaster: the state doesn't supply health care, but then also prevents the free market from operating effectively.
Germany has socialized healthcare too, FWIW. Cheaper cost per capita than our system, with better results.
My understanding is that health care is linked to employment because of the adverse selection problem that occurs in a free market of individual health insurance. Can you elaborate on why you consider this to be the government's fault?
Assume you can sign up for plan A at your company that costs 200$ a month and covers everything you want. Or you can buy Plan B which costs 180$ a month for the same coverage.
Assuming your marginal tax rate is over 10% then plan A costs you less money. Now, most company's bundle healthcare so it's harder to get that money out of the equation, but for small company's it easy to negotiate if you can get heath care cheaper though your spouse etc.
> How is the state linking health care to employment?
I understand that if you live in the US it's impractical to get private health insurance on an individual basis because there's low business in the space, meaning low competition, as well as the tax structures described by other commenters.
> My understanding is that health care is linked to
> employment because of the adverse selection problem that
> occurs in a free market of individual health insurance
(Or, if your uninsured/indigent, reduces the choices you have available to make a decision between anyway)
If I am terminally ill, I will probably reject treatment and choose to go peacefully.
Your family is your business, but I have watched both friends and family die fighting hard in the ICU. It would not have been my choice to watch them, nor for them to go through that for the sake of myself.
Fighting for the sake of fighting alone has no value.
Watching a loved one suffer is agonizing.
Lots of people put themselves into debt trying alternative or experimental therapies, even in countries with universal healthcare. The sad truth is that whatever kills you will probably not be something that the doctors can learn much from. It will be some disease that is well known, with lots of data on survivability etc.
I have friends who are medical professionals and I don't recognize them in this either: I highly doubt any of them have NO CODE tattoos or anything equivalent. I suspect society shouldering most of the cost might be a factor: with a privatized payment system, there are perhaps incentives to go too far that aren't there when there's no profit to be made? That's pure conjecture, though.
The choice of how much pain is worth it for how much of a chance at a longer life is going to look different depending on your religion, your responsibilities, your age, your experiences with pain, your family, your culture, etc. And yes, of course the cost of treatment will factor into that decision for both the doctors and the patient.
In a world where the only available treatment is blood-letting or getting your limbed sawed off by a hacksaw, a "do not resuscitate" policy is clearly more rational than in the Star Trek/sci-fi world where treatment consists of a doctor waving a magic iPad over your head and nanobots cure you painlessly. Since we're somewhere in between those two it becomes more complicated, but evaluating the risks and benefits and making an as informed choice as possible based on the available information still seems to me to be the rational way to look at it. Making future medical decisions based on an emotional reaction to individual cases, on the other hand, seems to me to be irrational and counter-productive.
Having seen his tour of the medical system, I desperately hope that if I were ever in that position, I'd have the strength to say no: treat the pain and I'll die in peace.
I understand that some conditions cause insufferable pain with very slim chances of surviving, but there are many success stories from people who have battled through. Its often these same people who provide the courage to others to battle on and raise money to support the families of those who have had similar experiences. We shouldn't be thinking about optimising our lives for our own happiness, but for the generations yet to come.
I will always fight for my life to the bitter end. There is no way I would leave my children to come to grips with why their father gave up without a long, hard fight.
I thought Sweden had committees to decide on what standards of care would be provided or not, preventing you from making the mistakes discussed in the article?
EDIT: Also, remember that the US government spends more per capita paying for people's health care than Sweden, but manages to spend that huge amount of money on only poor and old people who don't have employer-provided health care.
I also have "fight for life at all cost" experience, though only with animals (I provided a kitty foster home, and through that assisted in a vet clinic somewhat). It's not like with humans, but enough.
I have also seen my grandfather's last days, so maybe that influences me somewhat.
If I ever get cancer, barring some incredibly lucky circumstances when it's completely resolvable, I will avoid treatment. The suffering is not worth it, and the pressure on the loved ones is not just financial.
It's not about being tough and macho. A lingering decline can be psychologically painful for everyone involved. Pretty much everyone I know that has been involved in caring for someone who suffered a slow decline - particularly alzheimers - don't want to go through that themselves.
You say now that you may want all the tubing and to be bounced around from doctor to doctor (not all of whom know what they're doing, by the way), but it's a very different beast when you're actually experiencing it. Some folks just say 'do what you gotta do'. Others say 'I don't care what you think you'll find with yet another test, the endless battery of tests is worse than the disease'.
When you die quickly, you personally don't suffer, but those around you are stunned by the sudden, often unexpected loss and life. It seems cruel and arbitrary.
You never get a choice, though. Some people, like my father, survive their first heart attack with no apparent long term damage while others, like my mother, don't. Some people get cancer. Some people even get hospitalized for things that aren't life-threatening--but when something life-threatening does happen, those medical problems become obstacles to effective treatment.
I don't have the link handy, but there was a study a while back comparing hospice care to class 3 chemo (that's the really, really poisonous bad stuff). The study found that families of those who went into hospice coped better with the loss. Furthermore, almost counterintuitively, those in hospice care actually lived longer on average. Sometimes, taking stress off the body gives it just enough room to keep fighting on its own a bit longer...
I've lost friends to sudden deaths -- usually accidents. It's a bolt out of the blue, but it's over quickly and there's rarely much suffering.
I've lost family "after a long illness" as the news reports say, and the roller-coaster of misdiagnoses, initial treatments, exploratory surgeries, continued uncertainty of diagnostic monitoring and procedures, hope for treatment advances, false hope from charlatans and quacks, relapses, remissions, and the final, inevitable, unstoppable, and increasingly debilitating decline, tears people, families, and communities to pieces.
I've also seen cases where the end was known, but treatment brought, at a relatively low cost and with little dread or pain, an extra six months of a life that was happy and full of love. In that case, not so bad.