RURAL ROUTES/Margot Ford McMillen

Throw Grandma from the Hospital Bed

Quit pretending you’re horrified. We do it all the time. Put a price on life, I mean. I’m always touched when somebody has an auction or a bake sale to pay hospital bills for a deserving family.

The recently incessant outrage about how much to spend on health care has shined a bright light on the subject of how much a life is worth, or what we would in other contexts unashamedly call “human capital.” There’s even an argument — stop me if you’ve heard it — that we should spend more, more, more on dying since the process creates jobs.

That idea puts a whole new meaning on the Department of Human Resources.

(Dear Diary: Folks have gotten a lot poorer around here since they pulled the plug on Grandma. We never did find out exactly what was wrong with her, except she was pushing 90 of course, and we thought she’d be OK after she got the new liver, the pacemaker and the year of physical therapy. Four years ago, when they first put her on that ventilator, she said she’d had enough and asked us not to resuscitate, but she couldn’t sign the paper with that IV in her hand and, then, with the tubes into and out of her, all we heard was that swooshing sound, and then we began to like those cheerful people brushing her hair and her teeth, and, well, now she’s gone and they’re on the streets…)

For many in the “health” business, which has very little to do with health, of course, the conversation is about how far to go. And the answer is often, sadly, to go as far as the money will allow and then some. More CAT scans. More prescriptions. More surgeries. More rehabilitation. All that medicine keeps the hospitals in business. To these economists, the future lies in increasing the number of hospitals and doctors. They worry about shortages of doctors and nurses, and the need for new hospitals. Now that the prisons are going broke and the shopping centers are shuttered, city planners advise building hospitals.

But talk to a few of the survivors and you find out who pays the bills. In many cases, even when a family has insurance, or even when a doctor has made the mistake that puts a patient in the operating room, the bills end up bankrupting the family.

And these angry, self-righteous mobs that turn up at government hearings, trembling with indignation and horror, may be talking about pulling the plug on grandma but they’re thinking about something they’ve heard on the radio, delivered in a spooky voice, with some kind of angry music behind it.

(Dear radio star: Please incite these people to shout at lawmakers about something that could actually help them, like better food in the schools. Or less spending on war machines. Or diplomacy in the middle east. Or public transportation…)

I like a protest as well as anyone. It gets the adrenaline up and the blood moving, but I try to understand the issues before I show up with a sign. And, when I want to be scared I’ll turn off the radio and think about life in the suburbs.

Having seen two of my beloved elders with lives stretched out way beyond comfort, joy, or, yes, usefulness, and having talked to a number of good friends about what we want when we we’re moving toward the light, I can’t imagine that all those protesters really think Grandma’s better off plugged in, tubed up, and electrically pumped out. Wouldn’t she rather be remembered as the story teller, the giggler, the cook, the piano player?

Sometimes the protesters are described as “populists.” They’re not. They’re shills for the insurance companies that make gazillions off overcharging for premiums and then not paying for services. It’s amazing that people can be persuaded to speak out against things that might actually benefit them and their families.

I get some of the angry e-mails insisting that patriots show up at one hearing or another and I know some of these protestors. They say they’ve “never done anything like this before,” proving that in the protest business the noisy beginner can win.

I come away from the conversation thinking that folks just enjoy having something to do. And they like to be scared. Gen X-ers play scary video games. Boomers turn up on opening days for movies about aliens and computers gone wild.

Or maybe life has gotten so confusing that there’s comfort in simplification. Phrases like “socialist medicine” or “death panels” simplify ideas when the familiar pyramid of folks with the old power at the pinnacle has been replaced with maybe a black guy at the top, or a Latino woman.

Maybe that’s why we cherish the old patterns, the fund raisers that attempt to help families bankrupted by hospital bills. Bake sales are great. But for the thousands of dollars spent in a month of hospital time?

That’s a lot of cupcakes.

Margot Ford McMillen farms and teaches English at a college in Fulton, Mo. Email: margotmcm@socket.net.

From The Progressive Populist, September 15, 2009


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