Even while the Affordable Care Act debacle is mired in other problems, the “death panel” controversy lingers on, as conservatives exploit the public’s visceral reaction against an inevitable result of modern health care cost-sharing, and progressives dishonestly deny and ridicule the reality of that result, because it makes health care reform less attractive.
The case of Jahi McMath is instructive, if anyone bothers to consider its practical and ethical implications. Jahi, 13, underwent a tonsillectomy Dec. 9, and emerged from her post-op recovery legally dead, due to massive swelling in her brain. She was placed on a ventilator, and according to its policy, Children’s Hospital Oakland was preparing to take her off life support when the family strenuously objected. It petitioned a court to keep her technically alive so she could spend Christmas with them. An Alameda County judge Monday ordered hospital officials to keep Jahi on a ventilator until Dec. 30 while an independent neurologist reviews her case. Meanwhile, her mother told CNN and other local media that although she appreciates the second opinion and court order, she will fight to keep her daughter on life-support as long as possible, saying,
“I’m her mother. I’m going to support her. It’s my job to do it. Any mother would do it. I just want her to have more time. There are so many stories of people waking up in her situation.”
This is, undeniably, a tragic, heart-breaking situation. If the family wanted to keep Jahi on life support indefinitely and could pay all costs while also ensuring that her continuing care would not cause a shortage of space, facilities, equipment or personnel needed by other patients, then the handling of her maintenance would be the business of nobody else, certainly not the government. That is not the case, however, and virtually never is in such tragedies. Jahi’s care is expensive, and will soon create costs in the tens of thousands, and eventually hundreds of thousands. However the costs are divided among the hospital, insurers and the government, in the end, you and I will pay, either in taxes, insurance premiums, or higher prices for medical services. An ethical argument can be mounted for this when the health and life of a child is involved, but not when society is paying for futile hopes, denial, and the sentimental wishes of a family to pretend their dead daughter is spending Christmas with them. I don’t want to pay for it, and should not have to.
In a shared system, there must be a mechanism to prevent people from wasting everyone else’s limited resources. That means death panels, either operated by private insurers, or the government. Unfortunately, most Americans, like Jahi’s family, will continue to behave as if they are paying for such extraordinary care and nobody but them has a stake in the treatment of their daughter, even when that is far from the case. There must be death panels, or we all have to pay for our own health care and insurance.
Anyone who supports shared health care costs and denies the necessity for death panels is a liar, or a fool.