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Harris Sherline: Deciding Who Lives and Who Dies, Part II
In a society that bases life and death decisions on cost, such as the QALY (quality-adjusted life year) system in Great Britain, it’s easy to see how it’s possible to deny health care to people who have the potential for great accomplishments.
For example, Helen Keller, who was born blind, deaf and mute, through the patience and perseverance of her nurse and companion, ultimately became a world-renowned figure for her accomplishments in helping those with disabilities. However, my guess is that if she had been born at a time when the health-care industry was making cost-based decisions about who should live or die, she would not have been spared.
She has been quoted as saying, “I dreamt of heaven the other night, and the pearly gates swung wide. An angel with halo bright, ushered me inside. And there to my astonishment, stood folks I’d judged and labeled as quite ‘unfit,’ of ‘little worth’ and ‘spiritually disabled.’ Indignant words rose to my lips, but never were set free, for every face showed stunned surprise, not one expected me!”
Another person who probably wouldn’t be with us today under a health-care system that restricts access on the basis of cost is one of world’s greatest physicists, Stephen Hawking.
Hawking, born in 1942, has suffered for about 40 years with ALS (amyotrophic lateral sclerosis), more commonly known as Lou Gehrig’s disease. The list of his accomplishments is too long to detail here, but he has authored a number of important contributions to the fields of cosmology and quantum gravity, including “black holes.”
Hawking developed ALS in his youth, while attending Cambridge, and has become increasingly paralyzed over the years, to the point that today he is almost completely immobile and can no longer speak. He has been quoted as saying, “It is a waste of time to be angry about my disability. One has to get on with life, and I haven’t done badly. People won’t have time for you if you are always angry or complaining.”
If the British QALY system for evaluating the worth of individuals had existed at the time Hawking became paralyzed, would he have received the care and support that have kept him alive for the past 40 to 50 years, or would the cost of his care resulted in the conclusion that it was simply too expensive?
There is a long list of people who have made significant contributions to society and who might well have been denied health care on the basis of cost under the British QALY system or a similar policy that could potentially become the method for health-care decision-making in the United States under the type of health-care reform that the Obama administration has been pushing. The following are just some examples:
» Christopher Reeve (1952-2004), actor: He was paralyzed as a result of a horse-riding injury and dedicated the remaining years of his life attempting to harness the power of medical research to enable people with spinal cord injuries to recover and walk again.
» Ray Charles (1930-2004), musician: He became blind at age 7, learned to play the piano and went on to become one of America’s greatest entertainers.
» Jose Feliciano (1950-), Stevie Wonder (1950-) and Ronnie Milsap (1945-), composers and musicians: All were born blind and overcame their disabilities to become leading songwriters and entertainers.
» Franklin Delano Roosevelt (1882-1945), U.S. president from 1933-45: He suffered from polio, which he contracted in 1921.
» Louis Braille (1809-1852), inventor of the Braille system of reading and writing: He became blind at age 3 as a result of an accident.
» Anne McDonald (1961-), Australian author and activist for the rights of people with communication disabilities: She developed cerebral palsy as a result of a birth injury. Diagnosed as having severe intellectual disability at age 3, she was placed in an Australian government institution for people with severe disabilities and lived there without education or therapy for 11 years. McDonald wrote her story in Annie’s Coming Out, a book she co-authored with Rosemary Crossley in 1980 (the film Annie’s Coming Out based on the book won several Australian Film Institute awards and was released in the United States under the title Test of Love).
» Hubert H. Humphrey (1911-78), two-term U.S. vice president and senator: He is credited with saying, “The moral test of government is how it treats those who are in the dawn of life ... the children; those who are in the twilight of life ... the elderly; and those who are in the shadow of life ... the sick ... the needy ... and the disabled.”
Those are important words everyone should keep in mind during the debate about reforming America’s health-care system. If the changes lead to health-care rationing and decision-making about who lives and who dies based on monetary considerations, we will not have moved forward but backward in our quest for fairness and equity.
— Harris R. Sherline is a retired CPA and former chairman and CEO of Santa Ynez Valley Hospital who has lived in Santa Barbara County for more than 30 years. He stays active writing opinion columns and his blog, Opinionfest.com.
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» on 11.01.09 @ 08:30 AM
As Reagan used to say, “There you go again!”
You very conveniently neglected to mention the British scientist Stephen Hawking, who suffers from motor neuron disease. The ultra-conservative Investor’s Business Daily said on July 31, “People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” Apparently you believed this drivel, hook line and sinker, Mr. Sherline.
One problem: it is totally false. Mr. Hawking wrote in the Guardian: “I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.”
I think you need to give both sides of the story, in order to qualify as credible.
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» on 11.01.09 @ 10:54 AM
By basing health care on pure cost considerations makes you wonder about the morallity of the people pushing this monstrous bill. And they are passing themselves off as caring. I wonder if Obama or Pelosi would want treatment withheld from someone they loved because it cost too much. But then they don’t have to worry because they have exempted themselves from the public option in favor of their free gold plated health insurance.
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» on 11.01.09 @ 11:32 AM
The premise suggests that these decisions aren’t made already. They are, and by people who are solely motivated by self interest- the profit of their company, enterprise or practice.
Today in California, a person who is 80 years old can die as the result of malpractice, and damages are limited to $300,000.
As a former Hospital CEO Sherline knows these and other facts, and yet still defends the status quo.
Better than criticize other countries systems, I would appreciate Sherline suggesting how he would reform the US system so that health care is less costly and more affordable, and covers all. Maybe the French, who spend less yet get better care as a nation than the US would be a system for him to examine and suggest the practices there we could emulate?
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» on 11.01.09 @ 01:12 PM
Geez, what a pile of blooming pork pies Harris Sherline has spewed out this time.
Helen Keller never benefitted from health insurance, private or public. Her family was affluent, and the teacher Anne Sullivan devoted herself to helping Helen, with no insurance reimbursement whatsoever.
The biggest rationing going on right now is in the health industry comes from guys like Harris Sherline and William W. McGuire (who made $125 million a year as head of United HealthCare) picking the pockets of the poor premium payers…. they accept the premiums and then deny care when the premium payers get ill.
Recently the insurance industry has been denying healthcare to rape victims, after they are raped. I guess the health care gurus like Harris Sherline say rape victims asked for it and don’t need health care.
So QALY is a million times better than the criminal element like McGuire and Sherline who run american health care now. The Hawking story Sherline tells is such a flaming lie (thanks Tex805) that I hope Hawking (who visits Santa Barbara regularly to work at UCSB) sends Sherline a cease and desist letter.
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» on 11.01.09 @ 01:57 PM
What about all the ordinary folks who don’t have health care now? Are there lives worth less than the famous?
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» on 11.03.09 @ 11:50 AM
What a sorry excuse for an article! I guess it’s true what they say about sequels: they’re always worse than the original, and Sherline’s “Part II” manages to be even less factual or relevant than “Part I”. Notice the “may well have been"s and “my guess is”?
Does he think that asking innuendo-laden questions is a substitute for journalism or fact finding?
And the blatant hypocrisy of SHerline, a former hospital administrator being all maudlin about balancing health issues of individuals with the cost of treatment. Astonishing!
Pathetic!
and, pointless.
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