Coming care crisis challenges nation's values

Death by de-funding
As funding for services to the poorest and most powerless members of our society shrinks, we as a people must determine how to distribute care resources in an ethical fashion. We must examine our values. We must examine our conscience.
Health care services have always been rationed by ability to pay, a state of affairs our society has accepted. If a person needs treatment that isn’t covered by insurance, isn’t covered by Medicare or Medicaid, and is unaffordable to the individual, the treatment isn’t given.
The problem is that the better the care gets, the fewer people can afford it.
Behold the future: As aging and ill baby boomers drain our public resources, there is going to be more demand for care than there are funds to pay for it. As a result, there is going to be physical pain, there is going to be crippling disability, there are going to be illness and death on a grand scale.
Treatment is available, but it comes at a cost. Do we as a society accept that people, and especially the elderly, should experience pain, suffering and shortened lives for want of cost-efficient care and adequate funding?
If not, what are we going to do about it?

Values vs. costs
We must ask ourselves, is the preservation of life an absolute value? If so, then so be it. But that means funding the required services, medications, medical staff and medical equipment to keep life going.
Does our belief in the value of life stand up if it means doubling or tripling our taxes or insurance premiums? If not, then we must come up with alternative funding, or decide who gets help and who doesn’t.
The standard cliche is that children are the future, therefore we should invest in them. But does that mean the present is already dead? Does the value of a life decrease from the moment a person turns 18, like a new car as soon as it’s driven off the lot?
Say we have $250,000 for health care services: Do we spend it all on one extremely premature infant or save six adults through coronary bypass surgery? Should we maintain five people in persistent vegetative states or perform 40 hip replacements for crippled seniors?
Is respect for the elderly and attention to their comfort and care an absolute value? If so, then so be it. But that means funding some minimum level of services for our seniors, and we the people should define that minimum.
Does the minimum encompass prescription drugs, independent living and surgical intervention? Or is it more like aspirin, a walker with tennis-ball feet and a tube of Ben Gay?
Does our assessment of the sufficiency of the minimum stand up when we picture our elderly mothers and fathers – or our aging selves – living that minimum?

The time has come to act
Until now, we have essentially washed our hands, shrugged our shoulders and left these life-and-death issues up to government budget process or insurance company policy.
Rather than whistle-stop tours on Social Security, we need our leaders to conduct town meetings, state and national forums, and lengthy public testimony and debate on health care availability and cost, Medicare, Medicaid and the value we place on life and its quality.
As people of conscience, we cannot do otherwise.

Clarissa French is editor of Springfield Business Journal.