HealthBeat readers who responded to my invitation to join the “truth squad” have sent in a number of superb examples of how the opponents of reform distort the truth. I’m starting with a piece by Dick Morris because it includes some of the most common false claims that are clouding the debate on healthcare reform. (Hat Tip to reader Harry Wetzler for calling my attention to Morris’ column.) In future posts, I’ll be spotlighting other, attacks on reform. Please keep the submissions coming. The only way to defeat campaigns of disinformation is to be as tireless as they are.
Very likely, the name “Dick Morris” sounds familiar. This is because Morris was Bill Clinton’s campaign manager when Clinton ran for re-election in 1996—until the papers broke the news that Morris had allowed a prostitute to listen in on his conversations with the president on more than one occasion. (The morning after, even the hooker raised an eyebrow: “Someone as intelligent as he is should have kept his lip buttoned when he unzipped his pants,” she told the Washington Post. “I mean, how can you maneuver worlds, and he can’t even control what he’s doing in his own room with a paid lady?”) The New York Times reported that Morris also gave the prostitute sneak previews of speeches that First Lady Hillary Rodham Clinton would be delivering.
Morris was known as a “spin doctor,” and not well liked by some of Clinton’s advisers. Former White House Chief of staff Leon Panetta later blamed Morris for advising Bill Clinton to lie about Monica Lewinsky: “All Clinton needed to do was to tell the truth at once, instead of listening to the advice of his double-crossing ex-consultant Dick Morrris,” Panetta told a reporter. “It was Morris, immediately after the scandal exploded a year ago, who explained to Clinton that America would never forgive him for his escapades with Monica. I had warned Clinton from the beginning about the bad influence of that man, who cares only about opinion polls, bends with the wind of the moment, and doesn’t give a damn about moral and is still on the scene political principles.”
Yet despite everything, Morris is still part of the beltway scene—and feels qualified to denounce the White House for not being truthful about what health care reform will mean in a column posted on The Hill earlier this month. (Presumably we can look forward to Elliot Spitzer taking on the mantle of Moral Authority in a year or two.) Morris’ piece, titled “The Death of American Healthcare” seems to me worthy of analysis because he does such an able job of packing so much misinformation into a relatively small space
We’ll Lose Our Doctors!!
Falsehoods: Morris begins by charging that “when America’s top health insurers and providers met at the White House and pledged to save $2 trillion over the next decade in health care costs (thus making our health care system affordable for more Americans), they were in fact “pledging to sabotage our medical care. The blunt truth, which everybody agreed to keep quiet, is that the only way to reduce these costs is to ration healthcare, thereby destroying our system.”
He goes on to “explain” how reformers will destroy American health care: by slashing doctors fees: . “Congress is trying to cut Medicare fees by 21 percent.”
Facts: Everyone in Washington knows that Congress is Not going to slash Medicare fees to doctors by 21 percent. The budget President Obama submitted to Congress didn’t even pretend this might happen. The president assumes that Congress will halt the scheduled cut in payments from Medicare to physicians, just as it has in the past– including last summer when the Senate voted 69 to 30 against across-the-board cuts. HealthBeat post.)
It would have been easier for Obama to pretend that draconian cuts would go through (as President Bush always did .) It would have made President Obama’s budget look better. But instead, Obama’s budget proposed setting aside $11.7 billion to maintain doctors’ fees at their current level in fiscal 2010.
Falsehoods: Nevertheless Morris insists that doctors’ incomes will plummet and that this will “just discourage people from entering the profession and those already in it from practicing. The limited number of doctors and nurses in the United States is the key constraint on the availability of healthcare. Our national inventory of 800,000 doctors is growing at only about 1 percent a year (18,000 med school graduates annually minus retirements), while the nurse population is stagnant at 1.4 million. To stretch these limited resources so that they can treat 50 million more people is possible only through the most severe kind of rationing.”
Facts: Although we are experiencing a shortage of primary care physicians throughout the U.S., we have more specialists than we need in much of the country. One might think that a town can’t have too many doctors. But in truth, excess capacity leads to overtreatment, and poorer outcomes.
As researchers point on in a 2006 study published in Health Affairs, “regions and states with more medical specialists and general internists appear to have lower quality of care as measured by mortality and common performance measures endorsed by the National Committee for QualityAssurance (NCQA).
Patients in regions with more doctors are twice as likely to be seeing ten or more physicians during the final two years of life, and end-of-life are is usually much more aggressive. Yet outcomes are no better, and often they are worse. A 2009 study published in Health Affairs reveals that patient satisfaction is significantly lower when patients are seen by more physicians—and the technical quality of care also is lower. Researchers suggests that having too many physicians [may] lead to “disorganized care and duplication of services” and that this many explain “not only for the poorer performance on technical quality measures . . .but negative hospital ratings” by patients.
The problem is that more doctors mean that “more happens to the patient,” but it doesn’t mean that he receives the coordinated, compassionate care that he needs. Too often, ten specialists see the patient as ten different body parts: a heart, kidneys, lungs, a breast—all in need of different treatments. A patient may be dying of congestive heart failure, and yet is subjected to a mastectomy (because a test discovered cancer), or hooked up to a dialysis machine. It is not that most doctors are intentionally over-treating, but that they have been trained to do “everything possible” to treat a particular organ. Patients get lost in the crowd.
Meanwhile, the authors of the 2009 study point out that when too many doctors are involved in a case, physicians themselves are frustrated: “A survey of physicians found that . . . in regions with more physicians, where patients saw more specialists, doctors also reported “that both the continuity of care with their patients and the quality of communication among physicians were inadequate to support high-quality care.”
Some assume that, as boomers age, we will need more doctors. But as I have explained in earlier posts, boomers will age as they were born—over a period of decades. We are not going to be hit by a tsunami of wizened hippies. Over those decades, we will adjust to changing needs; very likely, we will be making greater and better use of nurse practitioners.
It is true that, today, we are experiencing a shortage of nurses. But this is not because of a shortage of applicants to nursing school. The problem is that we don’t have enough nursing school professors to teach them. This is a problem that can be remedied quite simply by raising pay for underpaid nursing school teachers. As the supply of nurses rises, working conditions will improve; today, too many nurses are working in understaffed hospitals. We also need to hike pay for many nurses—but this will be much less expensive than training and paying for more specialists than we need.
We’ll Die of Cancer—Just Like the Canadians!
Falsehoods: Morris goes on to suggest that under health care reform, we’ll be deprived of needed treatments: “As in Canada, the best way to cut medical costs is to refrain from using the best drugs to treat cancer and other illnesses, thereby economizing at the expense of patients’ lives . . . death rates from cancer are 16 percent higher in Canada than in the United States. We will pay for the attempt to save $2 trillion with our lives.
Facts: Let’s start with the assertion that death rates from cancer are “16 percent” higher in Canada. What does that mean? To understand, one needs to look at specific diseases. For example, consider breast cancer. Public health data shows that while only 20.7 Americans die of breast cancer, 22.4 C
anadians succumb to this disease.
But this raises an obvious question: 22.4 out of how many? The answer: 22.4 Canadians out of 100,000 succumb to breast cancer. So while 22.4 represents an 8 percent jump from 20.7, if you step back and think about it, the risk in Canada is just a hair higher. In truth, the odds that the disease will kill you are very, very low in both countries.
Looking at “percentage differences” when comparing the small number of people who die from a disease is a common trick that many conservatives use when trying to prove that the U.S. has “the best healthcare in the world.”
Of course, they leave out the numbers that don’t serve their case. For instance, while 47 out of 100,000 Americans die of lung cancer, only 46.2 Canadians are felled by this disease. Full disclosure, the number of deaths from colorectal cancer is somewhat higher in Canada (18 out of 100,000 vs. 14.4 out of 100,000 in the U.S.) But again, the fact is that the chances that you will die of colorectal cancer are very, very slim in both countries.
But conservatives don’t want you to know that. They want to play on your fears of a dreaded disease, and suggest that if the U.S. goes so far as to extend healthcare to all Americans, you will be in danger. So Morrison writes: “In Canada, colonoscopies are so rationed that the colon cancer rate is 25 percent higher than in the U.S. (even though Canada has a much smaller proportion of poor people, whose frequently bad diets make them more prone to the disease).” Keep in mind, he is talking about the extra 3.6 people out of 100,000 who die of colon cancer in Canada.
Maybe Canadians should be undergoing more colonoscopies, but a study funded by the National Cancer Institute and published in the Annals of Internal Medicine reported that American physicians are doing too many of these very lucrative procedures. “Researchers found that 24 percent of gastroenterologists and 54 percent of general surgeons recommend surveillance colonoscopy for small, hyperplastic polyps. For patients with single small, low-risk adenomas, many of the physicians recommend surveillance every three years, or even more often.
“Evidence-based guidelines, in contrast, call for no extra surveillance after removal of a hyperplastic polyp, a benign growth not believed to become cancerous. And while the guidelines do recommend surveillance colonoscopy following removal of adenomas, which can develop into cancer, at most the exams are recommended only every three to five years.
We believe colonoscopy can be a life-saving procedure, but it shouldn’t be done more often than necessary,” Dr. Pauline Mysliwiec the study’s lead researcher explained. “When it’s used inappropriately, it puts patients at unnecessary risk.” Risks include a punctured colon.
Responding to the rising number of unnecessary colonoscopies, the U.S. Multi-Society Task Force on Colorectal Cancer and the American Cancer Society jointly issued new guidelines in 2008, recommending that low-risk patients undergo the procedure only every 10 years.
Falsehood: Finally, Morris claims that Canadians die of cancer because they don’t have enough cancer drugs.
Facts: First of all, the statistics show only a tiny difference in the number of Canadians who die of cancer. So lack of drugs cannot be a big problem. Secondly, in the U.S. some oncologists complain that there are too many cancer drugs are on the market , and that the vast majority just aren’t very effective. Too many set the patient up for false hopes—and subject him or her to additional side effects—while prolonging the process of dying.
“The truth is that there is no clearly effective chemotherapy for a distressing number of malignances,” says Dr. Peter Eisenberg, an oncologist in Northern California who has served on served on the board of the American Society of Clinical Oncology and the Association of Northern California Oncologists.
In the late 70s and 80s, Eisenberg says oncologists were more enthusiastic about cancer drugs. “ If a patient had cancer, and we knew that tumors responded to a certain chemotherapy regimen by shrinking, physicians assumed that the patient should have it. It was not until much more recently that the notion of quality of life, and the fact that just because we shrunk a tumor doesn’t mean that people will actually live longer, was clear to us,” Eisenberg observes.
While it is true that Canada is slower to approve some of these drugs than the U.S., this does not mean the difference between dying of cancer and being cured. Consider Avastin , a drug that Canada approved to treat colon cancer in 2005—18 months after it had been approved n the U.S. Avastin costs the average U.S. patient $53,000 for a year’s supply. Meanwhile, clinical trials show that patients who receive a combination of chemo and Avastin live just 5 months longer. During those 5 months, patients are likely to experience common side effects of the drug including diarrhea, mouth sores, tiredness and weakness, headache and loss of appetite. Rare, more serious side effects can include “holes in the colon requiring surgery to repair; bleeding leading to disability (stroke); and kidney damage.” In other words, quality of life during those extra months is not likely to be very high.
Do you wonder why Morris doesn’t cite any sources for his numbers? Because the numbers just aren’t true.
Falsehoods: Dick Morris concludes his rant with a flourish “once the healthcare system is extended to cover everyone, with no commensurate increase in the resources available, the change will be forever. The vicious cycle of cuts in medical resources and in the number of doctors and nurses will doom healthcare in this country. This wanton destruction will not be reversible by any bill or program. A crucial part of our quality of life — the best healthcare in the world — will be gone forever.
“Politically, voters will feel the impact of these ‘reforms’ very quickly,” Morris adds. “ When they face rejection or limitation at the hands of the bureaucrats, they will quickly understand that the their options have become limited. Just as in the 1990s, when HMOs first became universal, the patient outrage will create a political force all its own and those who foisted this brave new world on the American people will be in their crosshairs.
Fact: Virtually no one, except perhaps George W. Bush still tries to make the claim that the U.S. has “the best health care in the world.” In the film of Money-Driven Medicine, Dr. Donald Berwick, founder of the Institute for Healthcare Improvement” makes it clear that we don’t have the most effective care—“we just have more care.” We do have some very hi-tech care that can “rescue” certain patients, but here were are talking about a tiny percentage of health care—probably less than 1 percent. When it comes to treating and controlling chronic diseases like hdon’t have the best health care in the world. (See tkt tk
A Final Observation: In just seven sentences, Morris manages to claim that reform will mean the death of American health care. “A crucial part of our quality of life . . . will be gone forever” and that “patient outrage” will overturn “this brave new world.” To say that our
current system will be forever gone—and to say that health care reform will be overturned might seem like a contradiction. But propagandists like Morris don’t worry about logical flaws in the content of what they are saying. There is no content. The rhetoric is all about style. When you’re spinning, it’s just a matter of hitting the right high notes, buzzwords like “our quality of life” . . . “brave new world” . . . “in their crosshairs.”
A false appeal to patriotism, an appeal to the fear of change that we all share–and a plug for rifles—a perfect coda.
Good article …good reading.
>>> “…regions and states with more medical specialists and general internists appear to have lower quality of care”
That’s partially because of the fee-for-service method of paying physicians. A salaried doctor (VA, military docs) is more likely to refer patients to someone more qualified but today’s docs are jealous and tend to keep them in-house so they can drive up income by ordering more tests.
>>> “It is not that most doctors are intentionally over-treating, but that they have been trained to do “everything possible” to treat a particular organ.”
I would disagree. Doctors ARE intentionally over-treating because of the fee-for-service system of payment (that converts to higher salaries).
>>> “…a shortage of nurses”
Yes, but much of that is because for-profit hospital CEOs are cutting the nurse-to-patient ratios to drive up profits (and their salaries), but that is also driving nurses out of the profession. In 25 years of owning an independent testing lab my company thrived on hiring burnt-out nurses.
Jack-
For-profit hospitals tried cutting nursing staff 15-20 years ago.
People died.
They found out it doesn’t work.
But most hospitals are understaffed (non-profit and for-profit) because nurses don’t want to work in the chaos of our hospitals. It’s not just pay, it’s the working conditions–tyring to do three things at once.
In regions where there are more specialists, the reserach shows that doctors do refer to each other– that’s how a patient winds up being treated by 10 specialists. .
Maggie, I’d suggest that you spend some time working in the industry and quit relying on so much heresay.
I am surprised and freightened about how “off the mark” Dick Morris is on health care reform?
I wonder why Morris got it so wrong???
Dr. Rick Lippin
Southampton,Pa
Dr. Rick–
Morris doesn’t really care about truth, just about power.
Most of what you say is on target. I have to make an observation about nurses that I am sure will stir up a hornets nest of controversy but …
I don’t think we have too few nurses, I think we have nurses that are burdened by too much “bullshit”. Spend some time in a hospital and watch how much time an RN spends with patient vs. how much time the RN spends writing in the chart.
Nurses spend more time “charting” than they do actually laying hands on the patient. I think this is due to 2 things; fear of malpractice and the constant demand to “document” what is going on, and the teaching of the nursing school professors who you claim we are so lacking.
My prescription; fewer professors of nursing in nursing school teaching nurses about documentation, malpractice reform and decreased demand for “charting” allowing nurses to actually spend more of their time with the patients.
Now let the projectiles fly!
In my experience with Canadian women who have breast cancer their initial treatments are pretty similar to those of women in the U.S. Some frills like shorter wait times and the availability of Plastic Surgeons with fancy skills depend on where in Canada they’re located and whether they have supplemental insurance.
If their cancer comes back after the initial rounds then differences turn up. I think they are not getting the expensive treatments like Avistan, or gamma-knife surgery for brain mets.
People get pretty strident when a loved one is denied treatment, particularly when their cancer has returned. We’re going to have to have a national policy/standard to trim back spending that doesn’t seem effective in that area.
As for Dick Morris – he’s already demonstrated his intregrity. I don’t know why anyone cares what he says!
“People get pretty strident when a loved one is denied treatment, particularly when their cancer has returned.”
I agree. One thing that would help a lot is both public and private insurers being willing to pay providers to take the time to discuss end of life issues with patients and their families. Right now they have no problem paying for putting in a central line but balk at paying for extended meetings where providers do “nothing but talk.”
There is another good article on discussion of end of life issues in the NYTimes, written by Pauline Chen. Here’s the link:
http://www.nytimes.com/2009/05/28/health/28chen.html?hpw
Ann, Legacy Flyer, Pat S.
Thanks for your comments.
Ann–
You write that Canadian women don’t get “expensive treatments like Avistan.”
I don’t think they are missing anything.
The FDA refused to approve Avistan in 2007 becuase they was no evidence that it prolonged life by more than a few weeks (if that) or that it improved quality of life.
Then, in 2008, the FDA surprised everyone by approving the drug–ignoring its own advisory panel (which it rarely does.)
A course of treatment costs $55,000. There was still no evidence that it prolongs life.
There can be very serious side effects.
But Genentech, which makes Avistan, is a powerful company.
You speak of families becoming “strident” when the cancer comes back.
Families need to understand that there is no cure for many cancers.
In some cases drugs can prolong life–though quality of life might be poor.
Doctors need to be candid with patients and families and tell them “Your loved one is dying. We could give her this drug–and it might give her 2 extra months–though quality of life may be quite poor.
Ideally, a palliative care specialist talks to the patient and the family, laying out the options, and letting the patient make the decision.
See the NYT article that Pat S. links to in his comment. It makes it clear that patients and family are actually better off if the doctor makes it clear that the patient is dying.
Legacy Flyer
Both nurses and doctors tell me that nurses are expected to do too many different things in today’s hospitals, and as a result patients can fall between the cracks . .
I don’t know if documentation is the problem.
But I do think that nurse/managers need more say in how hospitals are run.
These days, hospital admniistrators are often MBAs–they are not nurses, they are not doctors, and they really don’t understand that hospitals are different from any other business.
Too often, these hospital administrators put profits ahead of patients when making decisions.
Pat S.
Thanks for the link to the NYT article.
I agree that doctors should be paid for the time they spend talking to patients.
At the same time, I would hate to think that doctors don’t talk to patients about death because they aren’t paid for the time it takes to have that difficult converesations. (And I know that isn’t what you were saying.)
As the Times story makes clear, doctors don’t like to talk about death and dying because they don’t know how. They’re not trained to do this. They themselves find the whole idea of death frightening.
Talking about death and dying needs to become part of medical school training.
The one thing I will say about paying providers to have a big talk about dying is that if it is coded and paid, it is well on its way to becoming standard. If the payers refuse to recognize it as a service, that contributes to the perception that it is a frill that is probably not necessary. In reality, it is necessary and is actually cost effective, since it contributes to more appropriate use of resources, benefitting the patients and their families as well as society as a whole.
I agree that doctors and other providers need more exposure in their training to addressing death and dying.
Pat S.–
Point taken. If talking to patient (and family) about dying is coded it will become something that doctors (and medical schools) will see as part of what doctors are expected to do.
Great article, Maggie.
I do agree with Legacy Flyer on the documentation issue, and the staffing issue. Especially in systems that have moved to computerized charting, nurses spend more time at computer stations than they do at the bedside. I see this every day I am in the hospital with my students.
Most documentation system are poorly designed, usually without any input from nurses. I’ve seen several systems that are either non-user friendly, or waste time documenting in a format that no one can read.
I do some legal consulting. I hate going through computerized documentation because it can be so difficult to get a clear picture of what really happened to the patient if the software is poorly designed. I have the same problem when my students and I are researching the chart in clinic.
Nurses spend an increasing amount of time with drop down menus and check boxes, and often don’t really understand what they are charting. I find the quality of assessments going down.
Nurses need to be at the bedside actually LOOKING at their patients.
As to staffing, I also agree we have plenty of nurses in this country. They simply aren’t working at the bedside. Better pay and more importantly, working conditions would go a long way to solving that problem.
And I also agree with you on the issue of specialists. I often see several consultations on each admission. Even my hospice patients will have several physicians of record. This leads to fragmented care. Sometimes figuring out which physician to call for orders can be a real chore.
As to the issue of too much care: Americans are brainwashed into believing they must do everything possible to save the life of an ill person. We see it in tv shows like House. Doctors are portrayed as gods who hold the power of life and death in their hands. This does a disservice to the medical profession–real doctors know all too well their power has limits. Yet they too are often brainwashed into doing more than necessary.
They are programmed to believe that they must do “everything possible” because they are brainwashed into believing that’s what patients want, because to have a patient die means the physician failed in some way, because if the patient dies and they “with held care” they can be sued.
My first nursing instructor summed up the differences between doctors and nurses this way: Care and Cure. Nurses care for their patients. Doctors cure them.
So the goal of medicine is still to cure disease, rather than to treat the person. Doctors either are afraid or don’t realize that the best way to treat the patient is to tell them they are dying, and give them time to prepare for death in a way that gives them dignity and comfort.
Patients feed into this because they believe their familes want it, or the family feels guilty if they don’t push for a cure, or because culturally patients are not given bad news.
This lack of information sharing inhibits the patient physcian relationship. If there are no clear expectations of what medical care is expected, and how it is to be delivered, then both patients and physicians make decisions based on false assumptions about what the other wants/needs.
Just look at the situation with the boy in Minnesota with lymphoma. The doctors are not listening to the patient or the parents. The courts are not listening. They assume they know better because the patient is young and the family obviously doesn’t understand the seriousness of the issue.
Believe me, those parents understand. They’re not religious nuts. They’ve seen what chemo did to their kid, and they fear the cure is worse than the disease.
Until we come to terms with these issues, quality of care will not improve.
Panacea–
Thanks very much for you comment.
What you & Legacy Flyer say about nurses spending so much time on documentation makes sense.
From what people tell me the problem is that the health IT in many hospitals today is way too complicated (and too expensive.)
It’s not designed for a busy hospital; it’s designed for a quiet office where users have much more time. And it’s designed by people who have no experience in providing clinical care.
I completely agree that medicine needs to pay more attention to Care rather than focusing so obsessively on Cure.
We all will die, and at that point, we’ll need Care.
Regarding the boy in Minnesota–it’s my understanding that he is suffering from a cancer that could be cured.
But I’m not an oncoloigst, and don’t know anything about the specifics of the case.
Still, even if the doctors were right that they could cure him, it strikes me that the doctor(s) failed to talk to the parents in the right way.
Probably no one sat down with them, took their concersn seriously and explained why they were hopeful (assuming the doctors were hopeful).
Doctors needed to take time to really respond to the boy’s suffering as a result of the chemo, and to reassure the parents () tha the chemo coudl actually could save him. (assuming that this is true.)
Taking the parents to court was the worst possible move and suggests an arrogance that would make me, as a mother, very reluctant to trust the doctors or the hospital.
The problem with the boy in MN is parental eccentricity.
The boy received one round of chemo and had the expected side effects: nausea, fever, loss of hair, etc. He was not happy with it.
He showed good results from the chemo, but his doctors wanted to continue with additional rounds of chemo.
The mother then decided she would manage the kid with herbal therapy as suggested by her religion, some sort of Native American oriented set of beliefs (she and her family are not Native Americans.)
She has now decided to submit her son to the chemo, at least partly because a re-check of her son shows the disease is progressing again.
I have known quite a few really enlightened oncologists who have excellent patient relations and could explain the facts in an empathetic way to a stone. They still run into patients who, for a variety of reasons, refuse treatment they should get based on the science. Since most of them are adults, they are free to do that. The unusual thing here is not that the family refused therapy, it is that the patient is a child, refusing a usually successful treatment strategy, and the doctors felt obligated to go to court.
Part of the problem in all this is that almost no cancer therapy is 100% successful — people die of diseases that can be successfully managed 80%, 90%, 95%, or 99% of the time. Small percentages — 1%, 3%, 5% — of patients also end up doing well without therapy. An honest oncologist has to explain that to her patients, and patients inclined to refuse treatment often seize on those facts to support their own decisions.
I’m glad you guys are talking about the boy in Minnesota. We’ve all seen stories like this in the media before and I usually agreed with they way the parents were portrayed by the media “religious nuts.”
However, I watched this Minnesota story play out in a much different light, I saw it through the eyes of a patient safety advocate who is much too familiar with all that ails health care. I thought the same things, not all cancers are curable, I thought of Maggie’s movie and the child who went through 12 years of cancer treatment, 12 years of hell for the entire family because the doctors said so, I thought of Farrah Fawcett and how her treatment is extending her life, an extension full of suffering and misery.
I think of all these things and I think HOW DARE a bunch of doctors and some judge hunt this mother like a criminal and HOW TYPICAL of how our healthcare system to abuse, ABUSE this family in such a familiar pattern. Should this child be forced to undergo chemo-therapy? It’s not for me to decide, it’s up to his parents who I would hope are making their decision based on what they think is best for their child….like another poster said, what type of informed consent discussion did they have? Did it mirror the Wennberg’s (from Maggie’s movie). It sure as hell isn’t for some judge to decide. Arrogance and bullying, that’s what I saw happen to this Minnesota family, and that’s pretty typical, I think, of how patients are treated.
You know what else? If that family couldn’t afford to pay for their child’s chemo, would they still be hunting them down like criminals, forcing them to get medical treatment? Let’s talk about that, because this country is full of people who are left to die because they can’t afford medical treatment…this Minnesota situation just doesn’t seem to make much sense. What if the parents had consented to chemo, but couldn’t pay for it, so he didn’t get it. Are they still criminals?
On the boy in Minnesota–
My sense is that a doctor just didn’t take the time–or didn’t have the empathy and imagination –to talk to the paretns in the right way, and rwally explain that while the side effects are very distresing, the chances of curing the cancer are very good.
(We should pay doctors for the hours it taekes to explain these things We pay dcos to cut and burn. We should pay them less to do that–and more to listen and talk )
That said, Pat S. could be right.
These might have been parents who just wouldn’t listen—until the mother saw the boy getting worse.
Too many physicians always add to the trouble.Too many diverse tests to get to a simple point…maybe very confusing and misleading for the patients.