[cancer] Work, society and me

Spent my first day in the new offices of the Day Jobbe yesterday. We were in an all-day meeting, in a conference room where the HVAC had been set to rather a low temperature to compensate for the presence of about twenty people. My hands were tortured by the air temperature. Also, I couldn’t open the water bottles, because I no longer possess enough hand strength to twist the cap hard enough to break the seal. It was good to be back among my peers, for whom I have been nothing more than a voice on the phone since last October.

Walked again this morning. Slightly farther and faster and yesterday, with a bit less distress to my feet. It was 81 degrees at 4:30 am around here, so I was fairly comfortable other than the nonsense in my extremities.

This morning in link salad I included a piece from Freakonomics, The End-of-Life War. That piece in turn includes a backlink to one of their earlier pieces on cancer costs. Freakonomics has been critical in the past of the value of cancer treatments.

In my case, the approximate retail value of the treatments I’ve received to date is in the neighborhood of $350,000. The actual insurance payouts are closer to $150,000. If as expected I have the forthcoming liver surgery and another chemo course, those numbers will rise to roughly $600,000 and $200,000 respectively. I suppose this is the ultimate form of NIMBYism, but I really don’t want healthcare cost cutting to begin with cutting my cancer treatments.

The discussion seems to be mixed in with late life and end-of-life care (as with the above Freakonomics link), where costs are often assessed in terms of degree of life extension and quality of life. Given resource constraints, I understand why these calculations are made, and why they are necessary. But as someone who can reasonable expect to live at least another 30 years if my cancer can be controlled, I think even that calculus shouldn’t condemn me. Add in conservative political resistance to extending and improving healthcare coverage (in my case, the relevant factor is lifting the lifetime cap), and the calculus becomes even stranger and more inhumane.

As I said a while back, I’m not willing to die for my conservative friends’ principles of limited government. Nor am I willing to die for the sake of an economist’s calculations. Certainly the costs of my treatments have already exceeded my lifetime payments in to the health insurance system, let alone to my current carrier. What is my life worth to them? What is my life worth to you?

My life is of infinite value to me, as this life is the only one I will ever have.

2 thoughts on “[cancer] Work, society and me

  1. pelican says:

    I’m in health care and I moved to the Canadian system two years ago. After I got here, I learned something that is really important, something that I may have understood intellectually (and thought I was being too cynical), but that I certainly did not understand emotionally until I’d been here a while.

    Many Americans think that they and their loved ones are OWED around 100 years of good healthy life- if not actual immortality- and that if something other than health and happiness is happening to them, they are getting screwed and someone is to blame … because they, personally, are NOT SUPPOSED to get sick, let alone die.

    I don’t read Freakanomics, but in my experience the fiscal (and moral) failings of the US health care system that have to do with end-of-life care are:

    1. painfully keeping the actively dying alive for days to weeks out of the wish to “do everything,”

    2. forcing those who are severely demented to live for months to years under increasing pain and stress through invasive procedures, aggressive treatments, and multiple hospitalizations.

    I don’t know you personally Jay, but from reading your blog, I don’t think you want to spend your last weeks (which will hopefully be decades from now) in the ICU, delirious or comatose, having “everything” done.

    Nor, do I think that should you live to the age of 85 and develop a severe dementia, that you would want to spend your last months to years incontinent, unable to speak or respond in any way that is actively communicative, bed-bound, with a feeding tube and a spreading bed sore on your sacrum that is deep enough to reach bone.

    I have no problem, in either of these situations, working in a health care system that is empowered to tell families “Your loved one is dying. It is her time. We are going to make her as comfortable as possible.” I have even less problem, as someone who WILL die (hopefully after getting old but no guarantees), living in a system where the default response is to preserve my quality of life and my dignity.

    I find it ironic that the label “conservative” encompasses both those people who would restrict health care for people who are living in order to “cut costs,” and those who claim that their religious beliefs should force the rest of us to pay for the care of someone like Terri Schaivo. Certainly, those who have religious beliefs that necessitate “doing everything” should be able to practice their religion freely … just on their own time and their own dime.

    All that said, the major costs and inefficiencies associated with health care in the US are administrative and these end-of-life issues shouldn’t be anyone’s major target for fiscal change. The real problem is that the current system (even post-Obama) privatizes reward and publicizes risk, and that discussion of any other issue is -IMHO- smoke and mirrors to whip up fear to keep people from doing *that* math.

    And, glad to hear you’re back at your day jobbe … have you considered some version of a “hand muff” for the conference room components of day jobbe? Easier to pull your hands out quickly than gloves, but still provides warmth and pressure (if your hands like pressure)? There are manly versions (black and camo) available in most hunting supply stores, some of which can support chemical heat packs, for truly bad days.

  2. Bryan Schmidt says:

    As I said a while back, I’m not willing to die for my conservative friends’ principles of limited government. Nor am I willing to die for the sake of an economist’s calculations. Certainly the costs of my treatments have already exceeded my lifetime payments in to the health insurance system, let alone to my current carrier. What is my life worth to them? What is my life worth to you?

    Jay, have a friend in England who hs been denied surgery by their public healthcare several times for surgery the govt claims is non-essential but his doctor says is. In fact more than one doctor because he got multiple opinions hoping to influence the govt decision.

    Unlimited government healthcare can be great stuff.

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