Sunday, October 14, 2012

Rocks From Heaven

The ten year old who suddenly develops a high fever and has swollen lymph nodes, it turns out to be leukemia, an acute variety, the 30 year old mother who upon awakening stumbles and cannot stand up and has a glioma, the 25 year old who suddenly looses sight and has MS, the 15 year old who suddenly break a leg bone, and has osteosarcoma, these are those rocks from heaven that hit many people day after day. Medicine may help, a bit, and perhaps more every day,

But upon reading an article in today's NY Times I was a bit confused. Here was a fifty year old man who decided to avoid any form of health care until the top caved in and the opinion writer tries to infer that it is the Republican's candidates fault. How far can this be stretched. Every obese person has assumed a certain risk for their behavior, every substance abuser as well, these are life style choice diseases. Every person who spends too much time in the sun also takes on a risk, one mitigated by subsequent follow ups to spot a pigmented lesion early and excise it, but with the risk is responsibility.

In the Times case there was abject and deliberate abrogation of any personal responsibility. It recounts a person who decides to leave a job and health coverage to go out a enjoy life and who neglects some key points, the result is terminal cancer. It is one of those things many a young physician often thinks but should never say, "Why didn't you come here earlier?" It is the case of seeing a 65 year old woman in the ER who has been both constipated and bleeding for six to eight months, only to discover that she has stage IV colon cancer, and she had insurance. Why did you not come here earlier? Terror, not cost.

As the writer states:

Yet remember also that while .... was foolish, mostly he was unlucky. He is a bachelor, so he didn’t have a spouse whose insurance he could fall back on in his midlife crisis. In any case, we all take risks, and usually we get away with them. Scott is a usually prudent guy who took a chance, and then everything went wrong. 

The Mitt Romney philosophy, as I understand it, is that this is a tragic but necessary byproduct of requiring Americans to take personal responsibility for their lives. They need to understand that mistakes have consequences. That’s why Romney would repeal Obamacare and leave people like Scott to pay the price for their irresponsibility. 

To me, that seems ineffably harsh. We all make mistakes, and a humane government tries to compensate for our misjudgments. That’s why highways have guardrails, why drivers must wear seat belts, why police officers pull over speeders, why we have fire codes. In other modern countries, ... would have been insured, and his cancer would have been much more likely to be detected in time for effective treatment. 

This is preposterous. The person in question may not have ever gone to a physician, the behavior seems to indicate as such. Furthermore under the ACA and the new CEC Panel they would have outlawed PSA tests anyhow.  Yes, you do have consequences for your actions. Take illegal drugs, then possibly HIV or overdose, smoke, lung cancer, sun tanning, melanoma, obese, well just dozens of things. Personal responsibility is key to a stable society. If no one is responsible but we all are for those who refuse then what is left, chaos. One can pity this person, one should, but he made a choice, choices have consequences. Ride a motorcycle without a helmet and speed on sandy highways and perhaps you will have an accident.

Is it harsh that the 10 year old has AML? Yes it is, the 10 year old had no choice. Should we as a society take care of the child, without a doubt. But a Harvard educated 50 year old who decides to make a choice which has possible serious consequences, well that is a different story. People have duties, responsibilities, not to be deliberate burdens on others. The counter is that society does have a duty or responsibility to deal with the rocks from heaven, the people who for no reason of their own making find themselves distressed. 

Is this Romney's fault that this individual made a personal choice which had consequences. If I chose to bet all my money in Black Jack games and lost is society to reimburse me for my bad luck, or stupidity, I think not. Is that 65 year old woman with terminal colon cancer responsible for her state, perhaps. Is the 10 year old child, never. 

We are in a society where there are well placed warning signs. Some are confusing, made so deliberately by Government, such as the PSA test, but others clear such as smoking bans. Some which should be more clear such as obesity.  But one would assume that a Harvard graduate would have some semblance of both intelligence and insight, and is it Romney's fault, doubtful, after all it is the current president's administration which wanted to do away with PSA tests as it stands, thus the end point may not have changed. Perhaps this is just a very poor example to prove one's alleged case.

Perhaps the most severe misstatement in the piece is that we all make mistakes but a "humane" government makes up for our misjudgements. Wow. Think of all the dumb things we have done in our lives, in the past we learned from them, not to repeat them. Now the left wants the Government to take away that primal learning experience. As I have said before to my children, every action you take has a consequence, think it through and act accordingly, you must live with the result.