Death vs. Life

“If some messenger were to come to us with the offer that death should be overthrown, but with the one inseparable condition that birth should also cease; if the existing generation were given the chance to live for ever, but on the clear understanding that never again would there be a child, or a youth, or first love, never again new persons with new hopes, new ideas, new achievements; ourselves for always and never any others-could the answer be in doubt?”
-Gates of Repentance

As we read this passage during the Yizkor (Memorial) Service on Yom Kippur, Judaism’s holiest day of the year, contemporary thoughts entered my mind. Does the healthcare debate pertain to this quote? Many additional questions germinated from this question. What do we want from health care? How far do we go to keep a person alive? Who should make decisions over life and death? Should the individual, their family, the doctor or doctors, the hospital or the government make those decisions? Should the decision be based on saving life no matter what, or life expectancy, or quality of life, or cost?

For all of the existential questions pertaining to healthcare, the general view seems to be as follows. For general problems of illness or injury healthcare should cover those incidents. When it comes to the life of a child, parent or grandparent, we think that everything possible should be done to keep our loved one alive. When it comes to someone else’s loved one, we do not want to be the person responsible for such decisions.

Those questions require intense discussion. In our national debate, those questions require intense discussion. If we do not find the answers going into this unknown area the unintended consequences will be enormous. In my opinion, cost will become the determining factor and only cost. Medical costs continue to soar way beyond the rate of inflation. That may be understandable occasionally but year after year. When the government took over the care of our senior citizens with Medicare over 40 years ago, the cost of medical care was approximately 6% of the GDP. Today the number is approximately 18%. We are having this debate now because healthcare is already reaching the non-affordable point.

This brings me back to the quote and the need to address the existential questions proposed. Because of medical advances, average life expectancy is approximately 80 years of age and will continue to increase for the foreseeable future. Is our ultimate goal to live forever? If so, our healthcare system costs will continue to explode. Will we come to the point where we can no longer allow people to have children? Are we being so selfish about our lives and those of our family, to say that there should be no one to follow us? I know these are extreme thoughts. I do not think that anyone truly believes that these actions will lead to this conclusion. Like the quote, most people would answer no to what is proposed. But how far do we want the healthcare system to take care of us and our loved ones? Should this not be the starting point of our debate rather than an afterthought?