Back from the Dead

By Robert Wallace
America’s Right

The headline read Back from the Dead, and at first glance the article seemed to be just one of those occasional happy, tearful medical miracle stories: A 56-year old man walks into a hospital feeling sick. Minutes later he collapses and his heart stops beating. For nearly an hour a team of doctors work relentlessly. They refuse to give up on the man, performing 4,500 chest compressions and administering 8 electrical shocks while using state-of-the-art technology to cool his body temperature down to 91 degrees to prevent brain damage during the ordeal.

Finally the man’s heart begins to beat again. He is placed in a medically-induced coma, and three days later he awakens with no brain damage.

“These doctors did not stop,” Joe Tiralosi said, fighting through tears to find the words to describe his experience. “Without them, and I’m serious when I tell you, I wouldn’t be here.”

So far, so good, but consider this exchange between a CBS interviewer and one of the doctors who refused to give up on Joe:

CBS 2 HD: Was there a time after 47 minutes in the room when someone said ‘Guys, enough’s enough. Time to end it’?

Dr. Gaudio: There were whispers of that but I imagined that he was a man with a family, with a family someplace and I didn’t want to go out and tell that family that we had lost him. I had to keep going.

Dr. Gaudio and the others who refused to give up on Joe were not making an economic decision. They were not tabulating the cost of their 45 minutes of service. They weren’t factoring into their decision making the expenditure of the three days Joe spent in the medically induced coma recovering. They didn’t estimate the price tag for all the costs that would be incurred testing him during his recovery. They were making a medical decision, the kind of life-and-death decision doctors make every day across this nation.

People who support the current health care reform experts no doubt believe that not worrying about costs is precisely the point of health care. Everything will be covered, right?

Wrong.

The recommendation that women younger than 50 and older than 75 not receive mammograms was an example of the kind of economic calculus that will take creep into our health care system if the government takes over. The government may very well pay for everything that is available, but it will also decide what is available. And when it makes that calculation you can rest assured that dollars and cents will be a part of the equation. And I can tell you right now that when the actuaries are tabulating the expected cost vs the expected benefit of treatments, several doctors and nurses spending an hour beating on the chest of a slightly chilled dead man is not going to make the cut.

Of course the alternative approach–reforming the health care system through free market principles–is not perfect. No system is going to be perfect. No system will ever be able to pay for every conceivable treatment for every person. No system will ever be able to even out the unfairness and randomness that is inherent in mortal life. I won’t promise that a free-market based system will erase human misery and sadness because human misery and sadness are a part of human life. As the Dread Pirate Roberts put it: “Life is pain, Highness. Anyone who says differently is selling something.”

The alternatives before us are not free health care vs. health care for the rich. Not only can government-run health care not offer us more efficiency, it can’t even offer us greater equality! (Anyone stopped to wonder why Senators and Representatives are keeping their own health care plan instead of the government option?)

The options we have are a realistic attempt to make the best of an imperfect world versus a deluded attempt to pretend that we can legislate our way back to the Garden of Eden. If we try to make-believe our way back to the Garden of Eden we are going to end up where Utopian efforts always finally crash-land: a dystopia. If, on the other hand, we are willing to embrace the awful randomness and tragedy of life then–out of misery–we will sometimes be able to rescue joy, as Dr. Gaudio and his team did.

The real decision we have before us is the decision between a massive self-inflicted tragedy we will never escape, or natural medical tragedies that–every now and then–we can.

—————
Robert Wallace ┬áis classical liberal studying economics in graduate school. He and his wife work as business analysis consultants, and they live as undercover conservatives with their two small children in a socialist bastion of a college town. He has been writing for America’s Right since December 2008.

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Comments

  1. T.I.M. says:

    Robert…Thanks for the Dread Pirate Roberts reference. Fans of "The Princess Bride" will note that after scaling the Cliffs of Insanity,"Roberts" is also brought back from the brink of death to live again. Or, in the movie's own words: "She gets kidnapped, he gets killed. But it all ends up okay." For either readers or movie fans, this is an extremely entertaining and well-written tale. Let's hope our health care "adventure" turns out as well.

  2. Anonymous says:

    WHY IS US HEALTHCARE THE BEST?

    Mr Wallace,

    I'm just a self employed individual who is having a hard time understanding why people think that the US has the best healthcare in the world.
    The US spends considerably more on healthcare than any other nation, yet people in the US have lower life expectancies than almost all other industialized countries.

    When I make a business or personal decision, I think about results. If I had to decide between two healthcare systems that I was going to provide to my employees…where system (a) had much higher costs and shorter lifespans, and system (b) cost less and people lived longer….I would choose system (b).

    If you would, please enlighten me and tell me where my logic is flawed.

    I read below your entry that you are studying economics. I'm not as educated as you, but I don't see where anecdotal stories have any
    place in economics.

    Chuck

  3. Ian Thorpe says:

    As you know Robert I live in a country with a public health system (and believe me it is not "free."

    But public or private, as I remaked on one of Jeff's posts yesterday the problem now is medical science has advanced so far that most lives can be prolonged greatly so long as an endless supply of money is available.

    Somewhere along the line somebody is going to have excruciatingly difficult decisions to make based on what is affordable.

    Just don't let America go down the road Britain's National Heath Service have taken where a bureaucrat fills in boxes on a form, applys a punched template and the form makes the decision according to how many filled boxes appear in the template's holes.

  4. Robert Wallace says:

    Chuck-

    I hope that your question was sincere, because I actually can tell you precisely where your logic is flawed.

    I'm going to use an analogy. Country A and Country B both have 1,000 people. They have identical healthcare services. The same number of doctors, the same number of nurses, the same technology: the same everything.

    The only difference is that people in Country A generally have healthy diets and lifestyles, but people in Country B are obese and sedentary.

    So what do you think the outcomes would be?

    Obviously Country B is going to have much higher rates of diabetes, heart disease, and other lifestyle-related conditions. And obviously Country B is going to have a lower lifespan.

    So – despite the fact that they have identical healthcare systems – if you used lifespan to judge healthcare Country B would look much worse. And you would be *wrong* to make that conclusion.

    The principle of this analogy is that you need to separate lifestyle/diet impacts on health outcome from healthcare impacts on outcomes.

    The simplest way to do that is to say "Given that a person has disease X, how do they far in Country A vs. County B?"

    So in this example you would say "There are 10 obese people in Country A, and there are 100 obese people in Country B, how do the healthcare results compare for these similar groups?" And what you'd find is that they get identical results *for those groups of people*. The problem is just that Country B has more of them then Country A.

    In the real world you can ask simple questions like "OK, for people who are diagnosed with cancer (or whatever) what are the results in America vs. the UK (or wherever)?" And when you look at the conditional probabilities that is where you see that the American healthcare outcomes are the best.

    So – to put it really simply – Americans have better healthcare but worse diet and lifestyle.

    "I read below your entry that you are studying economics. I'm not as educated as you, but I don't see where anecdotal stories have any
    place in economics."

    Which would be why this is in a blog post directed to the general public and not a research-paper targeting an academic audience in a peer-reviewed journal.

  5. Gail B says:

    Robert, you are awesome!

    You write well, and you are oh, so smart!

    Jeff, you have a lot to be thankful for in Robert, but then you are smart enough to know that already!

    Great article, and thanks!

  6. Randy Wills says:

    I would like to add a comment to Robert's excellent article and subsequent response to what I consider a sincere question by "Chuck".

    Robert's statement within his original article regarding "a return to the Garden of Eden" is exactly the point. Virtually every law or program that the government intiates is an attempt to fill the void left by the waning relationship between God and Man.

    How that bears out in Chuck's question and the sad story by "Anonymous" @ 10:52 AM is twofold:

    First, a well grounded relationship between the God of the Scriptures demands that the outcome of life's situations depends on two things; the understanding that we have a personal God who is interested and active in our lives and, secondly, we have a role in the outcome by taking repsonsibility for, and hence govern, our personal behavior. This includes personal habits of health and finance.

    In the sad case of the person who needed treatment but lacked the co-pay illuminates another factor in the whole saga of the "return to the Garden of Eden". We have become a people who depend on third-party solutions to our personal problems. We were intended to have relationships and responsibilities relative to each other (it's called community and concern for our fellow man) that makes unncecessary our dependence on disinterested, "for-profit", third parties – both the medical service providers and the insurance companies – who are consumed with self-interest rather than the welfare of the patient.

    A commitment to personal responsibility and integrity as taught in the Scriptures is the answer to this problem – not more doomed-to-fail government programs.

    Randy

  7. Anonymous says:

    these are some of the real giants among us. wow!
    May God bless each and every one of them every second of their lives.

  8. Anonymous says:

    Robert,
    Great article. One could only wish that this reform thing was about health care. It's not! It is a power and money grab, pure and simple.
    If these immoral bozos in DC wanted to fix some of the existing problems in our health care system they could do it for next to nothing compared to the $2T they are budgeting.
    A)Kill the State insurance monopolies; I want to buy insurance from a full shelf of products.
    B)Change the tax code. Let me have the same tax break that companies have.
    C) Give Medicare recipients a voucher to buy the policy thy want.
    D)Fix the tort laws (or kill all the lawyers- which ever is easiest.

    That would be a good start.

    kentek
    the States

  9. Anonymous says:

    I have to say, I am baffled about the reform Congress is attempting when all they talk about is insurance.

    Here's a great example of what needs to be fixed:

    After two years of trying different medications under treatment monitored by her employer (State of IL), my sister took it upon herself to get an MRI.

    She then took that MRI to a surgeon who was very agitated that she had not been sent to him or another surgeon earlier.

    Her condition is so severe, she risks permanent paralysis by delaying surgery.

    The CTscan was supposed to be yesterday. The insurance company called the provider the day before and told them the insurance company would not pay on the procedure if my sister did not pay the $175 co-pay BEFORE the procedure.

    Big surprise that my sister didn't have $175 on hand the day before she was supposed to have the procedure.

    She'll have to wait until next month.

    Does that sound right to anyone?

  10. Boston Blackie says:

    Robert, Great response to Chuck – simple and concise. It may be the fact I am 30 years out of college so I understand things more because of life experiences but WHY couldn't I have had professors like you when I had to take economics.

  11. Dee says:

    I worked in a hospital for 20 years, one of the finest in the area. We have people from all over the world coming there for treatment. They have taught other countries how to perform some of the procedures. I also worked in the trauma ICU with doctors who would give the patients every chance to survive rather than quit. The cost was never a factor to them. They enabled many a young person to continue living. I greatly admired them and have always felt that they deserved every dime they earned. Thank you for a wonderful article.

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