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Monday, April 04, 2005

You Get Life - and Death

Life is a terminal condition from which there is only one escape: death. Everything a man can possibly achieve is dependent on remaining alive, and that is why we fight death so hard. As long as someone lives, we tell ourselves, there is a chance – some small chance – that they may still yet achieve greatness. They may still provide that spark that lifts humanity from its pitiful self-imposed chains and sets our collective feet on the path of true liberty and freedom.
Life is precious. Anyone who has held a newborn or watched a loved one slip into oblivion knows this personally. As we watch someone heroically battle to remain in this world, so often now with tubes running in and out of every possible entry in the human body, we grit our teeth and declare that their life must be preserved at any cost. Rage, rage against the dying of the light!
But we don’t mean it.
As Jim Wallis has been reminding us for quite some time now, a budget is a moral document – a statement of values. This year’s federal budget is now winding its way through the legislative process with only the barest sound of protest about how it fails to provide life to millions of Americans. Medicare will be cut – sorry, seniors, who thought the Medicare prescription plan would help you buy medicine. Medicaid will be cut – sorry, kids, who thought they could go to the doctor when they got sick. Sorry all you guys and gals out there working for low pay and no benefits – you still have to pay Medicare tax but get absolutely no medical benefits at all.
This is happening because we insist on calling these programs “health care” programs. That makes them sound optional. After all, everyone can improve their own health – eat better, exercise, stop smoking and drinking. A health care program promotes good health. There’s always some fat to be trimmed in that mission.
The problem is that they shouldn’t be optional. If they were deemed “life care” programs, no politician in the country would dare try to cut them. Expanding them to cover everyone equally would be such a no-brainer that it would happen overnight. It would be a radical shift in our political and medical paradigm. It would force us to face some very tough questions, perhaps even some questions that do not have any good answers.
When, for example, do we decide that life is no longer worth protecting and defending? President Bush said recently that we should always err on the side of life. Always? Our technology is advancing so rapidly that we may soon get to a place where death, literally, may be forever forestalled – as long as you have money to keep the machines on. Do we, as a society, have a duty to force everyone to submit to that type of existence?
To my mind, the only thing more pitiful than denying someone who is begging for death is denying someone who is begging for life. Former Oregon governor John Kitzhaber writes today in the Christian Science Monitor ( click here) of a very compelling case where budget cuts necessarily led to someone’s death. Yet it is the “health care system’s” failure – not our life care system’s failure. Here was someone whose wishes were well known – he wanted his damn medicine! – and yet no one reached out and saved him. His death is only ironic because it was caused by a desire to save money and the manner of his dying cost hundreds of times as much as it saved.
It is cruel to have a system that denies you the medicine you need to live because it costs a couple of dollars, then denies you the death that lack of medicine caused by running up a bill of thousands of dollars. It is possible only because we view it as “health”, not “life”. Only when loss of life becomes imminent does it become obvious to us that we have made a mistake. At that point, no machine can bring back what we have callously thrown aside.
No man wants to think about his own death. Only a fool, though, denies that it will one day happen. By framing medicine as a quest for “health” rather than “life” we mask the real nature of the question before us. We could do more for the collective health of the country by stopping the heroic measures we use to extend life a few more weeks at its very end and applying it to life programs earlier in life. It would mean truly accepting responsibility for the shape our bodies are in when we get old and it would mean actually dealing with our mortality honestly.
Life is a terminal condition with only one escape: death. If we truly want to create a culture of life, and push death’s grasp back, then we need to form life programs instead of health programs. We need to learn how to live. Maybe then we can learn how to die.

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