I NEED THIS IN 2 HOURS.
Please read the article “Do the Poor Deserve Life Support?” Please discuss scarcity, as well as information that you gain from this article, I would like you to compose an essay that addresses what we should do with patients who are unable to pay their bills for the services that they require. Please use the scoring rubric as a guide for your essay.
I will be uploading my essay assignment to the “Turn it In” tool which will be checking for PLAGIARISM.
Dothe Poor Deserve Life
Support?A WOMAN WHO COULDN’T PAY HER BILLS IS
UNPLUGGED FROM HER VENTILATOR AND DIES. IS THIS
WRONG?
By Steven E. Landsburg
Po ste d Tu es da y, J an . 3 , 20 0 6, at 6 :30 AM ET
Tirhas Habtegiris, a 27-year-old terminal cancer patient at Baylor Regional Medical Center in
Plano, Texas, was removed from her ventilator last month because she couldn’t pay her
medical bills. The hospital gave Ms. Habtegiris’ family 10 days’ notice, and then, with the bills
still unpaid, withdrew her life support on the 11
th
day. It took Ms. Habtegiris about 15 minutes
to die.
Bloggers, most prominently “YucatanMan” at Daily Kos, are appalled because “economic
considerations,” as opposed to what the bloggers call “compassion,” drove the decision to
unplug Ms. Habtegiris. I conclude that YucatanMan either doesn’t understand what an
economic consideration is or doesn’t understand what compassion is, because in fact the two
are not in conflict.
Here, for the edification of bloggers everywhere, is an example of an economic consideration:
If you ask people—and especially poor people—what their most dire needs are, you’ll find that
“guaranteed ventilator support” ranks pretty low on the list. OK, I haven’t actually done a
survey, but I’m going out on a limb here and predicting that something like, say, milk, is going
to rank a lot higher up the priority list than ventilator insurance.
In fact, I’ll go further. The back of my envelope says that a lifetime’s worth of ventilator
insurance costs somewhere around $75. I’m going to hazard a guess that if, on her 21
st
birthday, you’d asked Tirhas Habtegiris to select her own $75 present, she wouldn’t have
asked for ventilator insurance. She might have picked $75 worth of groceries; she might have
picked a new pair of shoes; she might have picked a few CDs, but not ventilator insurance.
She might even have picked something health-care related—a thorough physical exam, or, if
there were better markets for this sort of thing, $75 worth of health or disability insurance. I
doubt very much, though, that with $75 to spend, she’d have chosen to insure against
needing a ventilator as opposed to any of the other minor and major catastrophes to which we
mortals are susceptible.
Now let me remind you what “compassion” means. According to Merriam-Webster Online
(which, by virtue of being online, really ought to be easily accessible to bloggers), compassion
is the “sympathetic consciousness of others’ distress together with a desire to alleviate it.” By
that definition, there is nothing particularly compassionate about giving ventilator insurance to
a person who really feels a more urgent need for milk or eggs. One might even say that
choosing to ignore the major sources of others’ distress is precisely the opposite of
sympathetic consciousness.
There is room for a great deal of disagreement about how much assistance rich people should
give to poor people, either voluntarily or through the tax system. But surely whatever we do
spend should be spent in the ways that are most helpful.
Therefore there’s no use arguing that the real tradeoff should not be ventilators versus milk
but ventilators versus tax cuts, or ventilators versus foreign wars. It’s one thing to say we
should spend more to help the poor, but quite another to say that what we’re currently
spending should be spent ineffectively.
This is not to deny that the health-care system needs a massive overhaul; it does. But that’s
not the issue on the table here. The issue is: Given the current system, should or should not
the federal government (or Baylor Medical Center, or somebody) effectively guarantee that
nobody will ever die for lack of a ventilator? In other words, should poor people be given
ventilator insurance?
The bloggers at Daily Kos say yes. But for the same cost, we could give each of those people a
choice between ventilator insurance on the one hand or $75 cash on the other hand. If it turns
out that I’m wrong and they all want the ventilator insurance, so be it. But why not at least
ask them?
You can’t do that with every government service. You can’t offer people a choice between
police protection and its cash value, because police patrols tend to protect entire
neighborhoods at once, not just specific individuals. You might not want to offer people a
choice between a flu vaccine and its cash value, because you’d really prefer to have
vaccinated neighbors. But critical life support isn’t like that; the benefits are targeted to
specific individuals. There’s no reason those individuals shouldn’t be allowed to choose
different benefits if they want them.
Tirhas Habtegris would probably have taken the cash. Then she’d have gotten sick and
regretted her decision. And then we as a society would have been in exactly the same position
we were in last week—deciding whether to foot the bill to keep Ms. Habtegris alive a little
longer.
At that point, there’s a powerful human instinct to come to the rescue. Well, more precisely,
there’s a powerful human instinct to demand that someone else come to the rescue. (I’m
guessing that in the wake of the Habtegiris case, nobody at the Daily Kos has taken to funding
ventilator insurance for the poor.) Be that as it may, choices have to be made. A policy of
helping everyone who needs a ventilator is a policy of spending less to help the same class of
people in other ways. Accounting for “economic considerations” means—by definition—trying
to give people what they’ll value the most. In other words, economic considerations are the
basis of true compassion.
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