The New Clarion

Two points, to start.

1. My father’s heart arrhythmias have settled, and his sodium levels have been managed through intravenous fluids and fluid intake restriction.  Though he could barely walk, he was deemed strong enough, to no longer be eligible for a hospital bed.  Indeed, if he chose to stay, three doors from my mother, he would be charged $750 per day!

2. Now, my mother’s TSH (Thyroid Stimulating Hormone) levels are unusually high, due to a benign pituitary tumor, causing her thyroid to be dysfunctional.  As a result, she has sudden blackouts due to rapid blood pressure drops (syncope), and must stay in bed.  Her dramatic collapses to the floor —unconscious, eyes open & staring— are terribly distressing.  So far, her falls have been caught every time but one, which fortunately only caused minor bruising.   According to her condition, she can still stay in a hospital bed, for ‘free‘.

Notice how the above bolded portions indicate the rules of socialized medicine that determine the care of the patient.  Sure, Dad could stay in hospital, but the cost is obscene, and the price is clearly set so as to drive patients out.  Only under altruism would such ‘logic’, such treatment, be seen as appropriate, because it serves others in the system.  In a private system the same choice would not be so starkly enforced,  Patients in a free market would have a multitude of choices that are not available in the government system.

Incredibly, another wing of the hospital provides a limited number of beds for “Interim Care”.   These beds are priced at a rate comparable to the Interim Care spaces offered by pseudo-private Long Term and Chronic Care facilities.  As soon as a private space becomes available, either Interim Care or Long Term Care (Dad doesn’t need Chronic Care), Dad must move out of the hospital, and away from his spouse.

If a local Interim Care space does not become available, then Dad will be subject to the “Idle Bed Policy” of the Ontario Government.   By that policy, unless he pays $750 per day, he will be placed in any available long-term-care bed within 150 Km (93 miles) of his home hospital, regardless of where his family or spouse may live.  Sure, over time, he will be a leading candidate for a closer bed, should it become available, but at his age, what is time? Clearly, the message is, Dad is sure to die anyway so why should it matter where he is placed?   Good Luck, Dad, your choices are conditional on the principles of the “Communists”.  You are no longer useful to the “collective”, so who in political power should care?

Imagine, you are struggling for life, yet find yourself some 100 miles from your spouse and family simply because ‘the system’ deems it.  It does not matter what you can afford, regardless of how much you want to be with your spouse, the system sees such things as a luxury it will not provide.

Dad has, for his entire life, been utterly smitten with my mother.  A single night, in a different bed from her, now reduces him to tears, though he stoically deals with it. She feels much the same.  Smacked Down, again and again, Dad struggles to rebound.  He is determined not to die before her, solely to save her from the grief he knows she will suffer if he were to die first.

A few days ago they were three rooms apart, down the hall.  Now, they will be “pets” shunted about at the behest of their masters (the government) based on the (struggling) decisions of their Veterinarian (the doctors who are ruled by their masters).

Things have changed since I started this post.  The scenario, & the hoops patients must jump, have switched.

The doctors, who are not Geriatricians, knew that my father was prone to Gout (elevated concentrations of uric acid that crystallizes in joints).  By restricting his fluids, for his heart, they allowed his uric acid levels to rise, through lack of electrolyte elimination (diuresis).  The consequence was that uric acid crystals formed in the most logical, target joint… the elbow he had injured.

Worse, the gout weakened his immune response in that joint, permitting an infection in his elbow, so he is suffering incredible pain, whilst in desperate need of intravenous antibiotics.  If you saw his elbow, you would be horrified; it looks utterly sick.

Now, if you are 30 yrs old, or 40, or even 50, that might not be such a big deal.  You will expect to recover, and to carry on with your life interests.  But, try to place yourself at 89 years of age— that’s 40 years beyond the optimistic 50 yr old!  You KNOW your chances of living another 3 yrs is slim, let alone living another 5 years, or maybe 10?

Worse, if you have ever REALLY loved someone, & find the absolute love of your life is in the same situation… how long can she, or you, sustain so great a value?

Nonetheless, the powers that be have determined to shunt you about as if you were a dog or a cat —a mindless pet— with no intellectual attachments to family, with no regard for your great love of 60 years! Can you grasp that,

Really?

The very accommodating, and sympathetic Discharge Nurse did an enormous amount of work to find the best arrangement, hopefully culminating in both of our parents being placed in the same Long-Term Care, semi-private suite in a local home. Sadly, she admits, she must work within the system.  But worse, for failing to grasp the enormous abstract principles at work, she does so willingly.

As the aging patient, you have no doubt that your placement is utterly beyond your control.

That is how it is under socialized medicine, …so “suck it up”, say the socialists.  There are only so many Long-Term Care beds, and they are not enough (the state moves with glacial speed to meet demand).   Make your choices, as to what homes have the shortest waiting lists, or that provide the environment you can afford, and then wait. Sure, you may die this year or the next, so just as the rest of us have to wait for a teller at our bank, so now you too can wait.

Will your wife of 60 years be allowed to share your double, semi-private room, should you get it?  “Semi-private” means your room may be sharing with a person of your choosing, if both of your health conditions match, but what are the chances of that?  Even so, you & your neighboring semi-private room will still share a toilet/sink —a matter that to many is a huge, personal and problematic, issue of dignity. If you are lucky, you get a chest-of-drawers, can bring in a TV, and can put your favorite pictures on the walls of your one room bedroom.  Oh Gosh, how great is that!  (That was, f0r those who do not appreciate it, is sarcasm.)

Though ‘they’ try to match you with a person of immediate value to you, you have no way of knowing if your roommate will be your spouse or some complete stranger, who was also subject to the idle bed poicy, and had priority.

Yes, you have considerable accessibility to health care —if your assigned doctor is any good, and the bureaucratic limitations match your situation— but, generally, your pets would receive better psychological treatment …your lifetime association with a very specific person, your spouse, is ultimately irrelevant.  You become a ‘body’, shunted about, because you are old.  A ‘body’ is a not-quite-dead thing . Can you sense that sense?  Geriatric patients certainly do.  If you can, then you are starting to understand socialized medicine.

Why…

Because, under socialized medicine, your particular life is not really as important as you might think, the System is done! To people whose primary focus is their bureaucratic budget, their system considers you to be an expense.  That means, by the plethora of younger voters who do not face such issues, that they are of greater importance.  By ignoring the aged, and by pleasing the 19 to 40 age group, a bureaucrat/politician can get the democratic power s/he seeks.

If you, as a teenager or a somewhat older person, want your parent’s, or your own, last days to have some meaning, and want to receive the most beneficial treatment possible, do NOT endorse socialized medicine!  Make your own choices, and put your money behind your choices!

Under socialized medicine, your placement nurse will be entirely sympathetic, but she can only do what the system allows. That is, she is the smiling representative of a system that does not give a tinkers damn.

A finer detail: certain blood tests, from my Mum, were couriered to a major city (Toronto) that is nearly two hours drive away.   Nine days later, the results were faxed to my mother’s doctor.  Nine days!! The blood takes 2 minutes to obtain, & l;ittle longer to test, but the system requires numerous steps, because it is is overloaded, so instead of two days, it takes nine!

So, what is the broad picture of geriatrics in Ontario?

Incredibly, there is only one geriatrician for 30,000 people over 65.  What? …you may ask.
Yes, that is how scarce an enormously important resource is, under Ontario’s socialized medicine.

If you are old, who gives a damn that more is needed to assuage the concerns of the over 50  electorate? They are sure to die.

Let’s make this clear.  My ex-wife is a geriatrician.  In a casual phone conversation, in five minutes, she was able to offer more advice for my aging parents than the Internists that were treating my parents had come up with, in four weeks of care!  THAT is the nature of government-provided health care; so few geriatricians exist that one needs personal connections to get proper medical advice.  So, in a market of 30,000 patients over 65 years of age, per geriatrician, young doctors should be rushing towards the opportunity to make a difference, so as to make a financial living.  Yet, they don’t, because under the supposedly moral system of socialized medicine, the state is the greater authority that chooses what is in the minimal interest of all patients.  Any selfishness of doctors or citizens, for the health care profits that might suit them, must be expunged, …and the state will ensure that it is.  No one observes that the whole altruistic system costs a lot more than would a free, capitalistic, and egoistic, trading system.