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Omaha Steve

(99,503 posts)
Mon May 4, 2015, 06:54 PM May 2015

Health care system 'prolongs death to make money,' Munger says on 'Squawk Box'

Source: Omaha World Herald

By Steve Jordon

Warren Buffett followed up the weekend of Berkshire Hathaway Inc. events with a three-hour early-morning TV sitdown Monday, repeating many of the comments he made to shareholders Saturday, chatting with Charlie Munger and Bill Gates and arm-wrestling Ndamukong Suh.

Munger, Berkshire’s vice chairman, said America’s health care system prolongs death unnecessarily. He described hospital rooms where people lie in bed with no hope of recovery and “invoices” pile up, ruining families’ finances.

“I’m ashamed of the way our health care system prolongs death to make money,” Munger, 91, said during the “Squawk Box” program on CNBC, broadcast from the lobby of downtown’s Hilton Omaha.

Munger, 91, acknowledged that health care cost and quality are complex problems but said Europe’s medical system does a better job of end-of-life care.

FULL story at link.



KENT SIEVERS/THE WORLD-HERALD
Warren Buffett, chairman and CEO of Berkshire Hathaway, right, Microsoft Chairman Bill Gates, center, and Berkshire Hathaway Vice Chairman Charlie Munger are interviewed by CNBC's Becky Quick for the television show "Squawk Box" in Omaha on Monday.

Read more: http://www.omaha.com/money/health-care-system-prolongs-death-to-make-money-munger-says/article_e54523b6-f259-11e4-876e-fb398dcfcfdc.html

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TexasBushwhacker

(20,147 posts)
17. I appreciate what Bill Gates has done to wipe out diseases like polio BUT
Wed May 6, 2015, 07:05 PM
May 2015

I wish he would keep the hell out of "improving" public schools. He never even set foot in one until he made his Microsoft money. He was strictly private school, prep school and then on to Harvard. One of the selling points of private schools is smaller class sizes. If you ask public school teaches what they would like to change, the number one thing is usually not their pay, it's small class sizes. But that is NEVER what they try to do. They cut public school budgets so much in Texas that they were measuring classrooms to see exactly how many desks they could fit in them. Over 12K teachers and support staff were laid off, including my cousin who was a librarian with over 30 years experience.

SoapBox

(18,791 posts)
5. WTF?
Mon May 4, 2015, 11:16 PM
May 2015

My Mom passed in January after a fall.

Fell on a Tuesday, half conscious Wednesday, non-responsive Thursday and passed at midnight.

It was a collapse of her kidneys and system after lying on the floor for a few hours (in our home).

What the hell does this clown think should have been done? Strangle her or something, a day or two sooner?

Fuck this guy...he doesn't know shit about people dying.

DebJ

(7,699 posts)
8. Soapbox, I'm so sorry to hear about your Mom, one of the
Tue May 5, 2015, 08:52 AM
May 2015

most difficult things we face in life.

But I think they are referring to the many many cases, of which my own mother might have become, but she thought ahead and
signed a living will to prevent that from happening, in her case.

My 86 year old Mom recently, in the past two months, slipped very deeply into dementia. The tragic thing is that after living an
honorable life dedicated to loving and caring for others and God, and courageously working through so much unearned sorrow
throughout her life (genetic health issues, hit by a drunk driver at 60, and many many other things) she is now in a state where it is almost impossible for her to ever feel even a moment of happiness, for weeks on end. Except for perhaps the briefest of seconds in weeks-long periods, she is lost in anxieties, not for the current status quo, but is constantly reliving every agonizing moment of her 86 years, from childhood, through two years ago. She has become unable to form new memories, and can't recall what she was doing five minutes ago, or one minute ago. The older memories stay with her, but those aren't the good and happy ones. It is the painful and tragic ones, and the anxieties of her life, that fill her mind every waking moment. This has been going on for two months now. My father sits by her side at the nursing home every day from 8am-7pm, hoping she will come home soon... but Mom is never going home again. She is stuck in the worst nightmare she ever foresaw for herself: stuck in a nursing home, in a wheelchair and/or a bed, unable to do anything much at all. Sometimes she can feed herself, but mostly, she falls asleep in the middle of her meals. It is a battle to keep her awake, lest she suffer more malnutrition on top of all else. And my father's dementia is progressing now too, as he gets almost zero mental stimulation during his waking hours spent watching her sleep, doing nothing.

And yet, were Mom to suffer a heart attack, kidney failure, a bad stroke, our medical system is geared only towards keeping her technically alive for as long as possible. They would attach her to breathing machines and intubate her all over, force feed her with a tube down her throat, etc. When you are in such a position, either you are suffering extreme discomfort and/or pain, or else you have been drugged into unconsciousness. To be in that situation and be younger and have hope of life and happiness afterwards is one thing. To be in that situation only to be brought back to a life filled with constant misery, is quite something else. Life is not just a bed of thorn-free roses. But it is also not 'life' at all, to be physically and/or mentally in great anguish every conscious moment, with no relief ever to be found except in death.

And the fact is that the largest portion of medical bills generated for people's health care in their final year, is actually in the last week, with machines and other extraordinary measures done to keep them legally alive, when in reality, they are often in pain, or drugged into unconsciousness, or like my mother, lost in painful dementia. This isn't life. This isn't human. And to bankrupt a family to pay for someone's pained and unhappy existence to be extended a week, or two weeks, or a month, when that existence is nothing but misery, or incommunicado, is grotesque, painful, torturous. It's more like being taken to a Black Site, than anything that resembles 'life'. There are much worse things in life, than death. I grieve for my mother every day, many times a day, and when I awaken at night, it is dreams of her that haunt me. She has no peace, and neither do I. But at least I know that she signed the papers that will prevent the torment of futile, inhuman, tortuous attempts to keep her legally alive, all to no end, except to extend her minute-by-minute constant anguish.

The way our society treats death and dying is really monstrous, in my opinion, and too much of it IS about profits for big companies, and very little about being human, and about death being a part of life. We were so much better off when people were allowed to do as my mother always hoped she would, and as her grandparents had, and died at home surrounded by family and things they knew and loved, rather than stuck in an ugly room with a little window surrounded by people that a)she doesn't know, and b)no longer has the capacity to learn who they are, so they will remain nothing but strangers to her, increasing her anxieties. Her worst nightmare for her ultimate end of life situation has come true, and it breaks my heart. I am powerless, except to pray for mercy for her.

And the pull for profits doesn't even cease when we pass from this life.... the funeral business is another nightmare too....

Soapbox, it was these types of things that they were referring to.......

I'm so sorry for your pain, and hope you take comfort though soon in realizing you were blessed with a parent that you did get to have time with, and who was worth missing at the end.



TexasBushwhacker

(20,147 posts)
12. That isn't what he's talking about
Tue May 5, 2015, 11:59 AM
May 2015

I'm sorry to hear about your mother's death. I'm sure you miss her. I still miss my mom, 11 years after her death.

What Munger is talking about are cases like my dad. He had a massive stroke in September of 2008. He was 75. He was paralyzed on one side and weak on the other. He could only speak a few words.

One doctor was honest with my stepmom and told her he would never recover. He told her he would die in the hospital sooner or later. She called him Dr. Doom.

But another doctor said, maybe he'll do better with a pacemaker. So they put in a pacemaker. He aspirated food from his feeding tube and got pneumonia. So they installed a feeding tube directly into his stomach. After he recovered from rhe pneumonia, they turfed him to a rehab facility. My stepmom spent a lot of money on sneakers and workout clothes. They took one look at him and said he COULD NOT be rehabilitated - at all. He was transferred to an extended care facility.

He was neglected. He got a bedsore on his tail bone. They would let him sit for hours in a soiled diaper. They bedsore got so bad that they transferred him back to another hospital, where he got a few debridment surgeries. By now he wasn't talking at all. They performed a colostomy in hopes that the bedsore, now 6 inches in diameter, could heal. But it didn't. They couldn't keep his oxygen level up with the nose tubes anymore, so they did a tracheotomy and put him on a ventilator. He was in the ICU. Eventually his kidneys were failing because the infection from the bedsore had spread throughout his body. Eventually, my brothers, his sister and the doctors convinced my stepmom to turn off the ventilator. He died within minutes. It was January, 2009.

Dr. Doom was right. Perhaps he could have had a better bedside manner, but the other doctors started the moneyball rolling by suggesting that he "might get better" with a pacemaker. He should have been transferred to hospice care. The "good" doctors had no right to tell an old woman that he might get better. If he was a charity case, they would sent him home to die. Since they could charge hundreds of thousands of dollars to Medicare in fruitless procedures, that's what they did.

DebJ

(7,699 posts)
15. Oh my how tragic. If your post doesn't motivate people to get a Living Will,
Wed May 6, 2015, 10:27 AM
May 2015

i don't know what would. Scares me silly to think of having to live through such a horrible, horrible ordeal.

TexasBushwhacker

(20,147 posts)
16. Living Wills and Medical Power of Attorneys should be a required part of signing up for Medicare
Wed May 6, 2015, 06:55 PM
May 2015

Yes, required. Because once a person is on Medicare, they will die on Medicare. Unfortunately, my father never made out a living will, even though he had already had mini and moderate strokes. He was 75, he smoked and he drank too much. But no Living Will. As for the POA, the spouse is not always the best person to choose. My stepmom was not very educated and held onto a lot of false hope. My brothers and I and my dad's sister would not have allowed him to hang by a thread for so long. And FWIW, she was the only heir.

Another case that comes to mind is Neil Armstrong. He was 82 and they apparently talked him into having bypass surgery. Exactly how long did they think they would extend his life and at what risk? It turned out that he died from complications of the surgery. But sure that his insurance got a big ass bill.

My mother fought breast cancer for almost 10 years. When the cancer was still spreading in her bones despite different kinds of chemotherapy, she told her oncologist she wanted to discontinue it and be transferred to hospice care. Her oncologist was happy to continue the fruitless chemo, with all its side effects, and pocket that Medicare cash. She wouldn't even say the words "die" or "dying". She just said, "Well you know what that means." Right on schedule, she died 6 months later.

Palin screaming about DEATH PANELS and the poor souls that believe her just doesn't get it. We NEED strict review of the procedures that Medicare is expected to pay for. Medicare shouldn't be paying for risky, expensive surgeries on people that are 80+. They should not be paying for chemotherapy for terminal cancer patients when it will, at best, extend their lives a few months.

RobinA

(9,886 posts)
6. If You Asked
Tue May 5, 2015, 08:35 AM
May 2015

many doctors, I think you would find that a lot of the "prolonging" is at family request. My anecdotal experience has been that heroic measures have never been suggested by doctors.

hedgehog

(36,286 posts)
7. I think it can depend on circumstances -
Tue May 5, 2015, 08:38 AM
May 2015

medical people often want to try some last treatment. The problem is, if one patient recovers, how can they know the next patient won't?
But to say it's all about making money......

DebJ

(7,699 posts)
9. From what I have read, it is the default position of medical professionals and hospitals
Tue May 5, 2015, 08:57 AM
May 2015

that they must do whatever they can to keep someone alive, unless otherwise instructed in a legally-binding manner,
such as a Living Will. And each of us has our own perspective on life, and prolonging life, including the doctors
themselves. Their entire lives are devoted to keeping people alive, that is their focus; their skill, their habit, and
for some, though certainly by no means all, some have a religious inclination to do so as well.

RobinA

(9,886 posts)
14. Legally
Tue May 5, 2015, 12:29 PM
May 2015

they have to until instructed otherwise, but that isn't the same as doing it on purpose to collect money. My grandmother lived to be 101. There was nothing technically wrong with her except she was old. She was in assisted living and we could NOT get them to stop ambulancing her to the hospital every time she blanked out for a bit. Normally she was fine once she got there. Liability-wise, they couldn't do nothing, even though all involved, including her doctor, didn't want her rushed to the hospital. Eventually she was finagled into hospice, where she remained for 2+ years. Under hospice they could quit with the ambulance rides.

mainer

(12,018 posts)
11. I agree. It's usually the child from out of town who insists everything be done.
Tue May 5, 2015, 10:29 AM
May 2015

Doctors are realists, and they know when to let the patient die a natural death. But unresolved family conflicts and grief keep family members from accepting the inevitable. Just think about Terry Schiavo.

Tracer

(2,769 posts)
10. I highly recommend this book on the subject:
Tue May 5, 2015, 10:18 AM
May 2015

"Being Mortal: Medicine and What Matters in the End" by Atul Gawande.

He's a doctor who has seen many people at the end of their lives and knows what he's talking about. He's also an excellent writer -- thoughtful and clear.

du_grad

(221 posts)
18. I also recommend a followup book by a colleague of Dr. Gawande
Wed May 6, 2015, 11:10 PM
May 2015
https://www.goodreads.com/book/show/22245549-the-conversation

The Conversation: A Revolutionary Plan for End-of-Life Care
by Angelo Volandes

It's not quite as good as Gawande's book but it takes end of life planning a step further and uses case histories to illustrate what can happen if you don't have a plan.

Yes, the default plan, in hospitals, is to do everything unless told NOT to do everything.
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