Planning one’s death at the end of a long illustrious life

Conductor Edward Downes and his wife Joan decided to end their lives on their own terms:

He spent his life conducting world-renowned orchestras, but was almost blind and growing deaf – the music he loved increasingly out of reach. His wife of 54 years had been diagnosed with terminal cancer. So Edward and Joan Downes decided to die together.

Downes – Sir Edward since he was knighted by Queen Elizabeth II in 1991 – and his wife ended their lives last week at a Zurich clinic run by the assisted suicide group Dignitas. They drank a small amount of clear liquid and died hand-in-hand, their two adult children by their side. He was 85 and she was 74.

Many people feel that suicide necessarily cheapens one's life. In many cases, I don't agree. I do think that the choice of when and how to die belongs to each person individually, as long as the decision was not made impulsively or under the influence. If the day comes when I decide that I can't bear the pain, or that I no longer find joy in my life, I would hope that I wouldn't need to travel all the way to Switzerland because inter-meddlers think they know better than me about the meaning of my own life.

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Healthcare executive: Michael Moore’s Sicko was accurate

Wendell Potter, a former healthcare executive told Bill Moyers that Michael Moore's "Sicko" was on target. Potter agrees with Moore that there is a significant role for government in healthcare and that government systems such as Canada and Great Britain are successful, contrary to the vicious and dishonest spin by the American healthcare industry. Note: For 20 years, Potter was head of corporate communications for one of the country's largest insurers, CIGNA.

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Fixing health care under the table

At Common Dreams, Bill Moyers and Michael Winslip explain that you won't see the way the health care debate is being resolved if you only spent time on Capitol Hill. No, it's much slimier than that:

Katharine Weymouth, the publisher of The Washington Post -- one of the most powerful people in DC -- invited top officials from the White House, the Cabinet and Congress to her home for an intimate, off-the-record dinner to discuss health care reform with some of her reporters and editors covering the story.

But CEO's and lobbyists from the health care industry were invited, too, provided they forked over $25,000 a head -- or up to a quarter of a million if they want to sponsor a whole series of these cozy get-togethers. And what is the inducement offered? Nothing less, the invitation read, than "an exclusive opportunity to participate in the health-care reform debate among the select few who will get it done."

If you are not one of the highly-monied invitees or the "select few," forget about the debate because, politically speaking, you amount to nothing at all. That's the process. Go tell that to all the grade school students who are being taught lies in their civics classes. They are being taught that this is a democracy, and that our government is ultimately responsible to all of those people who were not invited to that fancy dinner. As the authors, explain, this particular dinner was canceled only after a copy of the invite was leaked to the web site Politico.com. It was, after all, a big misunderstanding. This peak at how important bills are passed is not an isolated case. It reminds you that when Congress passed the Helping Families Save Their Homes Act, "the select few made sure it no longer contained the cramdown provision that would have allowed judges to readjust mortgages." Here's another example:

Everyone knows the credit ratings agencies were co-conspirators with Wall Street in the shameful wilding that brought on the financial meltdown. But when the Obama administration came up with new reforms to prevent another crisis, the credit ratings agencies were given a pass. They'd been excused by "the select few who actually get it done."

Shame on us. Shame on our leaders for following big business instead of leading.

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Health-less

The boogeyman of Socialized Medicine is being dragged onto the field of rhetorical combat to block the move toward anything smacking of Single Payer Health Care in the United States. The argument is old and hoary by now, that adopting a system like that available in Canada or the United Kingdom would lead to a collapse of American health care. Somehow the fact that expenses might be shared and disbursed through the government will render the world’s best health care system somehow crippled inside a generation is not seriously questioned by most people. Because most people don’t know. You can find case after case of anecdotal evidence to support the notion that British health care is worse than ours. Someone knows someone who, as the argument goes. And there is something to that. The waiting periods alone, the pigeonholing of treatment—horror stories abound which we glimpsed here when HMOs were instituted and accountants seemed to be in charge of medicine. There is, in fact, too much information for the average American to digest much less make sense of. Technologically, the United States has an extraordinary medical system. Unmatched in the world, despite some annoyingly negative statistics. That we achieve what we do in a country peopled by citizens who do the least for their own health than in any other country comparably empowered is amazing. Americans eat too much. Medicine can only do so much against a rising tide of obesity related illnesses. The tradition of the doctor giving you a physical and then telling you to eat right and get some exiercise is not a quaint leftover from an age that didn’t know as much as we do—that is sound advice and more than half the battle in maintaining good health. The explosion of Type 2 diabetes in children has been alarming, and this can be tied directly to diet and exercise. We also work longer hours under higher stress than almost anywhere else in the developed world. The need for vacations and long weekends is acute. This may sound sarcastic, but the link between stress and several major illnesses is no joke. We are also a violent society. If one looks at emergency room statistics, it becomes quickly clear that we are a people who like to beat, stab, and shoot each other at higher levels than almost anywhere else. What makes all these factors so overwhelming is that we have the means to do all this. Because a certain percentage, a significant percentage, of the population can afford to go to the doctor and have the consequences of all these lifestyle disasters “taken care of.” I put all this out front because the one factor that is muted in the national debate over the rising cost of healthcare is the fact that we are, collectively, idiots. We do not do, statistically, the simplest things to avert the need for medical intervention. The last detail in this litany has nothing to do with idiocy but with sentiment and perspective. It has been said for decades and it is true—80% of individual health expense in this country is spent in the last two years of life. We are, as a people, loathe to die and we will direct our health services to do absolutely everything to give us another day. In Europe, such people are told to go home and die. That sounds cold, I know, and I’m sure there are people in France and Germany and Italy with the resources to reject this advice. But the nations as a whole are not expected to pay for it. Here we are. Through health insurance.

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Dennis Kucinich takes on the Manhattan Institute

What is the deal with single payor? How does the United States compare to Canada on the ability to provide health care services? Rep. Dennis Kucinich is showing his frustration with Dr. David Gratzer, Senior Fellow of the conservative Manhattan Institute. Gratzer had it coming because he presented himself as an expert on the problems with the Canadian system. See here and here. For a clear presentation of why we do need single payor insurance and why we can afford it, see this report by Marcia Angell, M. D., Senior Lecturer in Social Medicine Harvard Medical School.

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