Today I saw my first coronary artery bypass graft surgery. I have to admit - it was very interesting, seeing the beating heart, etc. However, the circumstances surrounding his surgery highlight a lot of the tough questions that I believe lie ahead for healthcare reform. Here is an elderly gentleman, 80+ years old, with multiple medical conditions, depressed including a history of recent attempted suicide, who had a massive heart attack and found to have severe coronary artery disease. Due to an unusual reaction with a common medication used to prevent clots from forming, the patient required special drugs during and after the surgery. These medications costs upwards of $8,000 per vial, and multiple vials had to be used. The patient was also at great risk of bleeding out from the surgery, and his risk of dying right on the operating table was relatively high. The total cost of this marathon 7+ hour surgery will probably be in excess of $200,000. All this for an elderly gentleman who didn't want to live in the first place?!
I'm not advocating that we let people who attempt suicide to die (or to "finish them off"), but if we are to advocate for "healthcare for all", we must be ready to draw the line somewhere. Drawing the line is easy when we don't know the person - most would probably agree that this surgery might represent one of the "horrors" of American Medicare/Medicaid system, but to those who knew this man - who cherished his presence while he was awake and alive, would probably strongly disagree. So who draws the line, and when?
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