The Spirit has moved The Witch Doctor to consider Oregon (well it was not really the spirit – it was Dr Philyerboots in his current post.)
“The demographic and health care challenges deserve a more open and above board debate on rationing, but our politicians are too cowardly to trust us to do so. If only our politicians would trust us, as they do in Oregon. This system is not without controversy, but in the private sector insurance companies also ration. An insurance company is an organisation that sells you an umbrella when it is sunny, then removes it when the rain starts.”
OREGON HAS JAGGY ROCKS
The Witch Doctor first encountered the Oregon health care system many years ago when she was spirited away to a posh hotel by the seaside in order to be reframed into looking at our NHS “differently.”
Witches don’t take kindly to reframing attempts and, although usually quite placid souls, we can become quite belligerent if we think people are trying to surreptitiously change our view upon life.
We witches change our own view upon life if and when we want to. We don’t need the help of government lackeys. And we don’t respond to the smooth talk, good food and posh surroundings, free at the point of use for senior doctors, considered part of their compulsory Continuing Professional Development, and paid for by the taxpayer.
So there was a bit of a skirmish.
OREGON HAS TREACHEROUS SEAS
They introduced the term QALYs. We were told they were a product of the American state of OREGON. The Witch Doctor had never heard of “QALY’s” before and she listened carefully to what was being said. Remember, this was a very long time ago, and QALYs had not yet reached the UK as they have now.
Then there was a little game.
We were then all given a handout. We had to prioritise various conditions according to QALYs. (Quality adjusted life-years).
The Witch Doctor refused to fill in the damned form.
She said it was a load of piffle.
She said that no-one, absolutely no-one, was in a position, or should be arrogant enough, to attempt to measure another person’s quality of life to decide whether they were worth treating or not.
Basically, that was not what medicine was about. If a patient crossed your path and required treatment, and you had the means of treatment, then you treated them.
It was simple then.
That was the way it was in the UK way back then.
Anyway, back then, The Witch Doctor was a very busy, harassed witch and could have done without wasting a few days at that seaside hotel. She vociferously said something about how would she be viewed by the populace if she was quadriplegic and needed care 24 hours a day? How, for example, would an athlete view her quality of life then? Or a pop star? Or a Secretary of State for Health? Would her life be considered worth living by the populace? She then said that at least, as a quadriplegic she might have uninterrupted, quality, precious time to listen to her children, guide them, teach them in a way that was never possible as a mother working an 80+ hour week plus 1 in 3 on call in the NHS, degenerating to 1 in 2 to cover annual leave, sick leave, maternity leave, study leave, and delaying tactics in advertising the post when a colleague leaves or retires (and then it was 1 in 1 on call if no locum was available) Yes. This was the reality of many a consultant’s life before the new contract. in these days consultants had to work hours just as rigorous as junior doctors but doing different, less visible but every bit as demanding work.
Yes, being quadriplegic would have given her a strange and morbid type of quality in one aspect of her life.
She gave a few more cogent examples to make the point.
CERTAIN THINGS CANNOT BE MEASURED!
So, as you can gather, QALY’s did not appeal to The Witch Doctor back then.
She also said:
“This will lead to death by neglect in Oregon and may lead to euthanasia becoming legal in that state.”
Do you suppose she was correct in this assessment?
Of course not!
She was way over the top!
Of course she was!
As witches often are……
Eh, My Black Cat?
In the meantime My Black Cat is reading this:
a red apple ……………………
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