www.nypost.com/postopinion/opedcolumnists/43933.htm
Reprint April 6, 2005 -- TERRI Schiavo's protracted death focused attention on th e right to die, but it should also spark some serious thinking about an equally vital and emotion-laden matter: the cost of keeping people like Schiavo, and those near death, alive. Certainly, this is a matter for families, who bear heavy emotional and fi nancial burdens and devote hours to caring for disabled family members. But it is also of concern to society, which subsidizes the costs. That's partly because New Yorkers are so compassionate, health-care union s so powerful and government so generous with other people's money. Think about it: Medicaid spending on long-term care in New York amounts t o some $14 billion a year or nearly a third of all Medicaid costs. Medicaid overall, meanwhile, has been carving huge craters in state and l ocal budgets. Counties and cities have rocketed up taxes and laid off workers to pay Me dicaid bills. The tax hikes, meanwhile, are throttling local economies. For people like Schiavo (and certainly folks more functional than her), s ubsidized long-term care may be the only morally defensible option. But what about the pain to public employees, like those in Erie, who lose their jobs? Or to residents denied sufficient police and firefighters? Or to firms forced to close, move or fire workers because of onerous Med icaid-fueled taxes? What about the millions of New Yorkers who must struggle to pay outrageou s tax bills to cover the costs of elderly or home-bound New Yorkers? Let's face it: Keeping people alive and providing for much, if not all, o f their long-term care takes a huge economic toll. Families can decide for themselves how much care they want to provide. Bu t when government foots the bill, a cold, dispassionate public debate of the costs is essential. And again, nowhere is that more urgent than in New York, which spends far more on long-term care than other states. Pataki announced "bold changes" to health care, including steps to encourage elderly and disab led patients to stay at home, rather than go to more expensive nursing h omes and hospitals. after all, many folks would rather remain home anyway if they could. A few million dollars in new spending with uncertain savings on the other end. Nor does Albany want to get serious about closing loopholes that allow ev en the not-so-poor to get long-term-care subsidies. If nothing else, the Schiavo affair was about letting individuals and the ir families make the hard choices about their fates. Schiavo's parents f ought relentlessly to keep their daughter alive. They opted to suffer de voting endless days to visits, arranging care, fighting legal battles. Some folks, by contrast, feel relief when a long-ill family member succum bs, mostly because the emotional strain ends. And if individuals and families are not responsible for costs, they'll never feel a need to have them stopped no matter how hopeless t he situation. In an era when science allows incapacitated, brain-damaged patients to li ve for years on a feeding tube, governments like the one in Albany canno t afford to hand out blank checks. Terri Schiavo reminded everyone that when it comes to care-dependent pati ents, public officials, too, must make some tough choices.
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