Oregon’s Suicidal Approach to Health Care

American Thinker | Rita L. Marker | Sept. 14, 2008

Oregon seems to have found a surefire way to lower health care costs: Tell the patient you’ll pay for drugs that will end her life, but not those that would extend her life. Here’s how it works:

In May 2008, 64-year-old retired school bus driver Barbara Wagner received bad news from her doctor. She found out that her cancer, which had been in remission for two years, had returned. Then, she got some good news. Her doctor gave her a prescription that would likely slow the cancer’s growth and extend her life. She was relieved by the news and also by the fact that she had health care coverage through the Oregon Health Plan. It didn’t take long for her hopes to be dashed.

Barbara Wagner was notified by letter that the Oregon Health Plan wouldn’t cover her prescription. But the letter didn’t leave it at that. It also notified her that, although it wouldn’t cover her prescription, it would cover assisted suicide.

After Wagner’s story appeared in the Eugene Register-Guard, the Oregon Health Plan acknowledged that it routinely sends similar letters to patients who have little chance of surviving more than five years, informing them that the health plan will pay for assisted suicide (euphemistically categorized as “comfort care”), but not for treatment that could help them live for months or years.

Certainly, spending $100 for deadly drugs is cost effective. And, ever since the Oregon Death with Dignity Act transformed the crime of assisted suicide into a “medical treatment” more than ten years ago, it has been perfectly legal. Oregon doctors prescribe lethal overdoses of drugs. Pharmacists dispense them, sometimes with instructions to “take all of this with a light snack and alcohol to cause death.” Patients die after taking them.

On to Seattle
Now, an Oregon-style law is under consideration in Washington State. After engineering passage of Oregon’s Death with Dignity Act, assisted-suicide advocacy groups thought other states would rapidly adopt similar laws. But they were wrong. Because their attempts to pass Oregon-style laws in more than twenty states failed, the Portland-based Death with Dignity National Center (DDNC), along with Compassion & Choices (the former Hemlock Society), devised a plan in 2005 called “Oregon plus One” to break the logjam. It is based on the premise that, if just one more state follows Oregon’s lead, then other states will fall in line.

The plan was put into effect in early 2006. In its 2007 annual report, the DDNC noted that it had spent a year “researching and collecting data to determine that state which is most likely to adopt a Death with Dignity law…Through these efforts we have identified Washington as the state.” (Note that the assisted-suicide group chose Washington. Washingtonians were not in on the selection.)

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Comments

  1. After Wagner’s story appeared in the Eugene Register-Guard, the Oregon Health Plan acknowledged that it routinely sends similar letters to patients who have little chance of surviving more than five years, informing them that the health plan will pay for assisted suicide (euphemistically categorized as “comfort care”), but not for treatment that could help them live for months or years.

    I am positive that most posters on this board will draw the wrong conclusion from this.

    The real issue here is that Oregon has socialized medicine. Socialized medicine always turns deadly. It is cheaper to kill unproductive citizens or let them die than it is to treat them.

    The right to die quickly escalates into the obligation to die, as soon as the government gets involved.

    But, of course, the only party interested in escalating the control of government over the economy is the Dems, right?

    Sorry. The government now owns AIG. How many other insurance companies will the government end up owning? How much socialized health care is McCain/Palin willing to embrace?

  2. This is an extremely misleading article. It throws together a few facts, leaves out most facts, and then tries to portray this as some kind of terrible situation. Since I live in Oregon and spent 21 years in the medical world, let me offer a few facts:

    1) the lady in question was a lifelong smoker. One possible consequence of that is lung cancer.

    2) She has medical coverage through the Oregon Health Plan. If she didn’t have that as her insurance, she wouldn’t have any insurance.

    3) The Oregon Health Plan was never intended to cover everything for all people. Given limited funds, it intentionally rations health care in order to make sure that the most important treatments are available to people. It is not “socialized medicine.” Rather, you could look at it as a health plan “of last resort,” for people who would otherwise would have no coverage. In fact, no health plan covers everything for everyone.

    4) The medication in question would cost $4,000 per month. In this particular case a determination was made that this medication would not have an effect significant enough to justify the cost. The original article that appeared in the Eugene newspaper noted that “Studies show the drug increased the median survival rate for patients with advanced non-small cell lung cancer from 4.7 months to 6.7 months.”

    5) Patients on the Oregon Health Plan with advanced end-stage diseases are routinely notified that physician-assisted suicide is in fact an option. It is legal and covered by the plan. There is no requirement that patients use that program; it is simply an option. The overwhelming number of patients do not opt for that.

    6) Physician-assisted suicide in Oregon is rare. In 2007 49 patients ended their lives through that program. That’s out of more than 30,000 deaths, or around 16 one-hundredths of a percent. Most patients who used the program were college-educated, white, elderly, and suffering from advanced cancer.

    7) Whether or not physician-assisted suicide were available, the Oregon Health Plan would not cover the medication for this woman. Therefore, for the article to say that “Oregon seems to have found a surefire way to lower health care costs: Tell the patient you’ll pay for drugs that will end her life, but not those that would extend her life” is simply false. If the woman in question wanted to opt for PAS, the state would pay for that. If she didn’t, the state would continue to pay for comfort care, including hospice.

    8 ) The article implies that physicians do not provide accurate information to the state. But there’s no evidence of this, and no reason why physicians would not. Physicians failing to report PAS cases to the state could face disciplinary action by the State Medical Board.

    9) The article says that PAS safeguards have “enough loopholes to drive a hearse through.” This is certainly an exaggeration, but if true the solution would be to tighten the safeguards. But I am unaware of anyone on the political or religious right who has ever even suggested legislation to tighten the safeguards. This is because they have no interest in improving the program; they just want to end it.

    10) A proposed Washington law would mandate that in cases of PAS the physician would list as the cause of death the underlying disease. The author calls this “falsifying the record” and says that “To my knowledge there’s no other situation in medicine in which the death certificate is deliberately falsified – and in which this falsification is mandated by law.”

    Public records are altered all the time. For example, in the case of adoption a new birth certificate is issued showing the adoptive parents as the natural parents. I guess you could call that “falsifying the record,” but why would you? As a practical matter listing the underlying disease as the case of death on a death certificate is important for two reasons. First, it allows the state to accurately track the diseases that actually would have ended the patient’s life anyway. Second, it can be important for insurance purposes if the patient has life insurance that wouldn’t pay out in the event of suicide.

    In short, the article tries to make this appear to be a big scandal. But anyone who takes the time to understand the facts can see that it is not. It would have been nice had the author been more concerned with the actual facts of the case than in trying to score rhetorical points.