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Wards of the State: Social Responsibility
In difficult times, we may turn to the rigid rules of the government. It is then that we realize that things are not so simple. When we age, if we are incapacitated without a designated next of kin, we could become a Ward of the State. That should be on every adult’s list of horrors.
Being a Ward of the State means that it takes a judge’s order to define certain life states and procedures. You are not your own person because you have no people to fight for you. Anyone with any sense should fear this future.
Our responsibility is to care for those who cannot care for themselves. This is part of what community and larger healthcare is meant to do. It is supposed to leave life to the living and provide for those who cannot for themselves. We look to this, sadly, and continue to provide to them through Medicare, MediCal (Medicaid for you non-Californians), and Social Security or Disability. We provide and we provide judgment on what is considered reasonable care.
We judge because there are people who will not judge for themselves.
It is not only our right as Americans, but our duty to determine our own healthcare. We are called to determine our fates and to determine it for ourselves. Aging populations need to realize this. In order to mitigate costs and responsibility, the federal government should do everything within its power to unite families and to impress upon them the necessity of filial duty.
I fear the day that I will be so ill that someone will need to make my decisions, however, I have comfort in my daughter. Beyond, that, however, I know that no one will really care what I want. For them, it is a matter of wants vs. needs vs. costs. Life is not a simple calculation.
I want to live. I want to see my daughter’s graduation. I want to see my grandbabies. I want to move forward. When the government decides what I cannot have is the day that I start dying.
Do not let the government make your decisions. Designate your advocate. Write an Advance Directive. Write a Living Will. Learn about it! Learning about death frees you in life!
Published in General
Seinfeld was a show about nothing. This is a post about everything–life and death. Doesn’t get much more real than that. Yes, I should make plans. So should nearly everyone.
(Though I do have to say, Kaiser Permanente pushes it a little too hard. Any facility with a high proportion of older patients is festooned with posters about advance care directives. It’s no doubt well intentioned and useful advice, but after your fifteenth poster proclaiming “Want to kick the bucket quicker and cheaper? Just tell us!” you begin to wonder if perchance Kaiser’s job is just a little bit easier when grandpa makes a regal wave of the hand and says, “Don’t bother, guys”.
Kaiser is an interesting and unique model. People either love it or hate it. I am in the “hate it” category, but that is because I find their acute care and care of serious chronic issues to be lacking. They are good at maintaining wellness for well people. Don’t get me wrong. They really are!
As well as for workers, the union has a strangle hold on the owners. Nurses sit there during holidays even if they are not needed; they can collect a check either way. Unions are messed up.
But aside from that Kaiser operates on a model of maintaining wellness. When people are genuinely sick, their diagnostic facilities are great… it’s just hard to get into one. With some cancers, inflammatory conditions, and other acute needs, time is of the essence and Kaiser cannot always provide that.
Great post. I think people are afraid to talk about these things when they are well, but that is the very time you need to talk about them.
I agree with your post’s overall point. It is probably best to avoid becoming a ward of the state (although it’s extremely common for the elderly to transfer their wealth to children etc so they can appear destitute, so the state will pay for long term care and so forth). But in that case, they are intentionally becoming a ward off the state to avoid paying for their own care. That may seem odd, but again, this is EXTREMELY common.
Which brings me to a couple quibbles I have with one of the statements you make in your post:
I gather that your intended meaning there is that everyone should have a living will etc. And I agree. However, if I read that literally, I have two quibbles with that statement:
1) It’s not true. You can’t have a right to something that costs money. You can have a right to life, liberty, and the pursuit of happiness. But how can you have a RIGHT to a product that costs money? What if you can’t pay for it? Which brings me to my second quibble:
2) You forfeit any input into decision-making for your healthcare if someone else is paying for it. If I’m buying you dinner, you eat what I serve you. If you don’t like what I serve, you can walk out and buy your own dinner, but you can’t tell me what to buy. It’s my money, and I’m making the ultimate decision. I deal with this every day. I recommend a treatment, Medicare says no, I appeal on behalf of the patient, then Medicare writes a very nice response which says, no. And there you are.
I apologise for arguing a point that you didn’t intend to bring up. But I think this is important.
Yes, government healthcare will bankrupt our economy. Yes, it will stifle innovation. Yes, it will destroy the greatest healthcare system in the world. Those are all bad things.
But to me, the main reason to avoid government healthcare is so that each of us can maintain some control. Not over our dinner. Over our life.
This is important.
Again, great post – I agree. Sorry to stomp on a topic unrelated to your point. I’m not usually like this when I’m sober.
Dr B. I’m still drunk. I must be. I’m in the wrong post. But I love this post so I’ll just agree with you.
I would also add:
There is a great article in the New Yorker about some Vegas sleaze ball lady getting control over elderly folks with money and putting them in horrible nursing homes, getting them over medicated, and stealing as much as possible.
This lady did this over the will of the children even and a judge agreed with the evil lady. Repeatedly, dozens of times and cases.
Our government has the power to rip our world asunder.
I’m going to say something on the other side of this issue: Be very careful and think long and hard about signing on the dotted line to assume the legal responsibility for someone else. It is a very big deal.
I’ve done it twice because I wanted to help. I would never do it again. I would keep the relationship casual and not take it on legally.
If you do wish to help someone with this part of his or her life, please talk to a lawyer first about your legal responsibilities.
This is very difficult to describe briefly, but the truth is the state is going to do what it wants to do. The conservator and guardian have all of the responsibility and none of the control.
Postscript: I’m not talking about the end-of-the-line disconnecting of the life-support machines. There are myriad decisions that need to be made and authorized on the way to that moment.
Always a sound policy…
I think I’m lost, too. I thought I was in Facebook, but then I encountered something I disagreed with that was intelligently and persuasively written in good faith. That’s when I knew something was wrong…
I wish I could say this statement is paranoid and pessimistic. But she’s right. Careful with this stuff. I’ve been down this road many times and seen some unbelievable things. Marci has a point here. Careful.
And a postscript to my comment 8:
Before you assume any legal healthcare responsibility for someone, find out what the next-of-kin laws are in your state. It could be that you don’t need to assume formal, probate court-level responsibility. You may have the full extent of the legal relationship you need tied up in your next-of-kin status.
By the way, Social Security can make people “payees” without expensive legal work. You should look into that too.
Foundationally important to officially designate people who are aware/periodically reminded of your wishes – and will carry them out – firmly and constantly speaking for you and raising Cain when needed. Paper is great; until it gets buried in your chart. And, depending on your locale, calling 911 may take the choice to do less than everything possible out of your hands…Just a thought from the retired (hospital) chaplain Panda.
The quibbles are from your misreading my statement.
Let me rephrase: Americans have a right and duty to make their decisions over their own healthcare. This does not mean that anyone will pay for their decisions. But we have a right to our self-determination and it is our duty to make those decisions rather than burdening others with them.
I have no interest in government run healthcare.