The Death Panel Will See You Now

Welcome to "The Gods Are Bored," weighing in on health care with privileged information! You think Death Panels don't exist already? Think again! They're here, and they've been here for a long time.

When I lived in Detroit in the 1980s, I had top-of-the-line health insurance through Mr. Johnson's company and yet another insurance from my own workplace. I injured myself playing volleyball. Hurt my foot. Went home after the game, iced it a little. Woke up Saturday morning, and there was still some minor swelling and bruising, and of course it hurt.

I went to the emergency room at Henry Ford Hospital. I signed in and showed them Mr. Johnson's insurance card. Within a half hour I was ushered into one of those curtained areas where the doctor sees ER patients.

As I was limping through the hallway, I passed a person lying on a stretcher. Young black male, bleeding, breathing as if in shock. He was being totally ignored, while I was given the red carpet treatment. When the doctor came in to see me about my minor foot issue, I asked her about the guy in the hallway. She just shrugged.

I've always wondered if that young man had an appointment with the Death Panel. There's no way to know for sure. The Death Panel sees to that.

Fast forward to 2008. I went to my sports medicine doctor about my ailing hip. He's a very special doctor, the kind who sits down and chats and smiles at you, and then explains very thoroughly and clearly what should be done. There's nothing "routine" about his appointments.

Just as we started the appointment, the doctor got beeped by his front desk. He apologized profusely and left the room. He was gone a pretty long time -- maybe 15 or 20 minutes. When he came back, he apologized even more profusely. Then he told me candidly why he'd been called from the room.

He had been on the telephone with the governor of New Jersey. Apparently my doctor was on some kind of panel for state health care. The governor was asking my doctor which charity hospitals to close in our area. The governor also pressed my doctor about lowering the number of emergency coronary care units. Which ones could be closed? The governor wanted to slice in half the number of units in South Jersey.

I said to my doctor, "So in essence, what you're telling me is that a person who has a heart attack in Mount Ephraim will have to be taken by ambulance to Camden, rather than to Cherry Hill, which is much closer to Mount Ephraim."

He said yes.

I said, "So the resident of Mount Ephraim is much more likely to die en route to the hospital than, say, the resident of Collingswood, which is on the edge of Camden."

He said yes.

I said, "So essentially, it's not survival of the fittest so much as survival of the proximity-to-the-right-hospital."

My doctor said he was doing and saying all he could to save emergency care in all of the local hospitals. But New Jersey has a budget crisis, and one way of saving big money is to cut back on the number of critical care emergency rooms and charity hospitals.

Would someone please explain to me how this is not a Death Panel? Better yet, explain it to Tony of Mount Ephraim, who died of a treatable heart attack in the ambulance on his way to distant Cooper Hospital in Camden.

(By the way, the governor got his wish. A few months after my hip appointment, I saw a small article, buried in the back of the newspaper, noting the closure of five coronary care units in suburban New Jersey hospitals, due to reductions in state funding.)

My final note on this morbid topic has to do with location-related Death Panels.

One day I found myself in midtown Manhattan, standing on the sidewalk bearing witness to one of the city's infamous gridlock traffic jams. In the midst of this gridlock stood an ambulance, sirens blaring -- I mean blaring -- as it sat there, unable to progress an inch.

That ambulance was still sitting there, still blaring its horns, a half hour later. It had not budged.

If my uncle out on Polish Mountain, middle of nowhere, needed an ambulance and emergency care, he would have to wait about a half an hour, maybe slightly more, for the ambulance to arrive. Then it would take a half hour, maybe a little more, to transport him to the nearest hospital. Are his chances of survival better or worse than those of the patient in midtown Manhattan whose ambulance got stuck in gridlock?

The Panel will see you now. Don't fear the Reaper.