Who wants to live forever?

[bluejogger]

I found out that my kidney transplant is projected to last, maybe, 5 years. And so, I had to start the horribly depressing process of being put on the transplant list for a cadaver, as there is an estimated 5 years waiting list and I've just past the mark where I can be placed on the list based on my current renal function

Comments

[whswhs]

It seems odd to me that you're primarily objecting to emotional manipulation when they're making a medical decision that could literally be life or death to you. Unless you're saying that dying is bad, but being emotionally manipulated is even worse, which I suppose is a coherent position.

I suspect that the emotionally manipulative aspect is only a byproduct. This kind of medical procedure involves scarce resources (or else they wouldn't have that waiting list). If they bumped you right to the front of the queue, it would mean some other people would be pushed back, and might not get kidneys at all. No matter what criteria they use, some people won't get in. You don't pay the full cost of the treatment, and the organizations that do have every incentive to hold costs down, so it's going to be decided by bureaucratic procedures, and bureaucratic rules are always arbitrary. The people who actually set the criteria don't care about manipulating your emotions, they simply want to minimize the number of judgment calls about particular cases by setting general rules . . . and if those rules don't work well for some particular cases, that's an inherent tendency of large organizations.

Since our society isn't all that enthusiastic about the main alternative to bureaucracy, which is having everyone pay their own medical costs and letting supply and demand equilibrate, we're going to be stuck with bureaucratic rules for a while, I think. And I'm not sure that you can have rational, consistent, sensible bureaucratic rules in the real world.

[bluejogger]

Look, I agree with you. At some point, economically speaking, the correct choice is to wander out into the forest with a gun and not return. I'm not going to demand that we spend every dollar to give everyone a few precious extra seconds in a hospital awaiting the final heart attack or brain flatline. Or subsidize the no kidney patients from the people that have two working ones.

I just want them to be an adult about it and say, "here's the standards as of (date), meet them, or not, your choice". I guess I'm asking too much.

[whswhs]

I'm sorry; I didn't mean that to be an editorial about free market versus medicine versus insurance versus government funding. I'm just saying that I don't expect bureaucracies to follow rules that make sense. Or to be straightforward about telling people what their choices are. Dealing with bureaucracies tends to be a nasty experience, and I'm sorry that you're having to go through it.