Friday, June 10, 2011

How to profit from "death panels"

I am taking some CE credits online and am reading an article with the learning objective outlined as "Learn areas where professional psychologists might need to respond over the next decade to practice ethically." Apparently, if health care is rationed to the elderly, the psychologist simply helps them adjust or simply moves onto greener pastures:

One supporting argument for age-based limiting of care is that increased spending for seniors deprives younger patients of resources that are rightfully theirs, and thus the ratio of cost to benefit justifies and validates age related rationing of medical services for seniors. Those in opposition stress that age is a weak marker for predicting clinical benefit, and further emphasize that such rationing will lead society to be less and less troubled about this apparent devaluing of elders (Gordon, 2000). Psychologists have been well schooled in the treatment of older patients (American Psychological Association, 2004; Hinrichsen, 2010), but have not been trained to face situations where medical and mental health care are rationed. Through research and clinical experience they might be called upon to help shape the allocation of resources among older patients.

Professionals are placed in a difficult position when asked to screen for problems if services to address them are not readily available. For example the suggestion that primary care physicians routinely screen all their patients for depression must be tempered with the fact that these physicians do not have the time or expertise to comprehensively treat those found to endorse depressive symptoms, and mental health referral systems may be limited in their ability to handle a large influx of depressed patients (Linton, 2004). Psychologists may face a similar ethical quandary when diagnosing dementia or geriatric depression if rationing withholds services from older patients, eliminating their chance to be treated. This trend might offer a challenge or an opportunity for psychologists. Psychologists in settings that care for the elderly might lose jobs or be relocated to working with younger patients, but since psychoactive medication accounts for a good deal of the cost associated with care of older patients, if such medications are restricted or eliminated, there may be an opportunity for psychologists to expand their roles by filling the void with non-pharmacological (and hopefully more cost effective) behavioral interventions.

What about the ethics of fighting back against rationing healthcare to those over a certain age? I just got back my bill from the hospitial for my ICD battery change --the charge was high. As I get older, instead of a battery change, will I just get sent to a psychologist who can help me adjust to dying without treatment? Or perhaps the psychologist will be too busy trying to move to "greener pastures" with younger patients. What an opportunity (or is it a challenge?) for the psychologist.

But at least compassionate psychologists will make a buck! And why is it that when Sarah Palin talks about "death panels", she's an idiot, but when a psychologist does (because isn't that what is implied by restricting care to the elderly?), his ideas are printed up in a journal?

I sometimes wonder if the movie Logan's Run

Wednesday, June 08, 2011

"A hope is not a plan."

I am reading Dave Voda's book How to Protect Your Money from the Coming Government Hyperinflation on the Kindle. The book is a must if you are worried about high inflation as it gives what seems like good strategies of how and where to invest your money in the coming years to hedge against inflation.

Voda points out that the government talks a good game of "hope" that things will turn out alright but he states "a hope is not a plan. So while our politicians have adopted a policy of 'hoping' everything will turn out okay, it would be prudent for the average citizen to plan what to do in case it does not."

Some highlights include how to buy silver (he doesn't seem as big a fan of gold), the warning signs of an imminent currency collapse, tangibles to keep at home and the reason your IRA may not be safe. Scary stuff. But I guess it's better to be prepared than be caught by surprise.

I just hope the plan I put in action is the right one. The book seems helpful and for $2.99 on the Kindle is definitely worth it.


Sunday, June 05, 2011

Is marriage without romance a good thing? has an interesting article based on a book by author Pamela Haag entitled Marriage Confidential: The Post-Romantic Age of Workhorse Wives, Royal Children, Undersexed Spouses, and Rebel Couples Who Are Rewriting the Rules (via Hot Air). The author argues that "the 21st century is all about the postromantic marriage — one based on obligation, partnership and, yes, convenience." The article asks the question "How Married are You?" and goes on to describe five different types of marriages, none of which sound all that great.

One is a kind of business partnership, the next is for purposes of parenting, another is a "workhorse wife" who does pays the bills and does all the chores (where can we all find one of those?), another just agrees with anything the spouse says to get along, and the final couple is "semi-married" and simply functions separately.

Does this ring true for any of you? Rather than "Rebels rewriting the rules" as the book title suggests, it sounds to me more like people who have given up on romance. Is that really a better option?