Monday, July 28, 2008

Right Ol' Bastard

I stopped at this news story on the front page of the World's Worst Newspaper.

Lemme give you the Cliff's Notes version: happy young fathead and friends go whooping and diving off a tree into the Little Luckiamute River back in '96. Unhappy fathead augers headfirst into sandbar, breaks neck.

Now effectively a corpse with a working head, he is kept alive only by respirator. He is on full disability, but is suing the State of Oregon for additional funds to pay for his in-home caregivers under the Americans with Disabilities Act. Note that he tried to go it with just his family helping out but burned through them and had to turn to the state to stay on his own rather than go into some sort of nursing care facility.

Now generally I'm a pretty blue-type blue person. I honestly believe that one of the important jobs of a government is to help people do things they can't do themselves: build courts, fight fires, defend countries. And help care for themselves if they're hurt. So generally my reaction to stuff like this is, OK, it doesn't hurt me and it helps you. I may not like losing the cool old iron corner curbs in North Portland, but it helps people in wheelchairs and sk8ters alike, so, go for it.

But I read this and my instant reaction was, screw you, Jack; if the choice is between spending more public money for you to live in an apartment in Salem versus you living in a nursing home, it's Happy Acres for you, me lad.

I think that, sadly, my decision was influenced by two items; first, that this guy isn't exactly Steven Hawking and keeping him in his house is unlikely to get a return on the public's investment outside his own happiness, and, second, that he didn't get his injury being blown from an MRAP in Ramadi - he and his buddies made a dumbass decision and he paid for it.

Extra credit for his pal who "drove back to the river and, in anger, sawed down the tree" they were swinging and jumping from!


So am I just being a right ol' bastard about wanting to deny more of my taxes to this poor mook? Does the fact that this guy pulled what was essentially a stupid boner and surveyed himself make a difference in who is responsible for his care? I'm honestly curious; what do you think we as "society" should do for this poor sonofabitch, and what part, if any, does the culpability for the guy's injury play? Comment away; I am always curious to find out exactly how much of a real jerk I am...


Meghan H said...

I think we don't get to decide who is or is not worthy of assistance, either by circumstance, IQ, or usefulness to society at large. If you're permanently disabled, that's what may (if you're broke) merit needing support.

I agree the dude was not the sharpest tool in the shed for getting paralyzed by riverside shenanigans. As taxpayers, I guess we might have some say in whether the state starts paying his caregivers a few more bucks an hour...if nursing homes are a better, more cost-effective option and could provide equivalent quality of life, great. The problem is that they currently DON'T, from my experience.

The state makes decisions all the time that impact someone's quality of life negatively -- just look at the story in today's O about the woman who was denied lung cancer treatment by her Oregon Health Plan, but told it would pay for the drugs she would need to exercise her right to die as given to her by the voters of our great state.

Gray areas abound...

Lisa said...

As meghen says, we can't pick and choose who gets support, only decide upon the most sensible approach. Darwinism doesn't work so well in our societies, and we constantly celebrate our failures (Challenger license plate, anyone?)

This guy clearly needs profound care, and it would seem more reasonable for him to be treated in some sort of of group housing facility, vs. private housing. I do not think the latter should be a state-bestowed right.

Unless things are different in OR, my experience with medical disability care is that only the basal level of assistance is provided.

In this case, surely a group health care facility would be the logical choice.

FDChief said...

Conclusive proof that you are both better people than I am...

You're right about the nursing home care quality, Meghan, and yet I tend to agree with Lisa that one big issue here is that what this guy WANTS is to be in his own apartment while what is probably more COST-EFFECTIVE is to have him in some sort of medical care facility. So to me the cold-bloodedly rational decision is to tell the guy, look, if you want care over and above the level of the baseline, you come up with the extra scratch.

But I can see how if I was this poor dummy I'd want more than to be a living fleshbag in some soulless nursing home.

Gray areas, indeed.

One news item I caught the other day was that one of the federal agencies - the EPA, I think, or OHSA - was directed to reduce the cost it placed on human life so as to make it less likely that business projects can be denied permitting because of hazard to life and health. Your tax dollars at work.

Anyway, I think the take-home lesson is that we're probably lucky that I don't get to make these choices.

Lisa said...

I'm with you all the way, Chief. There will be no gray areas as funding becomes more constricted. The most cost-effective care choice is the only rational state option. Of course, those facilities need to be efficient and humane.

If a patient wants something beyond that, it is on his dime.

Tangentially, I believe euthanasia should be an option. The herculean efforts to keep people like Terry Schiavo in persistent vegetative states against their own stated wishes and those of their family boggles the mind. What--so they can become a cause celebre for the fundamentalists? The Bush brother was despicable in his stand on that one.