Tuesday, November 29, 2011

Be careful what you wish for

In Greek mythology there’s the story of Sybil of Cumae, who was offered everything she wanted by the sun god Apollo. She requested and was granted eternal life, but to her eventual horror was not also given eternal youth. As a result, her body withered and decayed until it had to be kept in a basket. At the end of a thousand years, there was nothing left but her voice.
This ancient tale reminds us of what we seem to have forgotten—that longevity can be as much a curse as a blessing. Quantity of life should not be confused with quality of life. Most of us, if given a choice, would choose to “die young as old as possible,” as F. Scott Fitzgerald once quipped. But how, exactly, do we determine when a good time to die actually is? How can we grow old without also growing feeble of mind and body?
When Sybil, hanging in her basket, was asked by a group of boys what she wanted, she replied: “I want to die.” The continuing degradation of her body, projected across the unlimited bounds of time ahead of her, was a terrifying prospect.
The form of immortality that we seek in the 21st century is modest compared to that bestowed by the Greek gods. We don’t expect to live forever—only longer than what the law of averages would dictate. If the average life span for an American is 78 years, then we’re likely to think that 87 or maybe 92 seems about right. If we’re 72 and facing a medical crisis, then 75 or 78 looks pretty good. And if we’re 57 and are told we have 18 months to live, then beating the odds and reaching 60 is what we hope for. When it comes to time, we always want just a little bit more of it. We lust after a hint of immortality.
While Americans are living longer than ever, it’s become painfully obvious that we’re having a hard time paying for it. Our ever-increasing life expectancy is a crushing burden that’s driving us to financial ruin. We labor under the illusion that with better regulation and more government control, the cost of medical care can be made affordable for everyone. But that’s absurd, given the life-extending potential of our drugs and technology and everyone’s presumed access to them. If you think we have a healthcare crisis now, imagine what will happen should life expectancy be extended by another five or more years.
Our fragmented and overspecialized healthcare system does a superb job of maximizing returns to providers—doctors, hospitals, drug companies—but not to society. Fee-for-service reimbursement allows providers to reconcile their ethical duty to patients with their economic self-interest. The more they do, the more they earn. Restraints are few because both providers and patients resist limits on their choices. We can’t say no! Government regulators and private insurers are too weak to control costs. As currently structured, the system cannot deliver value for money. It is gamed so that the powerful are enriched while the poor and middle class are priced out of the market.
There is an element of personal responsibility to this proposition that shouldn’t be dismissed. It’s unlikely to become a popular notion, but instead of striving desperately to extend our lives by a few months, perhaps we should accept our mortality when it’s apparent we are deathly ill. We need to break the cycle of hopeless medical intervention. As a Christian, I believe that eternal life and joy awaits me after this life. I understand that many who read this blog don’t have that hope. And I know that when the end approaches, most Christians don’t distinguish themselves from anyone else by their behavior and medical decision-making. We consume medical resources every bit as voraciously as nonbelievers. Everyone appears equally bent on spending huge sums of money in a futile attempt to cheat death and postpone the inevitable. The soul-searching question is: “Why?”
Writing in Prism magazine, Presbyterian pastor Peter Larson acknowledges that “To forgo medical treatment is a radical proposal…and a decision that should be made prayerfully and with the consent of family.” I suspect that what Larson is referring to here are forms of expensive treatment that might extend a person’s life by days or weeks, but which come at an enormous cost that ultimately is borne by us all. This is by no means an endorsement of euthanasia, but rather an acceptance of physical and economic limits. We are bound by creation, whether we like it or not. Accepting death with faith and courage can be a potent testament to our belief that death is not the end. Should that day come sooner than seems fair, then so be it. From the perspective of eternity, the day of our departure is a trivial matter.
As the cost of healthcare spirals out of control, we do well to consider the words of Jesus: “Whoever wants to save his life will lose it, but whoever loses his life for me will find it.” (Matthew 16:25). What Jesus speaks of here is surrendering ourselves to him in exchange for eternal life. That’s a promise of immortality infinitely greater than anything the Greek gods, or the gods of our healthcare system, have to offer.

1 comment:

grsmouse said...

It may be dangerous ground but thanks for tramping on it. Christians, of all people should consider what you write. I seem to remember Paul writing about "being present with the Lord, which is far better." As an old man I am not hoping to die soon, but I do hope that I will not resist God's upward call when it comes.