I may have missed it, but in all the discussions I have seen in the news media about Terri Schiavo I have not seen anyone raise the question of how much her life is worth in dollars and cents. Yet that is probably a question that lurks somewhere in the back of the minds of everyone who is thinking about the 41-year-old woman who has been kept alive for a dozen years, in a vegetative state. I wasn’t going to bring it up, knowing I would be accused of being callous and insensitive to the moral issues at stake, but it become just too obvious that all this is happening as our government in Washington, and all the state governments, are in frantic debate over the bankruptcy of our public health-care systems, Medicare and Medicaid.
In his Wall Street Journal column today, Daniel Henninger (a good man who I worked alongside 35 years ago when I was still newspapering) danced around the topic for several hundred words, but finally put his finger on what this national conversation is all about:
In 25 years, the baby boomers will be on the cusp of 85, becoming what a physician friend has called “history’s healthiest generation of Alzheimer’s patients” As the tsunami of red ink collapses the struts beneath the tar-paper shacks of Medicare and Social Security (which the Congressional elders say isn’t broken) the “scarce resource” argument will re-emerge, with soothing persuasiveness, for triaging the most ill among us, very old or very young.
The outpouring of support to give Terri Schiavo back to her parents may prove quixotic, but it ensures that these future questions of who lives and who dies won’t be decided by the professional class alone in conferences and courtrooms. It will be done in full view, where it belongs.
What Dan is saying is that the general electorate, young and old, has the most at stake in working out the rules as best it can before the tsunami hits, and Ms. Schiavo’s case floated to the surface of true national conversation at this time because it is a perfect proxy for all that’s coming.
Along these lines, Maureen Dowd, in her New York Times column the other day noted that House Majority Leader Tom DeLay was beating his breast on behalf of federal intervention to keep Ms. Schiavo alive at the same time he was denouncing the Democrats for refusing to vote for $15 billion in federal health-care cutbacks over the next decade. Maureen made the most pertinent point in suggesting that DeLay was effectively asking that the feeding tubes be pulled from many thousands of sick and dying who are alert while he was sanctimoniously pleading for the continued life of one citizen who is not and never will be.
The dollar-and-cents cost to Ms. Schiavo’s husband, parents and siblings plus the dollars spent by her fellow citizens through tax dollars easily exceeds $1 million. Some years ago, I understand, the private family funds that supported her ran out and she is in fact now being kept alive with state funds, between $80,000 and $100,000 a year. If this were a once-in-a-generation event, I seriously doubt that it would be getting this attention. The amount of money involved is trivial in the grand scheme of things our society has to deal with. But as Dan Henninger wisely noted, our society is soon to be hit with tens of thousands, perhaps even millions, of Terri Schiavos, who could be kept alive indefinitely by the taxpayers… which is the only realistic source of such funds.
I wonder how sanctimonious Tom DeLay would be if the life support for this inert human being was costing $1 million per year, or $5 million, or $10 million. What is the price of a living and breathing human, no matter how inert? There is of course a process by which society answers such questions, and Dan Henninger is absolutely correct in saying the answers are worked out in the open, not in the closed sessions of Congress and the courts. Thousands of years ago, when an economic contraction struck a part of civilization in a way that threatened society, there were no parliaments and courts to decide what to do. The mores of the people would change, in essence saying it would be okay for a woman who gave birth to a girl to put the infant out to die, so there would be one less mouth to feed. When things got better, the mores would change again in the other direction.
That’s the way the world worked thousands of years ago and it is the same now. It was of some significance today to learn that President Bush, who called for federal intervention to keep Ms. Schiavo alive, was plunged to a 43% approval rating, the lower number of his presidency, and at the same time polls show 80% of Americans oppose federal intervention to feed her even as they sympathize with her husband and parents.
There is of course a complication with husband and parents, with parents offering to take her off the hands of the state and care for her themselves, somehow. Her husband, though, has long ago decided to get on with his life knowing hers was effectively over, and has taken a common-law wife who has given birth to two children by him. With these conflicting interests, there is no other way to determine the outcome than with judges and courts of law, who have all sided with the husband. In specific cases like this, which will abound in the years to come, it is much too much to ask for a national conversation. One should be enough, although I expect there will more to come, each one painful but necessary.