In which I share a little something I’ve been thinking about.

I try to shield myself from too much media (because American media is, as you know, ON FUCKING CRACK) but one can’t be alive and totally ignorant of the issues. One does, after all, read the New York Times and listen to NPR on occasion.

In spite of myself, I’ve come to note that the nation’s health care discussion contains all these frightened, angry, negative words and phrases: Death panels. Loss of life. Quality of life. Spending. Cost. Rationing.

The dialog contains nearly circular discussion: “What if I or my loved one needs care but is denied?” followed by “Well we can’t spend infinite amounts of money on everybody, especially when quality of life is taken into consideration!” followed by “WHO EXACTLY IS QUALIFIED TO DETERMINE QUALITY OF LIFE?!”

Everyone seems to have missed the underlying issue here. There is no infinite amount of spending to protect against. The unspoken assumption is that all people, especially those who can’t pay for health care out of their own pockets, will inevitably choose in every circumstance to spend every penny they can.

That’s just not true.

There was a caller on Talk of the Nation this morning (“It’s Not Whether We Ration Health Care, But How”) who said that his elderly father declined a valve replacement surgery because it would probably only extend his life a year and would require six months to recover from. We’ve all heard stories of people halting or declining treatment for themselves or their family members because they knew that heroic measures wouldn’t provide a desirable outcome. It happens all the time.

Expensive, heroic surgeries and treatment modalities tend to be painful, debilitating, and require long recovery times. I submit that most people aren’t gluttons for pain and trauma, and that most of our national dialog on health care is riddled with insurance horror stories about individuals who were denied life-saving treatment they actually needed. The story of the health care end-user who just spends millions just for fun is, I submit, wholly imaginary.

Therefore, if we adjust our thinking away from this imaginary spender, we have less to protect from and therefore less to legislate about. Let’s let people decide what they need, and make sure they get it. Let’s not make them accept things they don’t want to accept.

Problem solved.

Anyway.