CURE Report
Cost-Cutting, Care-Cutting, and the "Living Will"
by Earl E. Appleby Jr.
For what shall it profit a man, if he gain the whole world, and suffer the loss of his soul? (St.
Mark 8:36)
"Is society ready to analyze death and the prolongation of life in terms of cost-benefit analysis, or to consider shifting
the use of expensive facilities from the hopelessly ill to those whose future holds more promise?" asks scientist Dale Wolfle.
If by "society," we mean those with increasing power to decide life and death matters directly endangering our loved ones
and ourselves, the tragic answer is yes.
In health care, cost-cutting is a code word for care-cutting--what Dr. Harry Schwartz of Columbia University has described
as checkbook euthanasia. The checkbook euthanasians have long regarded the misnamed "Living Will" as a key weapon in their
fight against life, life deemed too costly by their balance-book souls.
In June 1977, Robert A. Derzon, Administrator of Health Care Financing of the Department of Health, Education and Welfare
prepared an internal document for the use of Secretary Joseph A. Califano in a budget meeting with President Jimmy Carter.
An accompanying memorandum noted that:
Although these initiatives undoubtedly will generate great controversy among health care institutions, physicians,
insurers, and consumers, many can have a substantial impact on rising health care costs.
The first item in this pro-death document, revealing entitled Change Social Values Regarding Cost-Inducing Activities
bore the heading Encourage Adoption of "Living Wills." Warning "there is still religious resistance to this concept," the
care-cutting bureaucrats urged the Secretary to remind the
The cost-savings from a nationwide push towards "Living Wills" is likely to be enormous. Over one-fifth of Medicare
expenditures are for persons in their last year of life. Thus, in FY 1978, $4.9 billion will be spent for such persons and
if just one-quarter of such expenditures were avoided through adoption of "Living Wills," the savings under Medicare alone
would amount to $1.2 billion.
Not content to leave such savings to the persuasive powers of Big Brother in Washington, Derzon urged "that federal Medicare
funds be withheld from states that do not enact living-will laws." In other words, if you don't agree to pull the plug on
your life line, Uncle Sam will do it for you.
As CURE's medical advisers remind us, no physician, save the Great Physician, knows the hour his patient will die. In
fact, research indicates that doctors are likely to underestimate the months of life remaining to persons diagnosed with "terminal"
illnesses. Of course, if life-saving care is denied a patient, he or she may well die within a year--sooner, if it is food
and water. As a former United States Surgeon General once put it, "it is the physician's decision which makes death imminent.'"
The "last-year-of-life" savings were rung up postmortem by cynical government accountants who know the cost of everything
and the value of nothing human life, in particular. They were calculated in the cold-blooded fashion of their German predecessors.
And while cannibalizing Medicare targets older and disabled Americans, euthanasia, as all holocausts, cannot be contained
for it is genocidal by nature.
"Additional federal savings," the report pledges, "would accrue to Medicaid and the V.A. and Defense Department health
programs." Thus we see the poor, the veteran, and the soldier added to the body count of the dying-for-dollars drive.
Professors Germaine Grisez and Joseph Boyle caution:
Proponents of the legalization of euthanasia regularly use premises that reflect their conviction that under some
conditions people are better off dead, that their lives are too poor in quality to be endured, that their lives lack meaning,
that their survival offends human dignity, that they deserve the compassion shown a sick beast, that they are mere vegetables,
and so on and so on.
No wonder one of the great teachers of American surgery in this century, J. Englebert Dunphy warned his colleagues in
his annual oration before the Massachusetts Medical Society nearly two decades ago:
History shows clearly the frighteningly short steps from "the Living Will" to "death control" to "thought control"
and finally to the systematic elimination of all but those selected for slavery or to make up the master race.
As Santyana observed, he who does not remember the lessons of history is condemned to relive them -not that we should
need reminding in a century stained with the blood of the Nazi and abortion holocausts.
Whose life will the misnamed ""Living Will" claim next? I pray God, it is not yours.
