HEALTH CARE

What My 91-Year-Old Mother Wants for Mother’s Day

(It’s Health Care for All)

When President Obama described his grandmother’s decision to have a hip replacement in the weeks before her death I couldn’t help but think of my mother, who will be 92 in June. Between 2000 and 2005 she underwent three hip surgeries, including two to “re-do” failing implants, preceded by weeks of immobilization and followed by rehabilitation. Today that third prosthetic is not in a perfect position, so (as is her way), she has sensibly agreed with her surgeon to live a sedentary life to avoid further surgery.

And I haven’t mentioned the amputation of her right arm at age 39 due to a sarcoma, or the fact that she taught herself to drive and sew with one arm, or that she re-read all of Proust in French two years ago, or that she is a world-famous psychotherapist who still works and still writes. The memoirs will be published next year. I challenge anyone reading this to find a tougher or more independent nonagenarian than my mother. My wife and daughter find her a formidable feminist act to follow.

My mother was luckier than the president’s grandmother. She did not have any other serious disease and recouped her strength following each of her hip surgeries. So when I read the president’s thoughtful remarks about the question of whether someone in his grandmother’s or my mother’s position should be able to elect hip replacement in their eighties, I thought it important to tell her story. As the president indicated, there are tough choices ahead. Perhaps not all expensive procedures can be justified for those near the end of life, but not everyone in their eighties is near the end. We don’t have enough data to justify the level of confidence that close cases require, which is why the president is right to support research that compares the effectiveness of medical treatments, and speeding the implementation of computerized information systems for better coordination of care. It’s not for government to decide life’s up at 80, but eighty-year-olds, like amputees who are decades younger, need evidence to make choices, with their doctors and their families.

Now you might suppose that my mother would join the chorus of critics of the administration’s efforts to secure adequate health care for all Americans, fearful that someone like her might someday be denied one hip surgery, let alone three. But if you spoke with her you would find that, like most Americans, she believes that a decent society should provide care as a moral imperative, and that markets alone are not well-suited to address the vulnerabilities that can come with illness, especially for those without family and resources. She would tell you that Medicare isn’t perfect, but at least the government doesn’t spend up to a third of her premium on advertising. How much better would it be if our health care system demanded a high quality of care rather than just paying for more procedures?

So she will not be cowed by the cries of “rationing” we will surely hear in the next few weeks from certain self-interested parties, anymore than losing her arm or her hip intimidated her. Smart government can and must deliver a reasoned, evidence-based health plan for all. Compassion demands it. Is that so much to ask for Mother’s Day?

Jonathan D. Moreno is the David and Lyn Silfen University Professor of Ethics at the University of Pennsylvania, a Senior Fellow at the Center for American Progress, and the Editor-in-Chief of Science Progress.

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