Op-Ed: The taxpayers’ stake in end-of-life care.

Suppose Grandmother has a living will. It says that if she fallsinto a vegetative state, like Terri Schiavo did, she wants to be keptalive on a feeding tube. How long? “Until the good Lord takes me away.”One terrible day, she is thus stricken, and in goes the feeding tube.OK, who pays for her care?

Most of the fist-waving a year ago was over whether Michael Schiavohad the right to order the removal of his wife’s life support. Terri’sparents said that they wanted their daughter kept alive, and that ifMichael did not wish to care for her, they would.

The parents’ view clashed with reality. The reality was that thenurses at a Florida hospice were taking care of Terri, and Medicaid waspaying for them. Clearly, the taxpayers also had a stake in thesepainful decisions, though no one talked about it much.

The time has come for that conversation, and it ought to be frank.Medicaid, the health-insurance plan for the poor, is supported byfederal and state taxpayers. Medical technology can keep people with nohope of recovery floating between life and death for decades. Thetaxpayers have a right to set limits on how much of this they willfinance.

Medicare covers the elderly and disabled, but does not pay fornursing-home care. Medicaid will. It has become something of a game formiddle-class families to transfer an ailing relative’s assets to, say,their children, in order to make the patient “poor” and thereforeeligible for Medicaid. The Deficit Reduction Act — signed by thepresident but now held up by lawsuits — would make such transactionsfar harder to do, according to Lawrence Davidow, president of theNational Academy of Elder Law Attorneys (www.naela.com).

Read the rest of this provactive op-ed piece by Froma Harrop in the Seattle Times.