How Shall We Care for Our Frail Elders?

How Can We Best Care for our Frail Elders?

The issue of what constitutes "best" care for the elderly is not easily identified nor readily defined. There are widely differing points of view, each with its own strengths and limitations. In addition, arguments are often full of bias and assumptions, making it even more challenging to form an intelligent opinion regarding this difficult problem. Differing points of view provide a variety of evidence, biases, and assumptions to be examined and interpreted before coming to a personal conclusion.

Alan Sager, an associate professor at Boston University's School of Medicine, is in favor of a national health insurance policy that guarantees "quality health care for everyone" (Sager, 152). He insists that the government already spends enough to provide health care coverage for every citizen (Sager, 153). He presents a four-part plan with health care for all with no out-of-pocket expenses, financially neutral physicians and health-care professionals, hospitals operating on limited budgets, and freedom for each individual to choose a caregiver (Sager, 157). Sager provides many specific percentages, dollar amounts, and population numbers to supply supporting evidence. However, his attacks on Medicare distract from his proposed plan. (Sager, 155).

Richard Lamm, former governor of Colorado and current professor at the University of Denver, asks some difficult questions as he challenges the priorities in our current health care system where "we spend too much money on high-technology care for a few and too little on basic health care for the many" (Lamm, 160). He also carefully cites percentages and population figures in his evidence statements. However, Lamm's biases weaken his argument drastically. He over-uses "hot" adjectives and draws parallels that do not represent evidence but rather pull at the readers' emotions ('pain-racked existence," "spend fantastic amounts," "small chance of survival," "over treating our sick and under educating our kids" (Lamm, 159-160).

The complexities of this situation run deep. There are no simple answers or one-time, one-size-fits-all solutions. There is not one correct answer. Some of the reasons for many of the uncertainties that cause this problem to be so complex are:

1) Extreme measures are being taken to extend the lifetime of very old people

2) Sometimes when life is extended the quality of life may be severely reduced

3) People with Alzheimer's and Dementia are no longer fully aware of their surroundings

4) The elderly have already lived for decades

5) Opinions about the sanctify of life vary widely.

Once an open-ended problem has been identified, the solutions offered must be examined for bias, assumptions, and objections. Personal, religious, and political biases infiltrate an author's choice of evidence to cite and color his or her conclusions. Sager makes his assumptions sound like evidence when he states, "the poor are typically in greater need of care," and "people in other nations [where free health care is provided] are healthier as a result" (Sager, 153). In addition, he ascribes a motive to Congress to add deductibles and co-payments, claiming it was done "to restrain citizens from using benefits" (Sager, 155).

These statements weaken his argument and detract from his actual