Obama's Grandmother and End-of-Life Care

How much time on earth is enough? How good does it have to be? What price are we willing to pay for it?

For decades, Americans have been debating when life begins, but now come the questions about the last days, as Barack Obama raises the hard fact that "those toward the end of their lives are accounting for potentially 80 percent of the total health care bill."

As usual, he sees the issue in human terms, recalling that "when my grandmother got very ill during the campaign, she got cancer...terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.

"So now she’s in the hospital, and the doctor says, Look...maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that--you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.

"And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly...things fell apart.

"I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether...society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question."

Yet it is sitting there at the heart of health-care reform, as Obama anticipates "a conversation that is guided by doctors, scientists, ethicists" followed by a "democratic conversation" among all Americans.

"It is very difficult," he says, "to imagine the country making those decisions just through the normal political channels." An independent group can give guidance without being determinative, but politicians will ultimately have to find some answers.

One of them, Arlen Specter alluded to it on Meet the Press today. The 79-year-old senator, who has been battling Hodgins lymphoma for more than four years, said, "I would support advanced directives, where we find so much of medical care is paid for the in the last few hours or few days of a person's life. Not to tell people what to do on their care at that time, but have them, have them think about it."

It's going to be a difficult and emotional debate, not only for those of us who are directly affected, but for generations who love their parents and grandparents. It is time to start.

Shrinking the GOP

The Arlen Specter party switch today is the latest sign of an eight-year process--the shriveling of the Republican Party to a one-size-fits-all collection of conservatives that started in 2001 with Sen. Jim Jeffords leaving and even John McCain flirting with the idea after being splattered by the Rove smear machine in the primaries a year earlier.

Party Chair Michael Steele affirmed the meanness that motivated Specter today by commenting that he “didn’t leave the G.O.P. based on principles of any kind. He left to further his personal political interests because he knew that he was going to lose a Republican primary due to his left-wing voting record. Republicans look forward to beating Senator Specter in 2010, assuming the Democrats don’t do it first.”

Nicely said. Translated, Steele is confirming that Specter's role in crafting a compromise to pass Obama's stimulus bill disqualifies him from the bitter-end party-of-no that is now the Republican brand.

This politically suicidal process cries out for psychiatric intervention, shrinks to stop the GOP from shrinking itself down to Rush Limbaugh and a few office-holding lookalikes.

Bush's Madame Curie Moment

It's hard to picture the President in a lab coat, but the White House today is giving him credit for the newest advance in stem cell research.

Reacting to the news that scientists have succeeded in reprogramming skin cells to mimic embryonic stem cells, a Presidential adviser tells us today,

“This is very much in accord with the president’s vision from the get-go. I don’t think there’s any doubt that the president’s drawing of lines on cloning and embryo use was a positive factor in making this come to fruition.”

If the way to encourage advances is to thwart scientists' work, Bush should take his place alongside Madame Curie in the annals of medical breakthroughs.

"My feeling is that the political controversy set the field back four or five years," says James Thomson, who led a team at the University of Wisconsin in discovering human embryonic stem cells in 1998.

“I really don’t think anybody ought to take credit in light of the six-year delay we’ve had,” says Sen. Arlen Specter, a Republican sponsor of the bill Bush vetoed in July 2006. “My own view is that science ought to be unfettered and that every possible alternative ought to be explored.

“You’ve got a life-and-death situation here, and if we can find something which is certifiably equivalent to embryonic stem cells, fine. But we are not there yet.”

Americans like Nancy Reagan and Michael J. Fox will be elated to learn about the new research, they are not likely to be hailing George W. Bush as a benefactor of mankind.

"Die Hard" Starring Larry Craig

Now that he is represented by Michael Vick’s lawyer, Sen. Craig may not be going to the dogs after all. Spurred on by Arlen Specter’s unsolicited legal advice, the Idaho Republican is now prepared to embarrass both parties by putting himself, and the rest of us, through a Senate Ethics Committee hearing to determine if his men’s room behavior was inappropriate.

If this comes to pass, the sessions should be held in secret, not on the grounds of national security, but to save whatever shreds of national sanity remain.