Who Makes The Choice?

This article reports on President Obama’s remarks last night about saving health care costs by avoiding expensive treatments of patients who are deemed to be terminally ill or otherwise unlikely to enjoy a long-term benefit from the procedure.  The President is right, of course:  one sure way to reduce health care costs is to eliminate the kinds of treatments or procedures that are available under a health care plan, or to limit who may obtain those treatments or procedures. 

One issue with the health care debate, however, is whether the American people will want to cede decision-making about the kind of care that is available to them, or their loved ones, to a governmental agency.  I think most people view decisions about care, when dealing with diseases like cancer, to be extremely difficult, highly personal decisions.   It is one thing for a patient and his or her family to decide that the best course is to not undergo painful or expensive treatments that may have only a small chance of curing an otherwise terminal condition.  It is another thing entirely for that decision to be made by a bureaucratic agency.

Quebec, A Church, And A Choir

Kish and I are in Quebec for a conference. It’s a very interesting city, particularly in the old section where we are staying. It is as if a portion of an old and charming European walled city had been lifted out of France or Luxembourg and plopped down in Canada, complete with crooked streets, pastel colored brick and stone buildings, outdoor cafes, and street performers.

Eglise Notre-Dame-des-Victoires

Eglise Notre-Dame-des-Victoires

Yesterday, as we we browsing through shops, I decided to take a break from the next shop down the street and instead visit the Eglise Notre-Dame-des-Victoires, which is one of the old churches in Quebec — and there I had one of those magical travel moments. The church itself is striking. There is a sharp contrast between its simple stone exterior and its extraordinary interior, which features cream and gold coloring, large paintings, an altar with a castle theme, and a wooden boat hanging from the ceiling that appears to be an exact miniature replica of a sailing ship, correct in every detail. It was a feast for the eyes.

The wooden boat hanging from the ceiling
The wooden boat hanging from the ceiling

What really made the moment special, however, was that as I entered a choir happened to be singing. It was a choir of mostly children and teenagers, with one or two adults thrown in. They sang with only an organ for accompaniment, and their voices were terrific. Kish joined me and we sat there, mesmerized by the scene and the music as they sang hymns and an Irish prayer set to music. The choir closed with a rollicking version of an old spiritual, When I Lay My Burden Down, and then everyone filed out of the church and the moment was over — but it is a moment that I will always remember.