There are a lot of tragic aspects to our current health care system. No one seems to be happy with it, and no one agrees on how to fix it. But I think there’s at least one area where we could make progress, in a way that could avoid a lot of political fighting — mostly because it wouldn’t require any taxes or regulations, which are the things we’re usually fighting about.
That area is the tendency of patients, or the families of patients, to delay death for as long as possible, at any cost. According to one estimate, in any given year Medicare alone pays over $50 billion in doctor and hospital bills during the last two months of patients’ lives.
Now, this attitude is understandable, because death is scary. Even someone with a firm belief in some kind of afterlife can grow frightened as the time to test that belief draws near. (I saw this happen with my own mother.)
For people without such beliefs, I recommend the perspective offered by the Roman emperor Marcus Aurelius in his Meditations. Either there is something after death — in which case, why fear dying any more than you would fear being born? — or there is nothing after death — in which case, what is there to fear?
But that seems to be difficult for a lot people to accept. Fortunately, there is another view that seems to split the difference, which is the Tibetan Buddhist belief in reincarnation.
Without going into too much detail, the basic idea is that when you die, if there are still issues you need to work on, you return to take another crack at them, in a new body. Reincarnation is the process of coming back. Karma is picking up where you left off — the idea that if you need to deal with something, you can’t avoid it even by dying!
(In that sense, it’s kind of a spiritual analog to student loans.)
Think of it this way. Suppose you’re at Disney World, and you’re on some ride, like Pirates of the Caribbean. And the ride breaks down just as you’re nearing the end of it. So now it looks like you’re going to have to sit there for 10 minutes, 20 minutes, or who knows how long, in the dark, with nothing to do.
Now, on the one hand, if you think you’ll have to leave the park at the end of the ride, you might want to sit there, delaying the inevitable, even if it means being bored out of your mind. At least you’re still at Disney World!
But on the other hand, suppose you don’t have to leave the park, and there are lots of other rides that you’re looking forward to. Wouldn’t you want to get out of the boat and move on to the next one?
That’s reincarnation in a nutshell — realizing that there are lots of other rides after this one, so jumping off this one is no big deal.
Or, as Chogyam Rinpoche once put it: ‘The bad news is you’re falling through the air, nothing to hang on to, no parachute. The good news is there’s no ground.’
While this might be too large a change in worldview for some adults, there may be a way to ease the transition for everyone else.
Consider that we can start preparing children to write before they’re really ready, by encouraging them to draw the kinds of simple shapes that are used to make up letters — lines, circles, triangles, squares, and so on. Then writing becomes a matter of transferring a skill set that they already have.
In much the same way, we could start teaching children — or adults who are still open to learning — to accept some version of reincarnation by encouraging them to look at most activities as being iterative in nature.
(That is, you don’t write a single draft of a story. You keep writing drafts until you’re happy with it. You don’t make a single design for an airplane, or a house. You keep tweaking the design until you’ve worked out the kinks. You don’t write a single version of a computer program. You keep adding features, and removing bugs, until it does what you want it to do. And so on.)
Then accepting reincarnation would become a matter of transferring a belief set that they already have.
Perhaps instead of thinking I have just one life, so I have to hold onto it for as long as possible, people could learn to think I have lots of lives, so maybe it’s time to take what I’ve learned from this one and go on to the next.
I’m not saying this would be an easy sell. But it sure would save some of us a lot of agony, and all of us a lot of money. So isn’t it worth a shot?