In 2004, for example, Lamm was part of an unsuccessful takeover of the Sierra Club by zero-population-growth advocates. But Lamm—who will be the keynote speaker at the Oregon Health Forum's annual awards dinner Wednesday, Dec. 6—is perhaps best known for his work in healthcare policy.
It's in that field where Lamm has been at his most controversial. He has long said that advances in medical technology, especially those that extend the lives of the elderly and the desperately ill, come at too high a price for taxpayers. In Oregon, Lamm feels a kindred spirit for his views. Here's why:
WW: In 1984, you were quoted as saying we all had a "duty to die" rather than a "right" to die. Has your view on our "duty" changed as you've gotten older?
Richard Lamm: No, I just lost my 98-year-old father...I'm 71 years old myself. But I also have grandkids, and I think that my aging body —in this new world of medical technology—can keep your kids and my grandkids from going to college. We have to come to grips with that.
That's a bold statement. Do you have a plan for how you're not going to become a burden to your grandchildren?
I belong to the Hemlock Society [now called Compassion and Choices, the group advocates for patient control over end-of-life care]. But I'm more interested in the public-policy implications of that question....I'm convinced we're going to have to separate "quantity of life" from "quality of life," and that we can't afford to use taxpayers' money to wring every last "quantity of life" out of people.
How can we do that?
The best way that I've seen...is Oregon's priorities system [which decides which healthcare services will be paid for with public money].... We're going to have to come up with a [state and national] system of priorities that says, "We don't fund artificial hearts," or "We don't fund people in a permanent vegetative state beyond a year" or "If you are desperately ill with cancer and you have a cardiac arrest, we don't call the crash cart." And we've got to get Americans over this idea that they have an entitlement to have taxpayers fund every desperate last hope in medicine. No nation denies its people as much health care as we do.
We're at least a little better off than some countries, right?
Yes...India denies more people health care than we do. But if you compare us to the rest of the developed world, we deny more people more health care. Americans have socialized medicine for the elderly, and it's the political power of the elderly that they don't want to give up anything that they have through Medicare to share with people who have nothing.
Are you calling old people greedy?
Well, that's not the word that I use. But I think they certainly have become entitled.
Are they like the fabled "welfare moms driving Cadillacs"?
Well, I think that people have to recognize that at a certain point many elderly people are on welfare just like a "welfare mother" is on welfare. They hate to acknowledge it.
What do you think of Oregon's assisted-suicide law?
If I were in Oregon, I would have voted for it. I personally don't want to get that issue mixed up in the whole issue of prioritizing health care.... Physician-assisted suicide is not an answer to healthcare costs. But I'm very glad that Oregon is piloting this issue.
In 1987, a 7-year-old Portland-area boy named Coby Howard died while waiting for an expensive bone marrow transplant that the state wouldn't pay for. Do you think Coby should have been allowed to die?
I don't think anybody should die. But what strategy saved the most people?...that's what Oregon asked. You don't want anyone to die. But I believe Oregon got it right—that you have an obligation to maximize the amount of health care and the amount of lives that can be saved. You can't do that an individual at a time.
As a Colorado state legislator in the early 1970s, Lamm championed a successful campaign to block the International Olympic Committee from hosting the Winter Games in Denver. Intensely popular as a result, Lamm was elected Colorado's governor in 1975 and served until 1987.
Lamm will speak at the Portland Hilton Ballroom as part of the Oregon Health Forum's 2006 leadership awards dinner, beginning at 6 pm. Tickets are $100 and available by calling 226-7870.