By looking at Houston's brand-new medical Taj Mahal's I can see why we have problems with runaway medical costs. Medical care is in a bubble, just like higher education and the (late) housing bubble. They charge what they do because there is an endless stream of other people's money. The medical bubble needs to be popped.Barry's doing a really lousy job of selling single-payer (i.e., government) medical insurance. It's even more convoluted than Hillary's botched attempt. Hillary's plan was secretive and ginned up without following the laws. Barry's plan is open but so laden with unrelated pork that no one can understand it.
Obama should go back to square one and put together a more simple plan that doesn't contain unrelated pork, present it directly to the American people ("My fellow Americans, we listened to you..."), then take it to Congress. Some quick points:
- Base it upon the Australian system. The program would entail a 1.5% income tax for everyone with a gross income of $50k or less., 2.5% on incomes greater than $50k. It seems to work for them.
- Just state the facts. The current system is crazy expensive if you're healthy; If you have a pre-existing condition you're SOL. The system's broken and we all know it.
- Lots of people are hurting right now. Tell Americans that BarryCare will save jobs because US manufacturers won't have the burden of paying for medical insurance.
- Tell Americans that it will free up existing jobs by pointing out that many people only work because of the medical insurance benefits. (I know many people in this situation, I am sure you do as well.)
- Keep the SEIU thugs out of it. They are a big turn-off for most of us.
- Not a US citizen? No free medical care for you. Pay for it yourself, just like Americans must do when we travel overseas. This one issue angers a lot of people and for some reason the White House doesn't understand why.
- He needs to reach out to his critics, instead of following Rahm Emanuel's model of dismissing critics with vulgar, mocking terms. Don't run off to some nitwit at Huffington, go onto one of the Fox shows. Grow a pair.
- Use the bully pulpit to browbeat Congress to keep simple and understandable.
11 comments:
How about admitting that keeping 90-year-old Alzheimer-ridden zombies alive indefinitely is a colossal waste of resources??
How about an attitude adjustment among the current geriatric crowd that they're literally bankrupting the whole country with the obscene amounts of entitlements (medical and otherwise) that they receive?? How about one of these folks actually gets turned down for their 3rd hip replacement??
Oh, I forgot... the current "caretaker generation" are the Boomers, who think that they're immortal and that their parents should be as well. Never mind, carry on then.
Yep, Medicare as currently operated allows unlimited fee for service.
If there's a billing code, Medicare will pay for it.
It makes no sense to spend most health care dollars on unpleasant or painful treatments that have little chance of success.
Many elderly have a very realistic view of their own mortality.
It is frustrating for my grandmother to be forced to go to the ER for symptom relief of her chronic health conditions (e.g. shortness of breath)
Only to be asked "well, if you don't want a heart cath, why are you here?"
Were I in my mid-90s like her and had watched my late husband spend essentially the last decade of his life in a hospital bed I'd also ikely pass on the "cures" in favor of just being kept comfortable.
We need a "pre-Hospice" for people like her who only want palliative care (outside of a crowded ER, please)
End of life certainly drives up the cost. But why the hell does my nearest hospital think it's reasonable for two stitches on my finger to cost close to $3,000? They looked at it, cleaned it, stitched it. $3,000, or $1,500 per stitch. It's crazy, and of course the insurance company won't pay that.
Many elderly have a very realistic view of their own mortality.
Too bad their Boomer kids don't. I think many of them would rather have their parents live to age 150 in extreme suffering than themselves suffer through their parents' deaths.
And let's be frank, though many elderly admit their own mortality, and some even admit they don't want to live any more, the vast majority won't do a thing to hasten the end.
I ain't planning on being a burden. Pull the plug if I'm unresponsive. If I get the Big C and it's terminal give me a bunch of really good painkillers and I'll go off to croak in the mountains after a few glorious weeks/months. I think it would be great to let the animals feast on my carcass. This is the way it has always been up until recently.
If you think that is dumb, why is it better to spend thousands to pump chemicals into a dead corpse, stick that corpse into a $5000 box, then bury the box? That's far more gruesome than feeding some hungry animals.
A note on the Australian system (which I was under for a while): That 1.5% doesn't come close to covering the cost. Something closer to the 10% NI tax in the UK is more like it.
Still, one thing I thought the Australian system (and UK as well) had going for it is that you could get the most basic of care on the government plan, but you could also but "top up" insurance or pay the doctors yourself if you wanted better care. I found that to be a reasonable way to work things.
I don't remember a single employer there offering that extra health insurance as a perk; you had to pay for it yourself. Which is probably how it should be.
Watch out for those who want to define "sub-human" and their economic value...seen it before in history...doesn't end nice.
Doesn't mean open season on the public bank accounts either..ability to pay, commercial insurance and charities should control..if that is hartless than mark me down...could ship them to India...lot cheaper to outsource med care since we don't have the means to take care of the wave about to hit the system anyway from the boomers.
It's not economic value, but the harsh cold reality of statistical lifespan.
Anything done to my grandmother doesn't change the fact that her life expectancy is only a couple of years.
Again, she understands that, and just wants relief from the symptoms of her multiple chronic health conditions.
She simply has no desire for "cures" that entail opening her chest or hooking her up to machines for the rest of her life.
But yeah, her youngest (65 year old) kid can't let go...
I was fortunate to see several people close to me die with dignity. No machines, no heroic efforts, just a calm acceptance that the end was near and it was time to go. An uncle, with terminal lung cancer, told one of his step-daughters, normally the rational one, "I'm going to die soon. Accept it, I have".
It's one thing to take some big measures when the result will be years of decent life. Extending a terminal patient's life by a few weeks or months of bedridden agony is cruel.
I still think the best way to go is to change health insurance back to what insurance really is: mitigation against catastrophic loss, not a payment method for everything that ails you. This would cut costs in a big way but it won't likely happen.
Great post Lou. My own father passed away last April after a long battle with Fronto Lobe dementia. He died the typical FTD death. He aspirated some food into his lung. He begin turning blue and went into cardiac arrest on Saturday. The ambulance was called and they paddled him and got him to the hospital where he was put on a ventilator. My brother and I were both out of town that Saturday. I made it back to Houston Sunday afternoon. There were no doctors available to discuss my dads condition on Sunday. Even though it appeared to me the only thing to do was turn off the ventilator, I wanted to speak with a doctor for confirmation before I pulled the plug. On Monday, I managed to tackle his worthless primary care physician. He was heading to the elevator trying to escape, I ran him and stopped him. He did condescend to speak with me. Knew next to nothing about my dads case, asked me what the Neurologist and Pulmonologist said and read dads chart with me standing there, trying to interpret what he was reading on the fly. I could not get him to answer the question. Can my dad recover in any meaningful way?
I did not talk to anybody who could answer that question until late Monday night and only because I spoke to the head nurse and tearfully expressed my frustration and being unable to resolve my dads situation. She got ahold of the neurologist he came in at night to meet with us. After speaking with him it was clear we needed to turn off the ventilator. At that point, it was too late to turn off the machine since we were giving his brain to Baylor for FTD research so some coordination was necessary. So Tuesday morning, the worthless doctor was called and signed the order to turn the machine off. Afterwards my dad passed away very quickly and peacefully. The point of this long post was that if I could have had a meaningful conversation about my dad Sunday we could have turned everything off Sunday or Monday morning at the latest. As it was the hospital charged 60K for being on the machine from Sat to Tuedsay. And the worthless doc charged 11K for his services. From what I could tell the oonly thing he did was sign the doc to turn the machine off. I figure taxpayers through medicare paid at least 50K unnecessarily. What I thought was cute was the I got the notice from Medicare about worthless docs charges. It said that medicare had paid the doctor 10K and that we would be billed 1K. Of course, the doctor is too smart to send us a bill for the 1k. Total scam IMO. I'm looking into who I should report this guy to. Sorry the long comment but all of this touches a nerve.
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