To understand the ramifications of any plan to finance health care, it would be helpful to explore the economic life cycle of most Americans. That cycle involves three phases. The first, an initial period of Dependency, begins at birth and lasts until the individual starts to earn a living. During that period he/she is a consumer, but not a producer.
The next period is Independancy. It is the period when he starts accumulating assets
and retirement benefits, from private and government retirement plans. It is also the period of high expenses for creating and raising a family with all the costs involved. During Independency he is both a producer and consumer.
The last period is again Dependency, supported by accumulated assets, retirement plans, and/or relatives. During this period he is still a consumer, but no longer a producer.
The purpose of health care is to improve the quality of life by reducing
Morbidity (illness and incapacity), and premature Mortality, and extending the life
span. A successful health care program will thus increase the length of
the final dependency period. It is in the final years of that period that the individual consumes the greatest amount of health care resources and incurs
the greatest expenses. Thus the dilemma.
There is another factor which is increasing the cost of health care to a large degree. Many of the more common ailments now have medications and treatments which
yield cures at modest costs. The more exotic and chronic ailments of age, such as Alzheimers, and degenerative conditions, do not respond to the most common medications. Much experimentation is ongoing for drugs for those conditions. Such
experimentation, and testing, is very costly. That cost must be amortized over a relatively small patient population, so the cost per patient is very high, and can continue over long periods, making those ailments very expensive to the health care
insurer, whichever type. That leads to proposals to limit treatment for such patients, a form of triage or euthanasia.
What plan we finally adopt will reveal a great deal about what kind of society we are, or pretend to be.
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2 comments:
What you say makes sense to me Marty. Makes me think of Hillel's comment: 'If I'm not for myself, who will be?. If I'm for myself, what am I?" I believe Hillel was suggesting that we cannot be only for ourselves--we must be for others also--we're one body, mankind.
What you pose in your blog is our dilemma---If we're for others also--how can we do it if it exceeds our means?
What you describe is true but is not why we have a health care crises that if not corrected will possibly bankrupt this country. The major indusrialized nations of the world all face aging populations, in many cases their situation is worse that ours considerating longeviety statistics. They are coping, we are not. WHY! Because we have a disfuncional fee for service system that rewards excessive and improper care. No one gets paid when we are healthy or to keep us healthy. Perverse incentives are built into this system and this must be corrected. If we do not, and instead add 50 million more people to it, we will bankrupt this country.
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