The Wrong Health Care Emphasis
I was reading an article about health care reform when my train pulled into the station. The platform was crowded. I looked around. It took just one quick glance to see the major missing piece in today’s great health care debate.
The people on the platform, a mix of young and old, black and white, richly dressed and otherwise, a perfectly random sampling of urban Americans, didn’t look all that healthy. One teenager appeared to be about five feet six inches tall and nearly as wide. And he wasn’t the only very overweight person on that platform. The men mostly slouched. The women, even the younger ones, seemed to be having trouble carrying not-that-heavy parcels. It might have been the light, but there was a distinctly pasty-faced appearance to many of those boarding as I exited the car.
Should there be a single payer health care system? Should we have a government insurer compete with private ones to hold down costs. Should the law passed by a Republican Congress that has Washington paying retail price for the drug purchases it makes for Medicare be amended? Should employer health insurance benefits be taxed to pay for those currently uninsured? All good questions. All well worth discussing.
But here’s the core truth that really matters here. There’s a demographic revolution going on in this country. People are living longer. Older people tend to need more health care and more costly health care. And the only long term way to address these rising costs, the only long term way with the slightest possibility of successfully addressing this economic challenge, is to make older Americans in the future healthier when they get older by helping them stay healthier while they are younger.
There’s a modest part of the Obama health care proposal that includes preventive measures. Great. There’s thousands of programs in individual schools around the country that get kids into better eating habits and get them to exercise more. Great. There’s many companies, tired of their own soaring health insurance bills, that have weight loss, smoking prevention, and exercise programs. Great.
The answers to future health care solvency are everywhere on view. What’s lacking is a truly coherent, universal, well funded effort by the federal government working through states, schools and employers to do what’s needed. This will cost money either directly via subsidies or with tax incentives. Bully platform propaganda will have to be backed up with an on-going media blitz. And this should not just be a Health and Human Services priority. Every agency of government must be brought on board to reinforce the effort.
Here’s the two two choices we have today when it comes to paying for future health care. We can get Americans healthier before they reach 60 and adequately finesse a future health care crisis. Or we can just play who-pays-how-much-for-doing-what games and end up bankrupting the republic. Bankrupting it 10 years later maybe. But bankrupting it nonetheless
8 Responses to “The Wrong Health Care Emphasis”
The Wrong Health Care Emphasis | The Moderate Voice…
I was reading an article about health care reform when my train pulled into the station. The platform was crowded. I looked around. It took just one quick….
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The real discussion on healthcare doesn't start until end of life issues are brought up. For most people, the lion's share of their costs will occur as they near the end of their life. Let's face it – most of us won't be on a ventilator, a dialysis machine, or most other expensive equipments until we are getting ready to die. Then the “save them at all costs” mentality sets in and all the stops are pulled.
For too many, these represent needless costs. There is a time when the only reasonable thing left to do is die. As a person of faith, I don't fear this point (but I'm not rushing towards it, either). Given the fact that most of us don't know enough about medicine to determine when we, or a loved one, has reached this point, medical personnel have to have the ability to pull the plug, so to speak.
No one wants to be the first to say this out loud, of course. There's no point on the political scale that is perfectly comfortable with using political power to determine when life should end.
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“There’s a demographic revolution going on in this country. People are living longer. “
Surprise. The typical onset of disability doesn't happen until after age seventy, which has long been what should be the new retirement age (including for government retirement programs; even if earlier retirement is permitted, “full” retirement should be age seventy). Some have advocated indexing the retirement age for longevity and health status, which is sensible.
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“What’s lacking is a truly coherent, universal, well funded effort by the federal government working through states, schools and employers to do what’s needed.”
Normal adults don't want a totalitarian system that requires “lifestyle improvements,” controls one's diet, exercise, mandates these things, and so on, i.e., constant effective parental (maternalistic or paternalistic) control by government. And if all things originated from Washington, that really is spooky.
“Let's face it – most of us won't be on a ventilator, a dialysis machine, or most other expensive equipments until we are getting ready to die.”
You are ignorant about dialysis, but the general idea you're presenting is easily and widely understood…
“There is a time when the only reasonable thing left to do is die. … No one wants to be the first to say this out loud, of course.”
It's been said out loud for ages, and even put into practice already, such as by a hospital ethics committee or a similar structure that aids the doctors (family members are excluded) in deciding on refusal to treat (and allow someone to die) due to “futility” (the key condition, more broad than but primarily involving end of life by the elderly).
Ignorant? Funny. I spent seven years watching my step-dad go in for dialysis three times a week, so I'm not an expert, but I've seen a bit more than the average Joe (plumber or not). Maybe you should read for comprehension. I did not say “most people on dialysis are dying” or something like that. I said that most of us – the general population – will not need dialysis…unless it is near death and our kidneys have shut down. Are you saying that the majority of people will, in fact, be hooked up to a dialysis machine when they have perfectly functioning kidneys? Is someone snatching people off the street and giving them dialysis to treat migraines now? I thought not.
Oh yeah – pretty much everything has been said at one time or another. Who has mentioned it in passing regard to the ongoing healthcare debates? Was there a serious discussion on capital hill recently that I missed? No, I didn't think so. And since the discussion was all about the ongoing health care debate…your comment has as much relevance as my dog's healthcare choices.
I'd be careful about tossing that “ignorant” word around. It can get stuck in unexpected places.
“I'd be careful about tossing that 'ignorant' word around. It can get stuck in unexpected places.”
“Are you saying that the majority of people will, in fact, be hooked up to a dialysis machine when they have perfectly functioning kidneys?”
“[... Y]our comment has as much relevance as my dog's healthcare choices.”
You'd be the surprised person. Not only with information or learning, but with any claim to logical facility.
There are _plenty_ of young and middle-aged people on dialysis and the population of these people as well as the elderly (senescence, diabetes, hypertension) is growing exponentially.
[sigh]