We Who Are About to Die Will Bankrupt You!

You've all read and heard far too much about health care bills and proposals, and given the deep partisanship surrounding the issue and the prevarication and inconsistencies from both sides, you are probably as concerned and mystified as I am. I don't know what I could write that would add anything to clarify the arguments, so I will merely report from my personal life how it works for all of us over 65. From the voices that I hear at town meetings, I think it's a case of "We've got ours, and we're pulling the ladder up behind us so that all of those 50 and under will be left with a bankrupt system."

I will present three case studies of people I know very well, who are currently covered by Medicare. One of the cases recounts the price of death. The other two recount the cost of staying alive. All three of them should, by all odds, be dead by now. But, thanks to the miracles of modern medicine, they survive. They are alive because of advances in medical knowledge, equipment and the drugs over the last 50 years. Every one of those advances has its cost, and it is clear that those costs are more than the current system can sustain. I am not going to offer any solutions to this problem, but will ask you to offer comments about each case and how you would handle it.

The three people involved live in a major medical centers where the best, and most expensive treatment is available. All of their expenses are covered by Medicare.

The first, and by far the most serious case, involves a patient with metastasized melanoma, already spread to liver and bones. Death is inevitable, but life might be prolonged for months. The patient has already received three chemotherapy treatments, which have reduced the size of tumors, but not stopped the spread of the disease. So far, the treatments and other medical services, tests, hospital stays and doctor bills have cost hundreds of thousands of dollars. Further treatment will add further costs, but the patient has a fierce will to live and is, despite the pain, able to enjoy some of the pleasures of life.

The second patient suffers from chronic, but not life-threatening, infirmities. Having survived lung cancer, this patient now needs a quarterly procedure to inflate a lobe in one lung. Each of the procedures cost somewhat less than five thousand dollars, but in all probability they will continue for as long as the patient lives. The patient also suffers from "dry eye" and requires the insertion of "eye plugs" four times a year at a cost of $150 per treatment. Both procedures are relatively new; the eye procedure was developed about 10 years again and the lung procedure has been around for about five years, and is just now becoming common. The patient seems fit and well in other respects, and is likely to lead a long life, but at an annual cost to Medicare of about $20,000.

The third patient has been hospitalized three times with pulmonary blood clots, with costs each time well over $10,000. The first two hospitalizations were covered by medical insurance, the last by Medicare. This patient is well in other respects, but blood thinner levels must be monitored on a bimonthly basis, and daily doses of blood thinners are necessary. Between medications and monitoring tests, this patient has approximately $4,000 per year in chronic Medicare costs. Additionally, the patient undergoes an annual kidney scan and occasional lung scans, with Medicare picking up approximately $3,000 in costs. These charges will continue so long as the patient lives.

Each of the above patients has additional medical and prescription costs for other less threatening conditions, and all of them exceed the cost of prescriptions that Medicare covers. They all see additional doctors, at Medicare's expense, for check ups, tests (often costly) for treatments of occasional illnesses or to define the state of their health.

I am sure that all of these patients are receiving more treatment than they have paid for in their Medicare contributions, and I know that Medicare cannot afford to continue this practice. All three of the patients want to live as long as they can, as healthfully as they can, no matter what it costs the current system. I know that it is selfish to say, "We've got ours, now you guys have got to figure out some way to get yours." But I guess that's what I'm doing.

Perhaps some of us who are over 65 think that we should pay more in taxes to help those of you under 50 from losing it all. The President's plan seems to be getting nowhere, and we who already have Medicare can just throw up our hands and say "The hell with it." But I think we'd better all give it more thought, and somebody ought to think about a solution rather than just shout, "No, no, no." It can't go on forever.

Comments

[raker]

What's the point? Medicare, like health insurance, isn't a savings plan from which you may draw out what you put in. The idea of insurance is that the whole pool of covered people pays, and when one has a loss they receive benefits. If you pay and pay and never require a payout of health care benefits, hooray for you. You win!

Medicare is good but it could be better. Seniors could still go broke paying monthly premiums, yearly deductibles, coinsurance, drug costs, all the things Medicare doesn't cover. We need single payer, first dollar, universal coverage for all.

[PlaceboStudman]

"We've got ours, and we're pulling the ladder up behind us so that all of those 50 and under will be left with a bankrupt system."

Its not just those on Medicare, or those 50 and older who are saying this. It's everyone who, whether they have insurance or not, live under the fantasy utopia that we're all going to live in our 80's or 90's and die peacefully in our sleep.

As much as people would like to talk about "prevention", they only do so regarding obesity and its related symptoms, and while obesity may be our most widespread health issue, it is one of the easiest to treat, and far from the most severe medical condition that people face. This health-car­e-without-­mentioning­-medicine reform is a joke, a sham, and an insult to those of us who are disabled, whether we have insurance or not, or those who are otherwise critically or terminally ill, whether we have insurance or not.

Sorry I have NO compassion whatsoever for someone whose biggest concern is gluttony or a sprained ankle or jock itch, primarily caused by your own negligence

[vim876]

Dear Old Fogies (Yes boomers...­I mean you too),
If you block health care reform, your grandkids won't be able to afford to pay for your Social Security and Medicare. Then you'll be at the mercy of the private insurers, too. And trust me, what they will do to get your money makes the rural legend of death panels seem tame. Like a lion with blood dripping from its jaws standing next to the cute slow loris that gets tickled in the YouTube video.
Sincerely,
The Under-65s

[LetsGoSteve]

We should all set aside a potion of our income for health care. Just like we do for our; food, clothing, housing, and transportation. Get the government & insurance companies out of the way, as much as possible.

We then should purchase insurance for unforeseen expenses that go beyond what is in our medical savings account. Every parent should be encouraged to enroll their children into a policy at the time of pregnancy. Once enrolled the insurance company should not be allowed to raise premiums because of a medical condition that develops during the pregnancy, or throughout the entire life of the child. This way the insurance companies will get the good with the bad, which will spread the risk throughout all of its members throughout the entire life of its members. The only changes in premiums would be for changes in the health care cost index, and life style choices. For those that are unable to maintain their insurance premiums, due to unemployment or under employment the tax payer’s should help make them make there premium payments. Those of us who are already born should be able to buy in at a rate for our age group with or without pre existing conditions.

[vim876]

I'm sorry, but it sounds an awful lot like a child who grew up to develop a chronic incurable disease as an adult in that system would be screwed.

Also, lifestyle choices? That's code for "Screw the fatties!" and everyone knows it. If we're screwing the fatties we need to screw underweight people too, and people who drink regularly, and people who live next to chemical plants or in LA, and people who...the list just goes on and on. If you think that's ridiculous, check the medical literature on how choice factors into weight. For 95% of people, it pretty much doesn't.

[tribalogical]

Excellent. I agree with that principle!

Now, let's simplify that, and add the power that "pooled resources" have on overall prices for goods and services.

Take that bit of money you're setting aside, and pay it into a 'universal health system'. Now, anything you or I, or the next guy needs, is covered (all of us are paying in according to our means, which is no different than each of us paying into a "health care savings account" according to our means).

But now, the accumulated power of all of our 'accounts' allows us to get that care at much lower cost, purchase medicines for far less, provide broader services for more people. Literally everyone.

Perhaps you don't need any health care at all over the first ten years or so. But you were planning to also pay for "insurance" to mitigate the risk of bigger, unexpected illnesses. You didn't use that either. And, what if you don't need to pay that extra insurance premium at all? Everything (including the big stuff) is covered by your other payment into the universal system.

That means more money in your pocket. It means you can invest it, or live a little better, or send your kids to college, put more into savings... start a small business. Whatever!

The only difference here is, my "system" costs each of us a lot less than your "system". And all of us, regardless of means, get to be healthy and cared for.

What do you think?

[angrydove]

I think it's pure GENIUS!

[Reese Schonfeld - Huffpost Blogger]

Thanks for your suggestion. I was looking for a fresh alternative, and I don't think anyone has ever suggested "cradle to the grave" medical coverage before, based on lifetime contributions. We should make all those contributions tax deductable, but I think we'd still have to figure out a way so that the very poor could afford to contribute. Maybe we could work out a scheme so that if they ever hit the jackpot and struck it rich (as someone would define it), they'd have to make large contributions to the insurance fund itself. Again, thanks for responding.