<p>Being extremely elderly, even without having had bad habits is often expensive. It seems to me that as a nation we have decided to prioritize lengthening life at all costs. Which is not inherently bad, but we just don’t want to admit to it. That choice isn’t really compatible with fiscal prudence, particularly when coupled with the common expectation of a long, secure retirement phase. All of these choices, particularly without honesty and responsibility, are what is sucking the life out of future economic prosperity.</p>
<p>tom,</p>
<p>Thanks for that article (#718), which, if I am reading it correctly, does away with the premise that we spend about the same on the non-elderly as other countries. The chart we had been relying on only accounts for federal government health care spending per capita, which is about the same as what other countries spend for non-elderly. So we still don’t know how much is being spent per capita (private dollars included) on healthcare for the under-65 population.</p>
<p>zoosermom, I agree with your post #722, but I think what has contributed to this is the seemingly unlimited stream of Medicare dollars that, in a (sort of) capitalistic country such as ours, has led to a humongous geriatric industry that feeds the problem. People are just following the money.</p>
<p>Exactly right Bay. This is a lot of money and it is lucrative. But it all starts with the demand. Personally, I don’t think there will ever be a good outcome for our kids. Just like pension costs.</p>
<p>Because I have lived the unfairness of bad health (my wife) which often occurs through no fault of the individual I hate the fact that insurance premiums could ever be based on someone’s use of the health care system. I understand that is in direct opposition to how a private insurer can operate.
The truly healthy have no idea the blessing they have received in comparison to individuals that truly have chronic health issue. I understand that many may have brought these issues on themselves but many have not.
IMHO it is something that we can provide as a society and count our lucky stars if we happen to be lucky enough to just have to pay for it and hardly ever use it.</p>
<p>I have never really understood the outrage at medical costs. If people are living longer, that isn’t bad and it is based in demand. Personally, I find the money spent to support pre-term babies totally worthwhile. Prosthetic limbs, cochlear implants, transplants. Wonderful but expensive things. I think those are good uses of money.</p>
<p>Tom1944, </p>
<p>Thanks for the link. I have to admit I did not examine that age chart closely.</p>
<p>It makes no sense that the US healthcare costs for people under age 55 are similar to other countries when our costs for drugs, procedures, hospitalizations, medical devices, doctors etc are higher than other countries and our population is also unhealthier. So thanks.</p>
<p>Bay, I think you make some good points. Your graph link is still fantastic even though that age graph may be misleading.</p>
<p>Poetgrl, yes… We could lose some freedoms if we try and cut healthcare costs. I agree with you 80 to 90 percent of the time whether you know this or not. I think you are intelligent. You are probably a great person. I do not agree with you on ACA. I do want ACA. There are many things in ACA that I do like and think are necessary.</p>
<p>
</p>
<p>I attempted to address this issue around post #20 of this thread but they all got deleted (considered political in nature?). Anyway - one simple statement. Unless you are able and willing to evaluate another countries ‘successful’ healthcare system within the context of that countries social, political, population size, immigration policy, population ethics, religious attitudes, family structure, available movement within SES classes etc. it is a nonsensical question. It is like pulling out a healthy heart from someone, placing it on the table and saying ‘see this works - why doesn’t mine’. It is a component within a SYSTEM, to remove it from the system and diagnose it in isolation will lead to a false conclusion.</p>
<p>Tom1944, I understand your last post. It is a great post. Post 729.</p>
<p>dietz - I agree with that but we can and should look at what works in other countries and what works in ours. The problem is we need to do so in consideration of what works and not what drives money and votes.</p>
<p>
</p>
<p>Which of my numbers are imaginary? I have done the research. (I also provide professional services in eldercare facilities and wrote a book about it.) The average long term stay in a nursing home is 2.5 years. The average annual cost is $75,000. I was not talking about overall cost for dementia, but comparing the costs of institutionalization for dementia versus non-dementia residents. It’s clear that a rehab stay–although short-term–is more expensive than a long-term custodial stay on a per day basis. </p>
<p>I wrote: “Dementia folk may be cheaper than the general population in a nursing home.” I was not talking about overall costs to society. I looked at your link, which I have seen before. What’s missing is a piecing out the added costs of caring for and treating people with dementia compared to other elderly. It can be misleading simply to add up the care costs of people with dementia and list that total as the costs for dementia. People with dementia catch cold, fall and break their hips, and require flu shots. Many people with dementia are otherwise frail and might require nursing home care independently of their dementia. I see that everyday on an anecdotal basis–people with dementia who are non-ambulatory, incontinent, have difficult to control diabetes, are blind or deaf, have chronic pulmonary or cardiac conditions, etc. These costs should not be lumped in with dementia costs. </p>
<p>The CDC report is guilty of this: “In 2011, total Medicare and Medicaid spending for individuals with Alzheimers disease is estimated at $130 billion.” It doesn’t break out the added costs for Alzheimer’s disease, which are significantly less than $130 billion. The overall bill for anti-dementia drugs–leaving aside their efficacy-- is only 5 to 10 billion. </p>
<p>I’ll add there are many wasted payments for dementia. Many people with dementia are otherwise healthy–absent of other chronic medical conditions. It’s overkill–so to speak–to put them in a $75,000 a year nursing home when a secure, nurturing assisted living center would be half the cost and be more in adherence with the gold standard of human service provision–the least restrictive environment. Unfortunately, although this might be slowly changing, Medicaid will not pay for assisted living. </p>
<p>I’m not saying dementia isn’t a significant and growing public health problem. There are several recent studies ranking the costs for people with dementia surpassing those of cancer. But again, these studies look at the total bill for those with dementia without parceling out the specific added costs due to the dementia itself. That study has not been done.</p>
<p>^^^
Interesting. We have very good health coverage but must use in network to optimize coverage.
Recently, we tried to AVOID visit to ER on a weekend. Primary care doc unavailable, situation could not wait till Monday but was NOT an emergency. Frustrated to find we had NO in network urgent care center to use.
So, options were out of network urgent care or ER that might not be covered since insurance might decide it was not warranted.</p>
<p>Following week, I had a lengthy discussion with “client services” of plan and also my employer HR… found that there is indeed this hole that they kinda just want to ignore…</p>
<p>So, some ER visits that could be avoided won’t be…</p>
<p>Medicaid pays for assisted living in some states, latichever,if you have low assets and income. It does in Washington.</p>
<p>(as an aside to musicmom) In that case, you might have been able to use an out-of-network urgent care center, and requested that insurance cover it as in-network since there were no in-network facilities within a certain mile radius at the time. (back to the topic at hand)</p>
<p>
Great post. When we moved my Mom, who had Alzheimers, to assisted living it was a learning experience for us. At least in NH dementia patients can not go to all assisted living centers … it has to be an assisted living center that specifically handles dementia patients (security so they can not wander off the site, etc) … and the real surprise, this significantly cut down our options. </p>
<p>Maybe as the number of dementia patients increases assisted living for them will become much more available. As you said it is MUCH cheaper than a nursing home and, also surprisingly, was a lot closer in cost to having full-time help at home than we thought it would be.</p>
<p>poetgrl, thank you. You’re right.</p>
<p>Axw, hadn’t thought of that angle, thanks.</p>
<p>Lol…ok…</p>
<p>LasMa…</p>
<p>For the record…healthcare in the US for those under 55 does cost more than other countries. </p>
<p>Medical treatment for Cardiovascular disease does cost more than medical treatment for alzheimer’s and dementia.</p>
<p>Although numbers seem to vary…</p>
<p><a href=“http://www.cdc.gov/chronicdisease/resources/publications/AAG/dhdsp.htm[/url]”>http://www.cdc.gov/chronicdisease/resources/publications/AAG/dhdsp.htm</a></p>
<p>Zoosermom: clinics for those with non-emergencies. Ages ago, young, I had a trip to the hospital and from the ER front desk, they diverted me to a doc in offices attached. The only hook is building them adjacent, in areas where a segment too routinely relies on ER, for things like the flu or a minor wound. Hospitals in my area are highly concerned about the costs they absorb. </p>
<p>Dietz makes a good point about context- some of us have experienced healthcare in other countries, but I don’t think any of us are well versed in how it works. On an older thread, just tossing this ball, it was said certain treatments are routinely denied, simply based on age. No idea if it’s correct (and that’s a good point, in itself,) but one example was denial of certain kidney care after age 60. </p>
<p>Plus, are taxes still higher, in the countries we think of, to cover social services? And, delivery is different when, eg, Germany, is the size of Oregon. Until recently, we had duplication of services among several local hospitals. Now X and Y are handled at one (you get transferred after triage, even in an emergency) and another focuses on Z.</p>
<p>[Data</a> By Topic - Dartmouth Atlas of Health Care](<a href=“Interactive Apps - Dartmouth Atlas of Health Care”>Interactive Apps - Dartmouth Atlas of Health Care)</p>
<p>this is an interesting study. It’s the Dartmouth study.</p>
<p>75% of medical expenses are in health care for those with chronic illness. Caring for those with chronic illness in the last two years of their life accounts for 32% of medical costs in the US. 7 out of 10 people die of a chronic illness. </p>
<p>This is a good “for the record.” Feel free to post some other records and cite your sources.</p>