Wouldn’t a lot of those 80 year olds, especially future 80 year olds, argue that they’ve already paid for their care in the form of Medicare taxes withheld from their paychecks whether the math works out or not - especially some of the 80 year old individuals who’ve paid into the system their entire lives and perhaps have drawn little out until they hit something beyond 80?</p>
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That’s just it - it’s easy to be philosophical on this point until it hits home with yourself or a close loved one.</p>
<p>My 29 yrold was a NICU baby. She was born 10 weeks early, in the NICU for 8. Had surgery when she was a day old.Transfusions of platelets for the week after that. Thank goodness we had ins.</p>
<p>(actually, I was an NICU baby too, only I was only month early. But in those days they kept you in the hospital until you weighed 5lbs)</p>
Well, since Medicare isn’t a savings plan that you can “draw out” of, but a current benefit for old people paid by current wage earners, they’d be wrong. And since Medicare wasn’t even created until 1965, they’d be doubly wrong. </p>
<p>But yes, some would argue that anyway. Being factually wrong doesn’t prevent that, I’ve noted.</p>
<p>Kluge, why do you keep repeating that Medicare is a handout people should pay for. THEY DO. Currently, if you want full coverage (and not all medications) it is roughly $300/month, and that is about $25 less with Obamacare.</p>
<p>If these stats are true, no wonder mandatory health insurance was part of the health care reform bill. I’m surprised so many are without insurance. My 27 year old Dd has a pretty solid Anthem policy, as an individual,
for less than $150 a month and she manages it on a part-time teacher’s wage. It looks like “grandma” is paying much more for her medicare than my Dd pays for her insurance. </p>
<p>I just don’t see rationing based on age as fair in any sense, or necessary. We are all individuals, and an 80 year old could have 15 more years after a hip replacement, and I could die in two years after a hundred thousand dollars of chemotherapy. My feeling is that if, as a society, we really want to take care of our citizens, old and young, rich or poor, we can’t let corporate profits be the driver of access to health care.</p>
<p>I didn’t mean to. My general rule is, Don’t pay for tests and treatment for people who won’t benefit from it, especially expensive tests and treatment. I wanted to give the specific example of the general principle. My husband’s aunt was 90 years old and dying of a huge inoperable mass in her abdomen. She insisted, against her doctors’ advice, on some expensive test, an MRI or something. Her doctors explained that they knew what was causing her illness (a huge tumor), they had no treatment for it (because she was too ill for surgery), and the diagnostic test could tell them nothing that would make any difference. But she insisted and insisted, saying that her late husband had always said one should get all the tests. Finally they capitulated. Of course, the test told them nothing useful, because it couldn’t, and she died a week later.</p>
<p>I also didn’t mean to say that infants in the NICU shouldn’t be treated. Most babies in the NICU need and benefit from the NICU. But for some babies, in some sad cases, there comes a time when the doctors are just prolonging their death. Both parents and doctors need to be better at recognizing those cases.</p>
<p>I hope we solve the privacy issues and get better at data-mining in medicine. If Target can figure out when a woman shopper is pregnant before she tells her parents, we should be able to figure out when treatments are futile.</p>
<p>I agree with the testing not being automatically ordered & covered.
On another thread a Dr wanted to give a chest X-ray to rule out complications from a cold. Too many Drs order tests, just because they " happen" to have the equipment in their office or own the lab.</p>
<p>The thing about premies is- it could be hard to tell when the effort will pay off. For my daughter before she went into surgery, the Drs told my husband they did not expect her to live long. She was in a lot of pain afterwards , but there is only so much morphine you can give someone who weighs less than three lbs. ( this was also at a time when some parts of the country didn’t give premies anesthesia because they thought their neurological systems were not developed enough to require it. Needless to say, they had a high mortality rate)</p>
<p>The hospital that cared for her had few private patients & many of the babies didn’t have parents who were able to visit- either because they were out of the area ( it was a regional center) or because they were incapacitated in other ways.</p>
<p>In lieu of parents advocating for their childs right to go peacefully, the medical staff was given a tough choice to decide who lives.</p>
<p>However, while the reason why she was born early could not have been prevented ( she tied her umbilicus into three true knots- depressing her heart rate), the reason why I was born early could have been. ( My mother had gone into early labor, which stopped by the time she got to the hospital. Unfortunately, since the Dr didn’t want to have a " wasted" trip, he then induced labor.)
:rolleyes:
If they had just watched her they could have saved money. ( & I wouldn’t have lain in an incubator for a month with my parents peering through the door)</p>
<p>If tests aren’t going to change care substantially , they may not be necessary.</p>
<p>Heck, with SRs, it can be hard to know whether the SR will be rejuvenated and be active & live another 10-20 years. My dad is 87 and still busy with a lot of folks who are in their 60s & 70s. Not clear with many treatments as medical science stands today which ones will really help the patient or just provide temporary symptomatic relief (or actually make patient worse).</p>
Hmmm, but I wonder how many of them are making car payments on a car newer than mine (1998)? For at least a subset of these people they’re making a choice to not have med insurance in favor of spending that money on other things. I’ve known people who have done this and most of the posters here probably do as well.</p>
<p>We aren’t worried about the young people who don’t have insurance and don’t get sick, which surely will be the large majority of non-insured young people. We’re worried about the young people who don’t have insurance but do get very sick. They won’t be able to afford their treatment, and then what?</p>
Not only have I not “repeated” that, I never said it in the first place.</p>
<p>But $300 per month is a premium level which isn’t even close to the actual cost of providing medical care for the elderly. The bulk of the cost is paid for by taxes on younger people, and I’m questioning the rationality of the level of the subsidy and lack of any means testing for it. More to the point, once that monthly premium has been paid, the insured person has no significant “skin in the game.” Expensive and extraordinary treatment will be provided at no extra cost to the patient, removing any personal prioritization based on cost from the decision - but only for the old.</p>
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So… what are you, some kind of wild-eyed Socialist? As much as I might agree in principle, that’s just not the reality in America. Medical care costs money, and there’s only so much we, as a society, are prepared to devote to paying for it. Right now we allocate those funds through a mind-bogglingly complicated system of private and public insurance, personal funds, and taxpayer funded county hospitals. The system has huge overhead and prioritizes by wealth, the variable quality of health care benefits provided by employers, and (inversely) by age. I’m suggesting that a point arrives where the prioritization of a massive subsidy for health care for the elderly (some of whom can afford to pay for some or all of their health care costs, and might elect to skip extraordinary treatment if it cost them personally) at the expense of the young who receive no such subsidy is irrational, and some reassessment of those priorities is in order.</p>
<p>There’s another thread running “Would you donate a kidney to an 80 year old” in which direct prioritization is on display. It’s really pretty much the same issue, just less graphic in the case of allocation of money.</p>
As much as I might agree in principle, that’s just not the reality in America. Medical care costs money, and there’s only so much we, as a society, are prepared to devote to paying for it. Right now we allocate those funds through a mind-bogglingly complicated system of private and public insurance, personal funds, and taxpayer funded county hospitals. The system has huge overhead and prioritizes by wealth, the variable quality of health care benefits provided by employers, and (inversely) by age. I’m suggesting that a point arrives where the prioritization of a massive subsidy for health care for the elderly (some of whom can afford to pay for some or all of their health care costs, and might elect to skip extraordinary treatment if it cost them personally) at the expense of the young who receive no such subsidy is irrational, and some reassessment of those priorities is in order.</p>