Fields and DeGroot On Health Care
Sam Fields
John DeGroot
BY SAM FIELDS
Guest Columnist
Last week my doctor brought home to me the absurd misallocation of resources that dominates our costly but mediocre healthcare system.
He had a 91-year-old patient with advanced dementia. She developed failing kidneys which would have quietly and quickly put an end to the life she was no longer living.
Instead, at the family’s demand, but with the taxpayer footing the bill through Medicare, she was put on expensive dialysis. That will keep her around for months if not years.
$$$$$$
This is one example why the average person will often needlessly and cruelly accumulate half their medical expenses in their last six months.
Want another one?
The growing billions we spend every year on one pound babies born at twenty two weeks of gestation. They will be hospitalized for months at a cost of a million or more. We now know that these so called healthy babies ain’t so healthy. By age five or six abnormalities emerge
Notwithstanding spending over $7500 per person, we rank 37th in the world. Cuba, averaging $250 a year, ranks 39th.
No one can dispute that United States medicine is the most advancedfor those who can afford insurance or are so poor they get Medicaid. Or those over 65 with Medicare.
Screwed by this system are the uninsured working class and the unemployed. They are forced to forego medical care to make the mortgage payment or put food on the table. There are close to 50 million of them and their numbers grow every day.
But it’s not like the uninsured don’t get sick. In desperation they use Emergency Rooms for primary care and taxpayers pick up the bill. Talk about a waste of resources.
We need a “rational system of rationing our healthcare dollars to replace the “irrational“ system that dominates the 17% of GNP we spend for medical care. No one, including France, with the number 1 rated system, spends even half what we spend per capita. And they cover everyone.
We need a system that will just say NO to a 91-year-old with dementia or the parents of a 14-ounce baby. If they want that kind of care let them pay for it or buy extra insurance coverage.
We need a system that recognizes that a dollar of well care reduces illness costs at least ten-fold.
We need a system that understands that the obesity epidemic we are experiencing will bankrupt us with diabetes, heart disease and cancer.
We need to recognize that every time we spend dollars on exotic treatment to preserve a life without quality we are depriving those dollars to those who could really benefit.
–30â€â€
BY BUDDY NEVINS
My old pal and boss he was city editor when I broke in at the Fort Lauderdale News the always-entertaining John DeGroot has a different concern about health care.
He believes that special interest money blocks reform. He backs his argument up with plenty of statistics.
“The nation’s health care industry spent more than twice as much on Washington-based lobbyists and campaigns for the White House and Congress than BOTH the energy and defense industries during the past ten years,” he writes on his blog.
Read the rest from http://www.john-degroot.com/
July 3rd, 2009 at 10:05 pm
Sam,
You are correct up to a point. People need to be more responsible with health care.
Just about anybody but the family itself can see the folly of forcibly extending the lifespan of a 91 year old who doesn’t even know she’s alive.
When my 89 year old father in law went into his final crisis a year and a half ago, we did not intervene. We made him comfortable in his last few hours even though he didn’t know it.
When his 82 year old wife passed three years earlier, she made the decision that “enough is enough.” We respected her wishes.
But when you advocate the “just say NO” attitude where does it end?
Age 59 used to be the upper limit for patients needing a heart transplant. Do we set the age limit back to 59? How about 50 or 45? That would guarantee a better supply for the candidates.
How do we determine who gets a new liver and who doesn’t?
How about an 80 year old in an auto accident who needs immediate care or die?
Even if our 80 year old has enough money or coverage, choose between the octogenarian or the 30 year old who also needs the bed.
The 30 year old will heal faster and cost less.
Oh, those kinds of decisions won’t come at first, but they will ultimately.
Once we open the rabbit hole it’s a long way down, and Sam, you’re closer to 70 than 60. When do you draw the short straw?
Beyond that, American health care is in definite crisis especially with 47 million uninsured.
But there’s a little secret that most insured and uninsured don’t know.
Health care rates are entirely negotiable.
General practitioners charge anywhere from $100 to $130 for an office visit. But that’s nowhere near what they get from an insurance carrier.
Try anywhere between $40 and $60. Maybe even less per patient with HMO coverage. Insurance carriers negotiate rates, too.
I negotiated $55 for office visits. A win for me and a win him since he didn’t have to pay an office clerk to file my insurance claim.
Oh, and hospitals will negotiate, too.
Don’t ever take their itemized bills as gospel. I had an $18,000 bill negotiated to $1,800. That’s what insurance paid along with my “co-insurance.”
My daughter had a $900 emergency bill negotiated to $350. That’s what I paid.
The “high cost” of health care is an insurance company fantasy provided to raise premiums and have us spend more out of pocket for “co-insurance.”
But… That’s not to say that insureds don’t abuse the system too by running to the Doctor with every sneeze and sniffle.
July 4th, 2009 at 5:10 am
Sam’s discussion suggests, at least to me that we’ve lost our sense of who does what in a well organized system of health care.
The job and goal of a doctor is to cure disease and prolong life where possible. Ending someone’s life by denying them treatment simply because they are old and with the goal of saving money is unethical and uncivilized.
The job of a health care system is to organize service delivery so that doctors can do their jobs efficiently for the people. The job of a health care system is not to practice medicine, it is to support the delivery of medicine, erring on the side of the patient if necessary, but attempting where possible to reduce the cost of health care delivery.
The job of society is to support basic, common sense principals like “all people have a right to healthcare.” It is also to ensure that society maintains a health care system that focused on helping people first, helping them get well, without allowing the system to become alarmingly wasteful. And their job is also to pay for that service in some way, either directly, collectively or some combination.
You know we have lost our sense of balance on that issue when the suggestion arises that premature babies not be cared for, or medical care be denied to super seniors simply to save money.
July 4th, 2009 at 8:37 am
Sam Fields is advocating euthanasia with government bureaucrats deciding who gets to extend their lives and who must die. Is that what America has come to?
July 4th, 2009 at 9:14 am
If Euthanasia is defined as withholding life extending treatment then there is no doubt that it is committed thousands of times a day. In the time it takes you to read this reply doctors, hospitals, insurance companies will make euthanasia decisions a dozen times.
You seem to believe in a healthcare system based on “first come first served and its all you can eatâ€.
That would be wonderful if we had unlimited resources being offered to people who have told us that they want to stay alive no matter the quality of that life.
Wrong on both counts.
Up until now I didn’t know anyone whose hope is that in a state of advance dementia they would want to be hooked up to a dialysis machine. Apparently you are that person who would demand that your family exhaust all financial and emotional resources to keep you alive. It would be the Christian thing to do.
And I don’t know of any healthcare system, forced to give questionable expensive treat to one person does not ultimately deprive others of needed treatment. Except in your world.
By the way for at least another year I will be closer to 60 than 70.
July 5th, 2009 at 6:12 am
Sam, you have a very warped way of looking at things. Nobody at all has said that euthanasia couldn’t be a component in the delivery of medicine. You introduced that suggestion as a crutch to your indefensible views.
The statement made was that that doctors should remain in charge of providing medical care and determining what care is required. That’s what they are trained to do and that’s where those decisions should be made.
Hospice care, which you call euthanasia, is already a legally acceptable medical option that doctors must approve of with the consent of family. That option is there to humainly put someone down, to allievate their pain and suffering. It is NOT to be used as a cost saving strategy as you suggest. And it is absolutely NOT a decision under any circumstance that people want the bureaucrats of any health plan making.
People want doctors, not bureaucrats making medical decisions, they want doctors dedicated to saving their lives, not ones worried about costs. Doctors are already trained not to order procedures, tests or medical strategies that are pointless or counter-indicated.
But if a doctor wants a particular test to determine if a problem exists, then that test needs to be performed and paid for. Period. End of story. Because anything less than that is NOT good healthcare.
The job of doctors is to preserve and extend life. People don’t want them in any other job. They HAVE to be in that work if people are to live and survive medical episodes. Every day, countless patients bounce back from critical conditions in hospitals that gave them slim chances of survival. Many of them go on to live long and productive lives. That’s because they have doctors that are focused on them living, not dying.
All of this is common sense. What’s with you?