Reducing health spending, as Congress is finding out, is difficult.
Some health economists have pointed to medicalization of common complaints, like erectile dysfunction and attention deficit hyperactivity disorder, as one reason. Indeed, Dartmouth researchers, who are cited as favorites of the current administration, feel that an “epidemic of diagnoses” is what’s making us sick.
But, Darshak Sanghavi writes in Slate that this may be a red herring, and clouds what’s really driving up costs, namely, the amount we spend prolonging the lives of the elderly. He points to David Cutler, an adviser to President Obama, and his analysis that “it costs far more to prolong the lives of the elderly ($145,000 per year gained) than the young ($31,600), and the rate of spending on the oldest Americans has grown the fastest.”
None of the current health reform proposals target this, understandably, because it would be politically difficult to tell elderly voters that we need to spend less on their care.
And because of that, Dr. Sanghavi rightly concludes that, no matter what gets passed, “we’re just putting off the day of fiscal reckoning.”
Related posts:
- Medicare and cutting health care costs
- Cutting health care costs means reducing utilization
- AMA: Curbing the rise in health care costs is key to health-system reform
- ER visits and health care costs rise in Massachusetts due to lack of primary care access
- Rationing care is inevitable to control health care costs
- Health care costs 101
- Cutting health care costs
{ 13 comments }
I can’t help but think of the euthanasia debate.
This is only one part of the debate.
I have plenty of young people in my office requesting big, fancy tests that they don’t need.
If I were a science fiction writer, I would write a story, not about a society that wants to do away with you because you are “too old”, but rather a tale about a society that uses technology to keep people alive forever, even though they are miserable, perhaps because others profit from it, or simply like the challenge.
Yes, that is, if you want to cut costs.
Wait until those who are proposing not treating the elderly are elderly themselves. And wait until we are paying the nursing home bills of the “untreated” elderly as they now can`t walk, get out of bed or care for themselves.
constance:
no one is proposing not treating the elderly.
this is hogwash.
go spend some time on any icu, see the elderly on ventilators, trachs, g-tubes. It’s miserable. No reasonable person would ever wish that end upon themselves. People need to know their options. Pope John Paul chose not to be treated at the end, so it is not a religious thing.
Why nursing homes ? Families should take care of their elderly. That’s how it used to be. Now we expect others to take care of our parents.
Thanks for linking to these articles; this is a fascinating debate and topic that I’m still trying to discover my opinion on. Right now I think we need to spend our money on prevention rather than extension of end-life but that’s so easy to say when you’re not directly affected by the consequences.
Let’s see, with obamacare a lot of the elderly who paid their taxes and now need medical care and Obama will say “bye bye?” While today a lot of young working age non working people pay no taxes and will get medical help?
These politicians voted Against the Nathan Deal Amendment, that would Prevent Health Care Benefits to Illegal Aliens. Simply put–it’s not their BLOODY MONEY! So what! Do they care if taxpayers have to foot the behemoth bill, for anybody who snubs our laws and enters a sovereign country called America? The nationwide parasites are –CHEAP LABOR–businesses who could care less, because they pile up enormous profits. The corporate hierarchy have been having a field day–FOR DECADES. A foreign national gets hurt, their service manager or whoever the underling is, drives the maimed person and relinquishes any responsibility by dumping them on the emergency hospital entranceway. BINGO! nothing to pay!
Perhaps Americans should find some old shoddy clothes, no shave, no haircut and enter every emergency room in our country in the millions? Speak a lot of gibberish and carry no identification with a small splinter in their finger, a touch of a fever or any minor condition. By federal law the hospital will have an emergency on a–EMERGENCY. I am afraid Americans have been Lemmings going over a proverbial cliff, since who knows when? We just keep paying and paying even more to the IRS, to support–ILLEGAL IMMIGRANTS. Try getting free health care in any other country, other than societies in the European Union? A FAT CHANCE! We are literary being taxed to death, to give welfare to the business overlords. These legislators have already tried to weaken E-Verify, local police action 287(g) and now unwinding the 1986 Simpson/Mazzoli enforcement law–which worked, but again was never enforced.
Even our Democrats who are trying to engineer health care for every American—INCLUDED 20 PLUS ILLEGAL IMMIGRANTS AND THEIR LARGE FAMILIES. Here are 29 Judas Iscariot’s, who sold the American people out–for a lot more than 13 pieces of silver? HUNDREDS OF BILLIONS OF DOLLARS EVERY YEAR. Capps (D-CA), Eshoo (D-CA), Harman (D-CA), Matsui (D-CA), McNerney (D-CA), Waxman (D-CA), DeGette (D-CO), Murphy (D-CT), Castor (D-FL), Rush (D-IL), Schakowsky (D-IL), Braley (D-IA), Sarbanes (D-MD), Markey (D-MA), Dingell (D-MI), Stupak (D-MI), Pallone (D-NJ), Weiner (D-NY), Butterfield (D-NC), Space (D-OH), Sutton (D-OH), Doyle (D-PA), Gordon (D-TN), Gonzalez (D-TX), Green (D-TX),Welch (D-VT), Christensen (D-VI), Inslee (D-WA) and Baldwin (D-WI). I’m afraid I would be banned if I used the right epithet, when leaving a comment for these so called lawmakers?
These are the betrayers of–ALL–taxpayers. These 29 traitors gave illegal immigrants the right to pilfer your billfold and purse, while they sit in their Washington office collecting their 6 figure salaries. REMEMBER THEM AND THROW THEM OUT! DEMAND NO AMNESTY! NO FAMILY UNIFICATION KNOWN AS CHAIN MIGRATION! BUILD THE ORIGINAL FENCE! NO MORE HEALTH CARE OR ANY OTHER KIND OF BENEFITS FOR ILLEGAL IMMIGRANTS. CLOSE THE BORDER AND STATION THE NATIONAL GUARD. $2.5 TRILLION DOLLARS, JUST IN RETIREMENT BENEFITS? Learn uncorrupted facts at NUMBERSUSA. For myself and family! I am for any health care re-organization, as long as it doesn’t smell of copious profiteering and corruption, like the majority of private insurers do?
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Instead of focusing on our seniors, let’s start the cost discussion with direct to consumer advertising and defensive medicine.
As someone who cared for her elderly mother with Alzheimer’s at home, I must respond to Amy’s suggestion that we all take care of the elderly ourselves. Caring for an elderly parent at home is NOT always feasible, nor is it necessarily in the elderly person’s best interests or well-being to be living there.
I had to maintain a full-time job, because I not only needed money for day-to-day expenses, but also for health insurance and MY RETIREMENT. Mom had a bit of money put aside, so we were able to hire caregivers so I could work.
If that little bit of money hadn’t been there so that Mom could self-pay, I have no idea what would have happened – even with Medicare/Medicaid assistance [and Mom didn't qualify], I would have been unable to work. and what good would that have done ANYONE – including the federal and state tax systems!?
There are answers that are simpler than most imagine to be possible. You can see brief discussion of them at
http:doc2dochealthcarereform.com , particularly the entry called “Successful Ideas”. Consumer Directed Health Care has been growing by leaps and bounds. The ObamaCare proposals would outlaw it. Greg Scandlen and Regina Herzlinger are two of its most significant proponents. You can google their names to access a whole lot of useful information. First we need to defeat ObamaCare. Then we need to defeat the insurance lobby. Then we need to unite with patients to advocate for arrangements that promote the “doctor-patient relationship” and avoid third-party infringement.
yes….spending less only when the cost or means by which doctors provide health care gets cheaper significantly cheaper…how…cut profit across the board including doctors fees. make sense????? thats the health reform is all about….prevent the uncontrolled escalating cost of providing health care to everyone. also…..remove government waste and innefficiencies at federal and state levels.
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