A Modest Proposal on Healthcare Costs

Discussion in 'Politics, Religion, Social Issues' started by rdowns, Apr 28, 2011.

  1. rdowns macrumors Penryn

    rdowns

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    #1
    I was thinking about this the other day when I read that Medicare costs for the last few months of life are a huge percentage of costs. Maybe tie living wills and advanced directives to eligibility. What if...


     
  2. leekohler, Apr 28, 2011
    Last edited: Apr 28, 2011

    leekohler macrumors G5

    leekohler

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    #2
    I like this idea. I would certainly not want to be kept around on a respirator indefinitely.
     
  3. Ugg macrumors 68000

    Ugg

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    I have been an advocate of mandatory EOL statements since before I joined this board. Once you reach 65, it should be required that everyone fill out a form outlining their wishes. There is nothing worse than seeing a human vegetable being kept alive simply because modern technology allows it.

    Some people want to be subjected to extreme measures to keep them alive, others don't, but if it's not written down, nobody will know and billions will be wasted on needless, inhumane care.

    However, simply writing down your wishes isn't a guarantee that they will be followed. My 86 year old grandmother collapsed at a friend's funeral, was taken to the hospital and since they didn't have the facilities to deal with her heart issues, she was airlifted to a larger regional hospital where she spent her final 3 days in an intensive care unit.

    She wore a DNR bracelet and told everyone around her that she did not want to be hooked up to a machine at the end. I honestly don't know the procedures involved in a case like my grandmother, but I do know that her wishes were not honored and I'm sure those final days cost an insane amount of money.

    The whole system needs to be changed in order to show respect to our mortality.
     
  4. rdowns thread starter macrumors Penryn

    rdowns

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    #4
    I don't remember where I read the article but it said end of life medical costs are about a third of Medicare's expenses. That is absurd.

    And before you Christians go on about death panels, why would you want to put off meeting Jesus?
     
  5. skunk macrumors G4

    skunk

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    #5
    Perhaps a nagging suspicion that He might be out?
     
  6. wpotere Guest

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    #6
    Now that made me spit water on my monitor! :D
     
  7. Andeavor macrumors 6502

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    #7
    They need to buy themselves enough time to secure a spot in heaven, no matter the co$t.
     
  8. StruckANerve macrumors 6502

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    #8
    I usually keep my callous thoughts to myself, but I actually support "death panels" that would restrict certain care from the elderly. Double by-pass open heart surgery at 82? Why? So the poor old guy can hobble around half crippled for 3 or 4 more years so you don't have to feel alone? I know it upsets people but there are sick people that could use that care.
     
  9. rdowns thread starter macrumors Penryn

    rdowns

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    #9

    I bet a lot of Americans would if they knew the costs for these heroic measures treatment. Can you imagine? Root our fraud and end of life heroic measures and cut Medicare spending buy what, 40%??
     
  10. Doctor Q Administrator

    Doctor Q

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    #10
    I can solve this with a calculator

    If they keep improving healthcare until we live to be 200 instead of 100, then the expensive last week of our lives would be only half the proportion of our lives that it is now. (We'd have to avoid new techniques that would make the last two weeks expensive.)

    We'd save billions!

    Seriously, I don't think EOL statements have to be mandated, but a huge push in publicity about their importance would benefit everyone.
     
  11. CalBoy macrumors 604

    CalBoy

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    #11
    This is definitely the direction we need to go in, but Medicare needs to be adapted for the long term to become viable for the boomers and beyond. Medical science is going to keep being able to add hours or days to the end of life for thousands/minute. We can't devote 20% of the economy to keeping 90 year-olds alive for another 90 minutes. It just doesn't make sense.

    I think Medicare should adopt a quality of life matrix that pays for procedures only when they will have a positive effect on quality of life and result in a net positive QALY (quality-adjusted life year) that isn't absurdly low (like pumping a brain-dead 90 year-old's lungs and having 24 hour nurse watch).
     
  12. MacNut macrumors Core

    MacNut

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    #12
    The bigger issue is not the cost to keep people alive but why it costs so much to do it in the first place. I thought as technology got better the prices were supposed to come down.
     
  13. Ugg macrumors 68000

    Ugg

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    #13
    ICU makes hospitals lots and lots of money and there is absolutely no incentive for them not to keep them filled with people. It's possible that someday we'll have robots in ICU but until then, it's a matter of having them staffed 24/7.

    A friend who is an ICU nurse makes a lot of money. Shifts MUST overlap, there are generally only 2 patients per nurse. Couple that with all the expensive lab tests, specialists, etc, etc. Now tell me where costs can come down.

    It's not a matter of relying on technology to bring costs down but on government to straighten up the mess that is US health care. Private industry is only interested in making money, not in cost containment.
     
  14. MacNut macrumors Core

    MacNut

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    #14
    Even if the US takes over the health care system 100% the doctors and tests will still cost money. The only thing that will change is who pays for it. Until we get to the root of the problem mainly the hospitals, things will not change. We have to stop treating it as a business and strictly as a way to help people. The era of doctors making millions and getting kick backs has to stop. Yes it costs money and time to go to medical school but should it cost as much as it does?
     
  15. rdowns thread starter macrumors Penryn

    rdowns

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    #15

    While our healthcare system is broken, the vast majority of doctors hardly make millions.
     
  16. Doctor Q Administrator

    Doctor Q

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    #16
    With medical school costs and malpractice insurance, are doctors really that rich before they are near retirement?
     
  17. skunk macrumors G4

    skunk

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    #17
    You tell us, Doctor.
     
  18. Sydde macrumors 68020

    Sydde

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    I suspect malpractice insurance has a significant effect on medical costs. With every little error a medical service provider could make possibly resulting in litigation, they have to play CYA constantly, and still the malpractice insurers have them by the short hairs. Not sure what the solution is (probably not "tort reform") but how we are doing things does not seem very efficient.
     
  19. KingYaba macrumors 68040

    KingYaba

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    #19
    I think it was a few years ago when one of those flu things were causing people to panic. I even forgot the name. Was it Swine Flu or Bird Flu? :p Regardless, I kept up my hand washing and I've stepped up my exercise routine and healthy eating. I'm having a hard time remembering when I was last sick. It's one thing to go after treatment costs but people need to take the initiative and better themselves to reduce risk and through that, cost.
     
  20. iJohnHenry macrumors P6

    iJohnHenry

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    #20
    I believe it was S.A.R.S., and was no :p matter to those that died from it.
     
  21. Rodimus Prime macrumors G4

    Rodimus Prime

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    #21
    I think my uncles insurance cost per year is pushing if not over 6 figures and he is not exactly in the high risk category of surgeons.

    It is insane how high it cost them. While yes he does live a very good life and works hard for it. He and his wife spent a fair number of years eating PB&J for dinner because that was all they could afford.

    The cost for medical school is over 200k in debt plus everything else. Mix that with lost earning for at least 8 years and then you have the internship and resident. You are talking 10-12 years before you can really start bring in any kind of money.
    My uncle over 20 years practicing to get were he is today.
     
  22. Sydde macrumors 68020

    Sydde

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    #22
    And we had all been thinking it was AHIP that was making healthcare so unaffordable.

    malpractice rates vary state by state

    Appears to be a rather large and complicated picture. If I am feeling a little blah I will tend to ignore it, because I have no insurance. Of course, who knows, I might be feeling the onset of something serious, but if it is, I will find out down the road when it starts to really take me down. At some point, I will drag myself to a doctor, and maybe they will be able to treat me, but if I had gone in earlier, how much less would it have cost? Lack of prophylaxis is one of the most serious and expensive healthcare problems we have, and it is spiraling out of control.
     
  23. MacNut macrumors Core

    MacNut

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    #23
    One of the problems is that people will go to the doctor for the smallest of symptoms. The waiting room was packed at the ER when I had to take my mom in a few weeks ago. The majority of the people there probably could have been helped with over the counter medicine. It clogs up the system for those who have life threatening problems.
     
  24. wpotere Guest

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    They may also be there if they don't have insurance or money. The ER is a the cheapest way to be seen.
     
  25. MacNut macrumors Core

    MacNut

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    #25
    Im sure that is true, but people will run to the Dr with a small ache and pain, save the visit for a real problem.
     

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