Who pays? ( Bring out your dead. )
I recently took one of those drive-by polls on Facebook. One of the questions it asked is whether I thought health care was a right or a benefit. My only answer was “depends on who pays for it”. I’m all up for doing everything I can to make sure health careis a benefit for myself and my family. I’m not so up on paying for others who don’t necessarily care enough to do the same for me, or even for themselves. Some people are just fine with running to the emergency room every time they get a runny nose because it’s free for them. I don’t run to the doctor everytime I get a runny nose. It’s not free for me. That folks, is rationing in its purest form. I have a reason to ration. The person who considers it a right doesn’t. They cost a lot more to the system than I do. They cost me a lot of money in the process via ever increasing taxes. Not once in the history of this country has any legislator come to the public and told us we did such a good job of watching our medical expenses they’re going to lower the Medicare withholding rate. Not once. Not ever. Nada. It never has ever happened. Am I clear on this? Entitlement programs in the United States have spiraled out of control since their inception in the 30′s. What was originally a 1% tax is now a combined 7.65% of all wages ( up to certain amounts ), and going broke. It needs to be a lot higher. Then toss in the state taxes. Ours looks something like this:
- 2% of the first $3,000 of net income
- 3% of the next $1,000 of net income
- 4% of the next $1,000 of net income
- 5% of the next $3,000 of net income
- 5.8% of the next $67,000 of net income
- 6% of the net income in excess of $75,000
No telling what percentage of that goes to health care. It’s a big chunk that’s getting bigger tho. A friend of mine pointed out one of the complexities of the overall issue:
This is the place that almost all health care reform plans hit a block. The block is not exactly aided by the fact that the last few weeks or months of a persons life are typically the ones where his medical bills are the greatest. This is, of course, not the case for people who die in accidents and may not be true for those who end up surviving chronic diseases like cancer. But it is sufficiently common that the obvious way to cut the costs of any medical service is to not treat people who are really ill.
Since, eventually, we all die the medical cost of our final weeks of life is something that someone is going to have to pay for and, since we’re dead at the end of it, it isn’t going to be us unless we made suitable savings. So that means someone else has to pay.
And that is the probem.
So, I did a little research. Now, Dingus’s assumption is that all people experience some end of life struggle. I’m not quite that pessimistic. In 2006, in the US:
|Diseases of heart (I00-I09,I11,I13,I20-I51)||211||26.04%|
|Malignant neoplasms (C00-C97)||187||23.08%|
|Cerebrovascular diseases (I60-I69)||45.8||5.65%|
|Chronic lower respiratory diseases (J40-J47)||41.6||5.13%|
|Accidents (unintentional injuries) (V01-X59,Y85-Y86)||40.6||5.01%|
|Diabetes mellitus (E10-E14)||24.2||2.99%|
|Alzheimer’s disease (G30)||24.2||2.99%|
|Influenza and pneumonia (J10-J18)||18.8||2.32%|
|Nephritis, nephrotic syndrome and nephrosis||15.1||1.86%|
|Intentional self-harm (suicide) (*U03,X60-X84,Y87.0)||11.1||1.37%|
|Chronic liver disease and cirrhosis (K70,K73-K74)||9.2||1.14%|
|Essential hypertension and hypertensive renal||8||0.99%|
|Parkinson’s disease (G20-G21)||6.5||0.80%|
|Assault (homicide) (*U01-*U02,X85-Y09,Y87.1)||6.2||0.77%|
Currently a cool 7% of the population dies rather suddenly of non-health related issues. Now, #1 is heart failure. But, I don’t know how many of those are sudden heart attacks, or lingering heart diseases. Big difference in price. I can see very quickly how logical it would be for Health and Human Services to have public information podcasts and such encouraging people who are terminal, depressed, or just ready to end it all because their boyfriend ditched them to go ahead and do it. Intentional self-harm is not a drain on the health care system if done correctly. I can see a very sudden backlash to Obama’s anti-gun policies as people suddenly realize that if a couple of druggies in off each other, it lowers the cost of medical services for those of us who are, well, not criminals. Give em all a gun. The pro-life supporters will vanish in shame, realizing suddenly how selfish they are in expecting productive people to sacrifice their health coverage just so some crack-mother can crank out another brain damaged accident. Corporal punishment? You betcha! Shock tv will be taken to all time lows rivaling anything Heidi Montag’s done. Remember Logan’s Run? Directed by a Brit. They know a little about rationed health care. That’s one way to handle it. Of course, he had to go to a different country to make the movie. That should tell ya something.
So, this whole non-issue of end-of-life-care will resolve itself as we eliminate the things that drag life on in it’s final stage, and encourage those things that speed it up. It can be fun stuff too, doesn’t have to be all dismal and dreary. David Bowie sang about The Supermen, people who could live forever, but instead played games where the winner died. He’s a Brit too.
So, whenever some astroturfer tries to disrupt your argument for the health care system no one has defined yet by yelling you want to kill their grandmother, just tell them you’ve already got that covered. It’s what to do with the living we haven’t dealt with yet.