Slow Down There Pardner
One of the statistics getting thrown around during the health care reform debate is that Americans, unlike our wiser European brethren, spend close to 50% of all the money they’ll ever spend on health care, in the last six months of life.
Seems like a waste, doesn’t it?
And the President’s “rationing board,” (or whatever he’s calling it), will ration a lot of that away. The government will decide which treatments you really need, when you’re going to die soon anyway.
But let’s think about this for just a moment.
If 50% of the money is being spent, you can bet close to 50% of the profits are being made. And if that’s where the profits are, Big Pharma will – surprise! – want some more of that. And that means research. And research means new treatments.
New treatments means your last six months of life now happen around age 75 or 80, instead of around 60. Or 50. Or 35.
Someday, maybe those last six months will come at age 100. Or 120. Or longer. Who knows? What we do know is, given a chance to make a buck, American medicine has led the world in extending life. Sure, life expectancy might be longer in Japan or France. But that’s mostly due to American know-how combined with healthier lifestyles. If we cut out the fat (literally), we’d live longer, too.
The President is promising to save money by eliminating a lot of those seemingly pointless end-of-life treatments. But that’s also going to mean an end to end-of-life profits. And, well, you can bet our life expectancy will get frozen in place as a result.
Sure, we all pay for expensive treatments for other people who are going to die soon, anyway. But we also all get to enjoy the benefits of a industrious and profitable health care industry. And even if we ourselves don’t get to live to be 90 or 100 or more, there’s a much better chance that our kids or their kids will.
And yet Washington is in such a rush to “fix” what’s not broken, that six weeks is all we have to stop this madness. Just yesterday Joe Biden admitted the Porkulus Bill was pretty much a waste. That was nearly $800 billion down the drain, because we “needed” to pass a bill so quickly that no one had the time to figure out what was really going on. Now we’re talking another $1.5 trillion in nationalized health care spending.
Shouldn’t we take a little longer than six weeks to talk about it?
UPDATE: Debate? We don’t need no stinkin’ debate.
A big part of the reason the U.S. has a shorter life expectancy than other industrialized nations is simply that we count every person born alive whereas they do not count many neo-natal deaths. So there’s an apples and oranges quality to the comparisons.
I’m amazed that there’s as much as six weeks.
The longer this stuff hangs out the less “emergency” they can pull off and the more people start asking pesky questions.
Far better to pass it now, and have the pols wring their hands after the fact… right before they use this fresh failure as an excuse for even more power.
If Big Pharma was all of Big Medicine, that would make sense. Still, on the whole, your argument has merit, just not as much as you might think. Most of the cost of medicine is already filtered through an economic funhouse mirror when it travels via Big Insurance and Big Healthcare into the place where even when a consumer gets a bill and a multipage form explaining the benefits and the costs to the insurer and the costs to the consumer, deciding where the money made a profit isn’t easy to determine. I always assume the doctor made some, the medicine made some, and the insurance company better have made some or they’ll raise my rates again and that will suck. Of course, insurance companies make most of their money by investing, so that’s why benefits are going to be cut and rates will go up in times when investments are sucking ass, like right now.
Big Pharma makes the bulk of its money on bread-and-butter medicines that are taken every day by millions, not in emergency treatments taken by few people and only for a short time. A desperate and dying customer base isn’t something to look away from, and it’s certainly something to invest research dollars into, but it’s certainly not going to be the only thing a company relies on.
Life-extending medicines are a much bigger argument for government healthcare than against it, since you admit that healthy lifestyles and general maintenance are a vital element in longevity. If more people saw their doctors and more people listened to them, we’d live longer. I can’t see how government medicine would do worse than corporate healthcare, especially if we follow the model of the French, who have a public/private system that doesn’t seem to have the complaints about it that the English model generates.
Of course, I think our government healthcare will find unique American ways to fuck things up. But it will be mostly good, I expect.
Jon, just how do you expect government medicare to result in more people listening to their doctors? If the Canadian experience is anything to go by, it’s more likely to result in people not having a doctor to listen to even if they want one.
The Canadian experience is one of many possibilities. I’d open things up to more nurse-practicioners, for one thing. Fuck the AMA and their “only a doctor should…” crap. Most nurses today know more than doctors did fifty years ago, so it’s not like we don’t have enough access to medicine so much as an access to overpriced professionals when para-professionals would do. So let general practicioners be nurses (and vice versa,) and you’ve gotten rid of a lot of the backlog right away. And that’s just one possibility.
As for listening to their doctors, nothing can help that. But it’s more likely to happen if people can afford to see them, which is why socialized medicine would have an advantage. Whether people listen or not? Still up to the weak point in our current and any proposed system: the customer.
That’s nice. Are you writing the legislation?
No I’m not, and everyone, myself included, can be various shades of grateful for that.
But it’s creating the meds that turn the emergency, short-term treatments into long-term, manageable healthcare situations that holds the promise. Yes, three to six weeks of end-of-life meds won’t make Big Pharma big money. But 10-20 years of daily meds to make a bad problem manageable turns into money in the bank.
it’s more likely to happen if people can afford to see them, which is why socialized medicine would have an advantage.
I’ve been to a lot of doctor’s offices, and I don’t remember ever finding a doctor sitting listlessly, waiting for someone who can afford to see him. Maybe further socializing medicine will bring some government efficiency into doctor’s offices and improve turnover. Because that’s apparently the best thing about Canada or the NHS, is the elimination of wait times, so more people see doctors.
Most nurses today know more than doctors did fifty years ago
Sweet. We could return to the medical care of the early 60s.
I haven’t been following things that closely, so maybe one of you kind souls can help me out:
When we see that “last six months of life” statistic, we all picture incapacitated 80-year-olds on life support. But then, isn’t it possible that “50% of all the money” is spent on patients with severe problems, and that a fair number of them might nonetheless die – ie, regardless of their age, they will be in their last 6 months? Isn’t that the way we would expect (and want) things to be?
So, is this effect accounted for in the 50% statistic?
Most health care money spent at end of life? You mean like serious car wrecks, work accidents, heart attacks, falls in the home, and that sort of thing? Seems to me they want you to think that all these patients are sucking up all the health resources in the hopeless extension of the terminally ill patients lives. I am guessing that the statistic in question is true but not in the way you would presume. Maybe, we spend that much money late in life because that’s when it is necessary to do so and unless you want to abandon ER medicine you are not going to see the huge savings promised.