INSURANCE IS THE MEDICINE (via Glenn Dryfoos):

Health Care’s Generation Gap (RICHARD DOOLING, 8/17/09, NY Times)

With so much evidence of wasteful and even harmful treatment, shouldn’t we instantly cut some of the money spent on exorbitant intensive-care medicine for dying, elderly people and redirect it to pediatricians and obstetricians offering preventive care for children and mothers? Sadly, we are very far from this goal. A cynic would argue that this can’t happen because children can’t vote (even if their parents can), whereas members of AARP and the American Medical Association not only vote but can also hire lobbyists to keep the money flowing.

One thing’s for sure: Our health care system has failed. Generational spending wars loom on the horizon. Rationing of health care is imminent. But given the political inertia, we could soon find ourselves in a triage situation in which there is no time or money to create medical-review boards to ponder cost-containment issues or rationing schemes. We’ll be forced to implement quick-and-dirty rules based on something simple, sensible and easily verifiable. Like age. As in: No federal funds to be spent on intensive-care medicine for anyone over 85.

I am not, of course, talking about euthanasia. I’m just wondering why the nation continues incurring enormous debt to pay for bypass surgery and titanium-knee replacements for octogenarians and nonagenarians, when for just a small fraction of those costs we could provide children with preventive health care and nutrition. Eight million children have no health insurance, but their parents pay 3 percent of their salaries to Medicare to make sure that seniors get the very best money can buy in prescription drugs for everything from restless leg syndrome to erectile dysfunction, scooters and end-of-life intensive care.

Sir William Osler, widely revered as the father of modern medicine, said, “One of the first duties of the physician is to educate the masses not to take medicine.”

Except that the reason the old disproportionately consume health dollars is not just that they are politically powerful but that they are ill. Insuring the young (and, therefore, healthy) is the medicine that ought not be taken.

MORE:
Health Reform Fattens Big Insurance and Taxes the Young (Bernadine Healy, M.D., August 17, 2009, US News)

Imagine a 25-year-old man, perhaps your son, just starting out in life, with good health but a skimpy income. Right now, despite being laden with school loans and a car that's not quite paid for and trying to save up for a house—all on maybe $35,000 a year—he can get health insurance that will meet his needs at this stage in his life and contribute toward the national goal of universal coverage. To do this he might buy a catastrophic-care policy that covers him for major medical events, like a bad skiing accident, that could otherwise bankrupt him. This might cost as little as $500 to $600 a year and typically comes with inexpensive primary-care access. But under Obamacare, he would have to pay a premium closer to $4,000—a potential back-breaker that might force him to take a government handout, further burdening his fellow taxpayers.

That's because, as mandated by the House bill, his premium must be no less than half the highest premium paid by an older, less healthy adult in the same plan. By tightly harnessing the premiums of the young and healthy to those of the old and sick, reform would redistribute dollars belonging to younger Americans—much as Medicare and Social Security already do. But reform would hide this spreading of wealth by folding it into premiums, rather than revealing it on paychecks. Forced by government and enforced by the Internal Revenue Service, these hefty premiums would amount to a middle-class tax.

Posted by Orrin Judd at August 17, 2009 1:49 PM