Sunday, February 17, 2013

Health Care - Lets Face Some Realities

David Goldhill, in an op-ed article in today's NY Times (Feb. 17), has calculated that a 23-year old employee recently hired by his company at a starting salary of $35,000 will, over her lifetime, have borne a cost of $1.8 million in health care costs - assuming no growth beyond current estimates, that she never has a working spouse, and that she and her dependents never contract a serious illness.  (See full article for the details.)  His piece ends with yet another plan to mitigate this circumstance, suggesting that health insurance be limited to "truly rare, major and unpredictable illnesses."  "In other words," he goes on, "let's cover everyone but not everything."

Yet another potentially reasonable solution to a problem that will be ongoing as long as people demand "life at all costs."  If I were to offer you the choice of virtual poverty v. one more year of life, what would your choice be?  If I were to offer you the choice of virtual poverty v. one more year of your child's life, what would your choice be?  If I were to offer you the choice of virtual poverty v. one more year of life for your 80-year-old parent, what would your choice be?  Until we come to some sort of understanding as to what the actual problems are can we truly get a firm grip on a solution.

The marvels of medicine will continue to grow - new technology, new drugs, new techniques, new prostheses, new computer-activated appliances, the blind will see, the deaf will hear, the lame will walk - new hearts, new lungs, new livers, etc.  but at an extraordinary cost!  To provide all services to all people seems an improbable, if not, impossible achievement.  At some point soon we will have to face the reality of the cost of perpetual health and perpetual life.  At some point soon we will have to face the reality that this goal may be economically and societally unsustainable and that some limitation of services will be required.