How to eliminate health care injustices (part 1) — VOICES for REASONVOICES for REASON

Here’s an injustice in our health care system you don’t hear about enough: how Medicare funds veritable end-of-life health-shopping-sprees for the elderly at the expense of the young. Such sprees are one reason why Medicare has an incredible $50 trillion in unfunded liabilities.

Consider this firsthand account from Richard Dooling in a recent New York Times op-ed:

In the 1980s, I worked as a respiratory therapist in intensive-care units in the Midwest, taking care of elderly, dying patients on ventilators. I remember marveling, along with the young doctors and nurses I worked with, over how many millions of dollars were spent performing insanely expensive procedures, scans and tests on patients who would never regain consciousness or leave the hospital….

I and other health care workers solemnly agreed that the spending spree could not continue. Taxpayers and insurance companies would eventually revolt and refuse to pay for such end-of-life care. Somebody would surely expose the ruse for what it was: an enormous transfer of wealth….

We were wrong….

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.

Dooling’s account raises a clear problem—but what is the solution? Right now, the government exercises massive taxation and regulation that generally favors the old over the young. Is the solution then, for the government to favor the young over the old? Dooling endorses such a shift when he writes:

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.…

But who gets to determine which health expenses for the elderly are “exorbitant” and therefore unnecessary to treat? What if they need a scooter to function? What if there’s a chance that expensive, end-of-life intensive care will actually lead to a recovery? Is it fair for bureaucrats to deprive them of such things, when they have paid into the system, and planned their lives based on the government line that it will keep them healthy, pretty much no matter what?

Dooling’s solution to the government sacrificing young to old is effectively to have the government sacrifice old to young.

But is it necessary for anyone to be sacrificed? Prominent intellectuals say yes. (See some examples in Don Watkins’s post on the issue of rationing.) We as a society must make “tough choices” about who gets health care and who doesn’t, they say. Since “we” have finite medical resources, we inevitably have to sacrifice some people’s care to others, whether young to old or old to young.

No “we” don’t.

Continued in Part 2.

flickr/Darren Hester