Gov't: Health Tab to Hit $4.6 Trillion in 2020

[Hissyspit]

Source: Associated Press

Jul 28, 3:13 AM EDT

Gov't: Health tab to hit $4.6 trillion in 2020

By RICARDO ALONSO-ZALDIVAR
Associated Press

WASHINGTON (AP) -- The nation's health care tab is on track to hit $4.6 trillion in 2020, accounting for about $1 of every $5 in the economy, government number crunchers estimate in a report out Thursday.

How much is that? Including government and private money, health care spending in 2020 will average $13,710 for every man, woman and child, says Medicare's Office of the Actuary.

By comparison, U.S. health care spending this year is projected to top $2.7 trillion, or about $8,650 per capita, roughly $1 of $6 in the economy. Most of that spending is for care for the sickest people.

The report from Medicare economists and statisticians is an annual barometer of a trend that many experts say is unsustainable but doesn't seem to be slowing down. A political compromise over the nation's debt and deficits might succeed in tapping the brakes on health care, but polarized lawmakers have been unable to deliver a deal.

Read more: http://hosted.ap.org/dynamic/stories/U/US_NATIONS_HEALTH_TAB?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

[dkf]

1. K&R

If we want to address our spending problems, this is job #1.

[EFerrari]

2. So it begins. n/t

[tucsonlib]

3. Only One Way To Fix Our Health Care System, And We All Know What It Is

MEDICARE FOR EVERY AMERICAN!!

[customerserviceguy]

7. Won't work

The only reason Medicare has been able to function so far is that providers have third-partied the costs of treating Medicare patients on to the insured and the full-payer patients. The baby boom is going to put an end to that.

[Igel]

17. Indeed.

I've done the uninsured patient route. Paid more than what those with insurance would pay, and more than what the Medicare people pay.

There's a reason that many doctors aren't taking new Medicare patients. The HCRA talked about costs as though only costs to the government mattered--fixing costs is a good thing. But fixing costs is also setting prices, and what a lot of people are calling for are covert price controls. They seldom work, even when the government sets all prices everywhere.

[customerserviceguy]

25. Yeah, I know what you mean

I have an HSA, and I'd love to find a network of providers that would charge me the same as they do for a Cadillac-insured patient or a Medicare patient, and without an ounce of hassle from an insurance company, just simple basic payment in full at the time of service.

I would imagine that if there's a squeeze on providers, more might opt out of Medicare, my opthamologist said he took an early retirement for that reason.

[rfranklin]

4. "Most of that is spent on the sickest people..."

In other words, we spend hundreds of thousands on medical care for aged, dying people who have no chance of recovery. Or doctors perform operations which are absolutely unnecessary and often cause more pain and suffering for the patients. I saw this with both of my parents. My mother spent two years being tortured by the medical profession, my father was luckier, only a few months. both as the result of surgery which started their descent.

[No Elephants]

8. Yes, most health care money is spent on the sickest people. No surprise there.

And not only elderly ones. St. Jude's costa a fortun to run.

What alternative do you suggest?

[rfranklin]

12. Let's get more specific...it's about aggressive treatment that does not change the outcome...

And usually increases the distress for the patients and the family...


Federal health-care spending is currently about 8% of gross domestic product. The Government Accountability Office predicts that amount, unchecked, could almost double over the next 40 years. More than $50 billion a year is estimated to be paid out by Medicare each year for patients in their final two months of life.

...."In addition to its effects on patients' quality of life, unnecessarily aggressive care carries a high financial cost," says Dr. David Goodman, lead author of the study and director of the Center for Health Policy Research at Dartmouth's Institute for Health Policy and Clinical Practice. "About one-fourth of all Medicare spending goes to pay for the care of patients in their last year of life, and much of the growth in Medicare spending is the result of the high cost of treating chronic disease."


http://money.msn.com/retirement-plan/the-high-cost-of-dying-thestreet.aspx

[JDPriestly]

14. But who decides what treatment is aggressive an does not change

the outcome?

I know a doctor who will tell you that every family wants doctors to try everything to save the life of their parent, grandparent, child, spouse, sister, brother, etc.

No one needs to lose a loved one without making sure everything is done to keep the person alive. Death is such a horrible loss for normal people.

It takes a pretty calloused, ugly soul to decide not to make every effort possible to save another person's life.

In the end, it is up to the elderly or terminally ill person to decide for him- or herself to what extent they want or will want medical intervention. I have made my wishes known to my children and husband in this respect. We should each do that, if possible in writing.

But no one other than the person's closest family or intimate friends or doctor has the right to decide for another person or family that death is the best alternative about end-of-life issues.

Doctors hate losing patients. Most of them become doctors because they want to help people and try to save their lives.

Conditions that were considered fatal 50 years ago -- like certain heart problems -- are not deadly at all today.

We have to make medical care more broadly accessible.

A lot of doctors' time is spent treating common ailments that could be dealt with by nurse practitioners. That will be the trend in the future. It is already starting. And that will lower the cost of medical care. We also have to get private insurance companies out of the business. Hopefully we will be able to do that once Obama's health insurance reform has adjusted the system so that far more people are insured and the insurance company profits are controlled and health insurance is a less lucrative investment.

[Igel]

19. And that's the problem.

If somebody wants to say, "Do everything possible, I don't care if it costs $10 million a year, do it!" that's their business. As long as it's their business.

As soon as it's general revenues, it's everybody's business and everybody gets a say. In Britain there are procedures that have a low rate of return. They're not covered. There are procedures that do reasonably well but are very expensive. If you're over a certain age you're not likely to qualify for them. The alternative is that they're offered infrequently, so the waiting list is long: Same effect. It is the single biggest way of cutting costs--cut out service that treat not so much the patient but the patient's family.

My uncle was sick. He was taken the hospital in a coma. His living will called for a mini-conference of relatives to hear the prognosis. His orders were that if his siblings thought there was little point in continuing, to pull the plug. They pulled the plug.

Another relative had cancer. For 10 years after she went on disability she struggled on with cancer with various treatments an the occasional emergency hospitalization. She did some volunteering, she raised her son, but for 1/4 of every month she was out of commission--sometimes longer.

Then there's my mother. She can't conceive of the world without her; she can't conceive of being ill. I suspect that she'd want everything done to keep her alive. She has Alzheimer's. She's getting worse and worse, and is miserable because she's been grounded and has no life outside of what a "friend," a hired caregiver, provides. The disease will likely kill her indirectly. She'll die from nursing-home-related ailments when she has no mind and can't keep from crapping her diaper. This will take years. But she'd probably want every single complication to receive all the attention possible, just to keep her mindless body going. The assets she'd eagerly consume to slow her death and continue a life that even she doesn't find very pointful but which is better than the alternative--the universe being deprived of her--will be immense. When the time comes, I'd want the doctors to allow her suffering to end.

Making medical care more broadly accessible with no way to prevent a few from consuming a lot of public resources to no end would make it worse. Think of it as a tragedy of the commons, but instead of just letting a small community use the commons we'd let a much larger community use it. Not good.

Texas has been in the news a few times because it's heartless. It's there to free up hospital beds and treatment facilities that are in relatively short supply. If your doctors conclude that treatment won't help, they can follow a process to cut off treatment. Then they send you home, if there's nothing more they can do. You have a window of time in which you can arrange for transfer to another facility. If you have money and can pay, there's always a place that'll take you, even knowing that it won't help. If you don't have money and can't pay, that's that. The family's not ready for the person's death this week and want to postpone it; they're not likely to be any more ready for the person's death next month so why postpone it? Harsh, but it tries to preserve the commons.

[JDPriestly]

20. Frankly, Igel, I'm glad I'm not your mother. You sound like a very

cruel individual.

Most people feel sorrow and compassion when a loved one is in the situation of our mother.

Why aren't you taking care of your mother? That is what could happen if Medicare were not fully funded. You might either take care of your mother to the extent of your means, or potentially be charged with neglect and elder abuse. Medicare exists to relieve children like you from the financial and physical responsibility for their disabled elderly relatives.

I knew a very elderly man with fairly advanced Alzheimers who was in a loving marriage and family. He remained calm and happy and unafraid until the very end.

Our bodies and minds resist death no matter what. It is immature to expect otherwise. Watch nature. Each living thing treasures life and struggles to live. We are all part of the oneness of life.

[24601]

21. I'm sorry about your mother. I lost mine 11 years ago to multiple

myeloma - she had a four-year fight with it and was 69 when she died.

You don't sound cruel to me but rather one who has looked at this issue from an analytical approach. The facts are just that, facts and we can't change the cards we are dealt. We can only choose how we play them.

We've lived in the UK and were under their National Health System - never again. We were assigned a government doctor who was a shrink but was detailed by NHS as a family care doc. He also didn't believe in treating fevers because it was "nature's way of dealing with it.

They do some things very well - like the nurse "health visitor" who comes to your house when you have a newborn for checkups and shots. But the doofus family doctor" outweighed all the good.

[Incitatus]

15. Assisted suicide for terminal patients. nt

[LanternWaste]

16. I imagine many people perceive chemo and radiation as torture too--

I imagine many people perceive chemo and radiation, and even physical therpay as torture too-- yet I do not think uncomfortable or even painful treatment therapies are anything close to torture (outside of melodrama, that is...)

[SKKY]

24. So, what are you saying? Don't get sick? But if you get sick, die quickly?

I thought we were a more compassionate society than that.

[tclambert]

5. Hell, by then we may have the "eternal youth" pill, and health care costs will go DOWN.

[No Elephants]

6. And the bailouts of Wall Street and banksters pale in comparison.

[blank space]

9. Actually the problem is not the cost of health care

its the profit in health care.

Name me a single person, company,organisation that doesnt look at health as a cash cow - exaclty.

From Doctors raking in million dollar salaries to million dollar equipment, consultants and beuracracy - health needs to be deprofitized - pure and simple.

[EFerrari]

18. Howard Dean said we pay more for health care than nations with

universal health care and we don't get it.

[midnight]

10. Health care report wants us to know that health care is unsustainable? That line

of reasoning unfortunately is not working when it comes to several wars... Even before George Bush invaded Iraq for what we were told would be a cake walk and other untruths, it was said that this war was economically unsustainable...

[mother earth]

11. Medicare for all!!! Single payer system will cure what ails US.

We can no longer afford health care for profit. It's not efficient, and it's only rationing it. Let it fall!

[The Green Manalishi]

13. We can no longer afford health care for profit

WE never really could!

[plumbob]

22. What's missing is that the $8650 per capita now is not evenly distributed

between private plans and Medicare. Medicare patients average less than $5000 per year, while private insurance people average $12,000 plus. If everyone were on Medicare, we'd save more than $4,000 per person per year right now.

So: outlaw private insurance plans and provide Medicare for everyone. Save half now and even more later.

The headline is written to make the eye see: GOVERNMENT HEALTH TAB to hit $4.6 trillion in 2020.

It should read: GOVERNMENT REPORTS THAT private and public health tab will hit $4.6 trillion in 2020.

I know that the headline must follow the original story. It's the AP I'm criticizing for deception.

[MisterP]

23. well, obviously the answer is to force everyone into this system

Constitution be damned