Making the tough decisions

[phantom power]

Seniors would enter the health care world the rest of us live in, with co-payments, deductibles and managed care. Eventually, cost control would require some tough decisions about end-of-life care and the rationing of high-tech treatments that have limited efficacy. But starting with a value of $15,000 per year, per senior—the amount government now spends on Medicare—Ryan's vouchers should provide excellent coverage. His change would amount to a minor amendment to the social contract, not a fundamental revision of it.

That's written by an alleged liberal, by the way, not some tea partying moron.

Most old people would be lost in "the health care world the rest of us live in" because if you are self-employed or unemployed, as retirees are, you'd have to "shop" for insurance, go through huge hoops to get insured, manage a complicated health care bureaucracy that you don't understand, even when you are sick.(Anyone heard of elder scams? Yeah, I though so. And just because they are illegal doesn't mean they don't exist.) Doing all that is difficult even for people who aren't aged, infirm and often very ill with debilitating diseases. Acting as though throwing those people into the pool is going to somehow be beneficial to the individual, much less the system as a whole, is nonsensical in the extreme.

...

This is why all those average Americans are terrified of losing their jobs, millions of whom have recently done so, have been exposed to the vagaries of this individual market and will endure the tortures of the damned to avoid doing again. (Good news for employers, though ...)

For those of us who live the the world outside that employer covered system as this person suggests seniors should do, the idea that a sick old person of 70 could be covered for 15k a year is laughable. A good policy for a 50 year old with a health problem can cost that right now (and the health care reform isn't going to change it.) It's absurd on its face that sick senior citizens are going to be able to be "cost conscious." The assumption is that they are overusing the system, when the truth is thatthey are all in the rather immediate process of dying. So let's not kid ourselves that they are living in the same world we are as healthy adults. They aren't. And even those with good pensions won't be able to shoulder the high cost of senior medical care on their own. The only people who will have no worries at all under this are the upper 5%.

http://digbysblog.blogspot.com/2011/04/making-tough-decisions.html

[monmouth]

1. Let me tell you exactly what happens, and a great article by the way.

You are given the news and hopefully a prescription or two to either ease your pain or at least control whatever the ailment is. You then double check on your life insurance (if you have any), call the kids, organize your home for disposal, and wait to die. Mostly you keep this to yourself and fill your days as much as possible. Life savings will not go for treatments that will not cure but fill the pockets of pharmas, doctors, etc. Money in the bank is to cover your last bills and the rest the kids can have. At least that is how the dilemma is handled in my neck of the woods.

[SheilaT]

2. It's also not as if Medicare gives seniors a totally

free ride.

I work in the outpatient registration department of a hospital, and every time anyone on Medicare is registering for a procedure, we have to do something called "code-scrubbing", which means to make sure that the diagnosis provided will actually pay for the test ordered. And if it won't, or might not, we have to have the person sign an ABN, Advanced Beneficiary Notice, which advises them that they may end up paying for the test. They also have the option of instead going back to the doctor to get a new order, one which has a diagnosis which actually will pay for the test.

Some tests Medicare will only pay for once every 90 days, or some other limitation like that.

If we don't issue the ABN, and Medicare does refuse to pay, the hospital CANNOT go back and bill the patient, not without a properly signed ABN.