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Saturday, February 28

Er, is President Obama proposing geriatricide as a means to reduce America's budget deficit?

Yesterday New York Times columnist David Leonhardt took a stab at deciphering President Obama's proposed budget. Usually I don't mention a columnist's credentials but in this case I think it's helpful to know that Leonhardt didn't fall off the back of a potato truck. He studied applied mathematics at Yale and he's been writing about economics issues for The Times since 2000. So I think he's reasonably qualified to comment on the proposed budget. I was struck by this part of his explanation:
Mr. Obama would try to lift the incomes of the middle class and poor through two main channels, administration officials said. The first is an overhaul of health care, meant to reduce the insurance premiums now taking a large bite out of many families’ paychecks.

The details remain vague, but the budget begins paying for investments that would eventually allow Medicare officials to refuse to pay for medical treatment that does not show evidence of improving health. If successful, that change would vastly reduce the government’s long-term budget deficit. It is also likely to bring down private health costs, since insurers typically follow Medicare’s lead.
Small wonder the details are vague; many of the medical conditions that beset the elderly, including aging, do not improve with medical treatment. The best that can be hoped for is management of symptoms for a host of illnesses, such as Alzheimer's and COPD, which are typically associated with aging.

Of course the same holds true for many illnesses that not are age-specific, such as AIDS and asthma, and which can only be managed, not improved.

I have a hunch that the AARP would have something to say about a backdoor proposal to slip geriatricide policy into Medicare reform.

I hope that I've misunderstood Leonhardt's analysis or that he's misunderstood what he read of the proposal. Yet on the chance we've understood perfectly it's time to review a few basic points:

Granted, the Social Security problem is now at crisis proportions as the post-WW2 generation approaches retirement. But any solution that encourages involuntary manslaughter of the elderly is out of bounds in a civilized society.

I would remind President Obama that America's medicine fields have grown into mega-industries because of research and treatment methods aimed at helping people manage incurable illnesses and the wages of aging.

I also remind House Speaker Nancy Pelosi that allowing elderly people who cannot afford private insurance to die from medical neglect is not a humane way for a government to reduce humanity's carbon footprint.

There is a simple means to bring down Medicare costs and that's to omit Medicare fraud. For reasons I don't understand our government has made only the most cursory attempt at stopping the massive fraud.
Comments:
Yes, I believe you understand the "Board" of "experts" approach. They will have expertise in money and budgets mostly.
As a physician who spends most of his working life treating people with diabetes, I figure my work is about to end. They often spend more and will probably have their disease "redlined."

While it is true that a great percentage of medicare money goes to the last year of life, offing them to save money is not a very American concept.

I could agree with refusing to pay for MRIs for most people over 80 or 90, there are some procedures that are so damned expensive that we might go back to some cheaper methods of diagnosis.
 
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