On my recent visit in Vermont, at our HS reunion, one of my best friend's in HS and I were talking about end of life issues. Marshall said, "we treat our dogs much better than we do people" [at those end of life (EOL) times, when people are kept alive with little/no quality of life]. I whole-heartedly agreed.
A day or so later, I was talking with my niece's daughter (it's awkward to say great-niece but she is great) who has an MPH (Master's in Public Health) and works on health policy issues at a large, well known Boston hospital.
I shared with her what Marshall and I had talked about and mentioned Obama's push for health care reform.
She was very pessimistic that any meaningful reform can be accomplished because there are too many players involved (health insurance companies, medical specialties, nursing homes, hospitals, medical associations, pharmaceutical companies, pharmacies, etc., to name just a few) and too many politicians who are grateful for the support from those factions.
IIRC, she said health care is our (USA) nation's eight biggest industry (or was it the sixth?) and that in the US, one third of all health care dollars are spent on the last 6 months of a person's life (trying to delay or prevent the EOL). While most of those EOL people are elderly, that "last 6 months" was compiled from people of all ages.
One thing she thought might help is if a new medical specialty of physicians was developed to deal specifically with EOL issues (because most typical physicians try as hard as they can to delay death as long as posssible, using every possible intervention).
The USA spends by far the greatest amount per citizen of any nation yet we have the greatest per cent without health care and rank very far down in comparison with other developed nations in general quality of health care (infant mortality, infectious diseases, etc.). It's a system that works for those with adequate money but not for others.
Since paying for health care benefits/insurance has traditionally become the responsibility of USA employers, as health care costs have so sharply increased, they are at a competitive disadvantage selling their products in competition with mfrs from other countries which do not have those costs to be covered.
I hope, and she hopes, her pessimism is mistaken.
But I sure haven't got much idea of how to proceed. I DO think we need to reduce the amount of "take" all these players are getting.
For instance, many health insurance companies are for-profit corporations with stock holders who want maximum return on their shares. They pay executives, managers, sales, quality control, HR, examiners, etc., and their employees have health and retirement benefits.
These function as middle-men between the employer/employee and the health services providers.
To my mind, it's as if we were to employ a middle-man service compamy to buy our food. They'd set the price on what could be bought, what we could have or not have, what we'd have to pay extra for. They'd negoitiate with Aldi, Kroger, A&P, Hy-Vee, Trader Joe's, etc., for what they'd pay for which products. And then we'd have to take what they procured for us.
IMO, in the long run, we need to shrink these puppies. But they're currently such a large part of our economy that has to be done very gradually and in a way that lets those millions employed in the industry be absorbed by other work.
How?
Who knows.
Terrible, terribly complex American problem.
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A day or so later, I was talking with my niece's daughter (it's awkward to say great-niece but she is great) who has an MPH (Master's in Public Health) and works on health policy issues at a large, well known Boston hospital.
I shared with her what Marshall and I had talked about and mentioned Obama's push for health care reform.
She was very pessimistic that any meaningful reform can be accomplished because there are too many players involved (health insurance companies, medical specialties, nursing homes, hospitals, medical associations, pharmaceutical companies, pharmacies, etc., to name just a few) and too many politicians who are grateful for the support from those factions.
IIRC, she said health care is our (USA) nation's eight biggest industry (or was it the sixth?) and that in the US, one third of all health care dollars are spent on the last 6 months of a person's life (trying to delay or prevent the EOL). While most of those EOL people are elderly, that "last 6 months" was compiled from people of all ages.
One thing she thought might help is if a new medical specialty of physicians was developed to deal specifically with EOL issues (because most typical physicians try as hard as they can to delay death as long as posssible, using every possible intervention).
The USA spends by far the greatest amount per citizen of any nation yet we have the greatest per cent without health care and rank very far down in comparison with other developed nations in general quality of health care (infant mortality, infectious diseases, etc.). It's a system that works for those with adequate money but not for others.
Since paying for health care benefits/insurance has traditionally become the responsibility of USA employers, as health care costs have so sharply increased, they are at a competitive disadvantage selling their products in competition with mfrs from other countries which do not have those costs to be covered.
I hope, and she hopes, her pessimism is mistaken.
But I sure haven't got much idea of how to proceed. I DO think we need to reduce the amount of "take" all these players are getting.
For instance, many health insurance companies are for-profit corporations with stock holders who want maximum return on their shares. They pay executives, managers, sales, quality control, HR, examiners, etc., and their employees have health and retirement benefits.
These function as middle-men between the employer/employee and the health services providers.
To my mind, it's as if we were to employ a middle-man service compamy to buy our food. They'd set the price on what could be bought, what we could have or not have, what we'd have to pay extra for. They'd negoitiate with Aldi, Kroger, A&P, Hy-Vee, Trader Joe's, etc., for what they'd pay for which products. And then we'd have to take what they procured for us.
IMO, in the long run, we need to shrink these puppies. But they're currently such a large part of our economy that has to be done very gradually and in a way that lets those millions employed in the industry be absorbed by other work.
How?
Who knows.
Terrible, terribly complex American problem.
