Friday, July 14, 2017

The "skin in the game" argument for healthcare -- especially for seniors

Here’s an interesting perpective in the Washington Post by Paul Waldman on the “skin in the game” problem with respect to health insurance, link.

Now, I’ve applied the idea of “skin in the game” to a different issue, not just “free speech” but “the privilege of being listened to”.

What I do find in the health area as a senior, is that if you go to the doctor for a minor problem, you may be dragged in to endless appointments and tests, which can be disruptive. They may not be necessary.  Or they may save your life. Yet, as a senior, I know every one of us will "die of something". 

In the past, older people often did live into their 80s and 90s based on pure momentum with little medical care, if they had good enough genetics.  On my father’s side, a grandfather hardly ever saw a doctor until he lay down and died at age 89 after breakfast one Saturday morning on a farm.

In the old days, there was simply less we could do about a lot of things, so massive screenings for things wasn’t attempted.  If you got aggressive colon cancer you had a colostomy and soon died anyway (that’s what happened to a piano teacher). But if colonoscopies had been available then, there was little that could be done.  Likewise, coronary bypass surgery became more common in the 80s, but wasn’t attempted on much older people until the late 90s, as with my mother (I was shocked she was eligible for it).  Chemotherapy for cancer was well established by the mid 70s, but a lot of it wasn’t very effective for a couple more decades. 

Health care costs a lot more now because we can do a lot more to save lives for the people who need it.  But not everyone ever needs it. 

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