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Have you ever had a parent or an elderly relative reach old age and the stage of life where
their body and mind start to break down. They start breaking hips and many other parts of their bodies. They
start spending as much time in the hospital and rehabilitation centers as they do in their home, apartment, assisted or
senior living facility or nursing home. Their regimen of medication seems to impact or control every aspect of
their bodily functions and it takes an accountant to figure out all the pills they have to take each week.
They have a roster of doctors that specialize in every different body part. They need nurses or medical technicians
available on an everyday basis to make sure all of their medical needs are being met. Their lives revolve
around their medical issues.
Believe me I know all about this type of life for a person in old age.
My mother's medical adventures over the past five years or so have led me to more medical facilities
than I knew existed in the area where she lives. I have learned a lot about the business of medicine
during this period. And for the most part all of the facilities I have been in have been full. I call them senior citizen
dorms. It reminds me a lot of the dorms and apartments that my college age sons have lived in during the same time period.
And for those of us that have primary or secondary care-giving responsibilities for a person in old age it is a constant
effort to keep track of all the things that are going on with the medical condition of these very senior citizens.
Because of liability issues inherent in the medical profession and the insurance requirements that all the medical professionals
must work in accordance with to operate, every facility has a different group of doctors for their patients or residents.
The groups of doctors send "paperwork" back and forth telling each other what they have done and what the other
doctor should now do. In my mother's case I know that the only person in this world that has a full picture of my
mother's medical history and condition is my sister. My sister lives in the same area as my mom and she has
taken on the primary burden of dealing with my mom's medical issues and all the lifestyle ramifications of those
issues. My sister has saved my mom's life at least twice when my mom was in medical facilities where the nursing
staff did not know my mom or how to deal with her mental condition while recovering and rehabilitating from a major medical
problem. My sister has had to work with the medical professionals to correct my mom's medication regimen
many times because the doctor's in those facilities did not know my mom's medical history.
And
do you know what my mom and our family has paid for all of these medical services over the years? Essentially nothing!
Almost all of the cost has been covered by various parts of Medicare. Those items that weren't covered by Medicare
were mostly covered by supplemental US government paid insurance that my mom is eligible to have. Hundreds of thousands
of dollars of cost for all kind of medical services. You would not believe all the testing, examinations, and trips
to the emergency room that doctors have specified that my sister and I don't believe were necessary. Who paid for
all of this cost? The US government.
When a large percentage of the baby boom generation reaches old
age in the 2020 to 2030 time frame the cost of Medicare is going to bankrupt the US unless very fundamental
changes are made in the way the program operates. All of the duplication of doctors and testing, and the huge amount
of prescribed medication is going to have to be dramatically reduced to make the program affordable. We are going
to have to move to a national electronic medical record for all Medicare patients so that we can eliminate duplication
and prevent errors. The entire regulatory and insurance framework for the industry is going to have to change so that
huge amounts of overhead cost can be removed form the cost structure of the program.
During the past few years
various experts have calculated the cost of future Medicare services under the current rules. The cost is massive and
staggering. Our national political leaders ran away from this problem because of fear. They didn't have the
guts to tell the American people that this program must be radically changed for fear that the electorate would be very upset
and not reelect them. This fear doesn't change the numbers. We must start changing this program and the sooner
the better. It will take many years to phase in all the changes that are necessary. The technology we need to
implement exists and is being used on a small scale. We need to get it implemented and managed on a massive scale.
Instead of dealing with the massive issue of Medicare during the past few years the Bush administration decided
to "fix" the Social Security system instead. Social Security needs to be fixed. The level of the problem
is more than an order of magnitude less than Medicare. But it has financing issues that need to be worked
on by our political leaders. Our political leaders spent a lot of time and energy debating minor elements of some proposed
changes to the social security program. They accomplished nothing. The ran away from this issue as well because
of fear, just like Medicare. We need to eliminate the fear factor in our political leaders and start the dialog we need
to fix these huge financial problems that are marching closer to us in time with each passing day. These are huge issues
that need creative solutions. It will not be easy but we cannot bury our heads in the sand and pretend they are not
bearing down on us. We need to deal with these issues so that people have time to react to whatever changes are going
to occur in these programs.
Copyright 2006 by TPM
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