The Economist has an interesting piece on The benefits, and the costs, of living longer. Part of it is a look at health care:
[A]s a rule of thumb, the bulk of spending on an individual’s health care is concentrated in the last year or two of life, and particularly in the final six months.
This leads, especially in the U.S. to some rather stupid rationing. Ron Beasly at the Newshoggers explains this well with a personal case:
My 86 year old mother is in really good health but had started to be short of breath. They ran some diagnostic tests and discovered she had a bad heart valve. She was referred to a cardiologist who was ready to split her chest open and replace the valve. I asked him several questions:
1. She is in relatively good health now – following the surgery will she ever recover to be as good as she was before? The answer was probably not!
2. I told the doctor that I heard that being on a heart lung machine can have a negative impact on memory and asked him if that was true. The answer was yes, especially in older people.
3. The next question was what will happen if the valve is not replaced? The answer was the shortness of breath may gradually get worse.
4. I asked him if it were his mother would he suggest the surgery? The answer was NO!The bottom line is they were going to perform a procedure that would cost 50 thousand plus dollars that would have left my mother worse off after the surgery because Medicare would pay for it.
At 63 years of age I cannot get health insurance at any price. I am denied procedures that could keep me alive for another 20 or 30 years while Medicare pays for procedures that add little or even have negative impacts on the health of the patient. That's rationing and foolish.
My father was treated to death in a hospital where he was kept alive for three month with dialysis, which with a clear mind he had earlier rejected, while it was simply obvious that he was slowly dying.
A hospice where he could have died without pain and with good care would have been a tenth of the costs than the therapy to death provided to him. The saved money could have been used to provide better care for younger people.
The society must come to a better sense with the inevitability of death and stop spending money on people who are certain to die soon despite high-cost procedures.
Aging societies with negative birthrate like most of Europe and Japan will otherwise ruin themselves.
Countries like the U.S., which by a systemic failure provides full health care to elderly while denying it to its younger productive people, will cripple their population.
There are sound reason why health care insurance in the future will have to be public. As the private insurance providers get more sophisticated about their customers (DNA tests etc), they will not take any risky person at all but provide only to those who are expected to pay more in than they will get out. That isn't insurance, in which by definition risk gets distributed unevenly, but robbery.
The U.S. as well as other countries needs universal health-care provided by a public system. But that is not the only issue.
The real central issue in health care and the single most effective way to limit health care cost is to accept death as a natural occurrence and to stop to prolong live it at all costs by medical means.
Unfortunately the discussion about that are still missing.