You know the old adage, the first three letters of assume are ASS. But I will assume you are all reasonably intelligent despite your current penchant for reading material. Most of you have been exposed to business in one shape or fashion so I hope the following makes sense.

The most critical aspect of our financial futures as individuals and a country is tied up in a broad subject called medicine. Some facts and figures for the uninitiated. Medicine in the early nineties was as was defense and education 5-6% of GDP. It is currently 17% and if estimates hold true that will be 25% by 2020.

I watched a segment on TV this week that spoke of the work at the National Institutes of Health (NIH). There is a doctor and small staff that studies and tries to diagnose several hundred diseases we don’t even have names for. Literally symptoms and outcomes that we don’t know where they came from. They might affect only 100-200 people.

There was an article in our local paper about a Bubble Boy who has no immune system. Another woman is now able to move her paralyzed body by literally willing it to do so. It seems they have hooked electrodes to her brain and those impulses are relayed to a computer allowing artificial limbs to move. That’s the great part.

The bad part is that in all good things, they cost money. And I stand here unabashedly telling you there is a finite amount of money in this man’s world. It has to be allocated  to where it will do the most good for the common cause. That is not morality. It is reality.

We have promised the impossible. We have shown that we can keep people alive indefinitely. We have implanted limbs and vital organs in ways we could never dream. We have instilled hope through medical breakthroughs that help people just hang on hoping for a cure. We are rocked head on by a medical community and a public fervor that says heal at any cost. As is usual we’ll put it on the tab and worry about it later.

I know I sound like Simon Legree but I would really like one of you very sharp business types to tell me how to do this and not go broke. Let’s not forget we have 50 million Baby Boomers who are going to die no matter what we develop. Just put a number of $100,000 per person on end of life medical costs. Don’t worry it is trillions over the next 30-40 years. In today’s numbers.

Man what a bummer you are TTG! Guilty as charged. Wait a minute. You are talking about rationing, you say. Call Congress. Call the AARP. Call the VFW. Call the ACLU. Lock that crazy son of a bitch up. He is a dissident. A terrorist. How dare you bring the realities of monetary policy into life and death? Again. Guilty to the core.

Now I know what you are thinking. If you are young you want those resources for you and your children. If you are old you will get on some high horse about how you have worked hard and deserve every last nickel. If you are smart you will figure out a way to deal with it.

I really believe every man woman and child is entitled to basic medical care. If you have pneumonia, break a limb, suffer a heart attack or stroke you are more than deserving of immediate medical treatment. Beyond that it gets dicey.

You know I work with the dying through my work in hospice. Maybe I have a different view but it is not maudlin. I see nature take its course. I quite frankly find it more macabre to see someone laying there with tubes and ventilators hanging from every orifice trying to wring just a  few more breaths out of a broken body. Frantic resuscitations to live another day. There is a strange thing called quality of life.

As I write these words I guess whom I am really addressing is my generation and those that caregive. As we move later and later into life we have to have directives for what is reasonable and what is not. I don’t plan on dying anytime soon. Sorry Kath. But if and when I get some bad news I hope I will be realistic. Not heroic. Just letting nature take its course. Spend the money on my grandkids.

I have given a great deal of thought to this burden thing. Not only financial but psychological. There is a wonderful couple of whom the wife is in hospice. She has end stage whatever and every night she and her husband have martini together. She is beyond understanding of her plight. It really is a beautiful thing.

So I assume that many of you will disagree. That’s fair. I assume that you will go along that there is a lot of ass in me. Point taken. But I also assume that one or all of you will be able to come up with an alternative. Not a delaying tactic. No more we’ll deal with it after the election. I assume you feel this is all more important a campaign issue than the Rev. Wright and Bain Capital. Am I assuming too much?

As always

Ted the Great

Factoids:

Medical research contends that no disease is ever eradicated.

The current Health Care Initiative(Obamacare ) is not revenue neutral. The House version adds $239 billion over 10 years. The Senate version $597 billion.

We spend more per capita on healthcare than countries with universal healthcare but we only hit a fraction of our population.

We spend 1/3 of our healthcare resources in the last year of life.

Approximately 80% of elderly patients are hospitalized in the last six months of their lives.