How To Lose Friends……..

I have been working on increasing the circulation of Ted’s Head. Many of you have sent my site to friends and family and I encourage all of you to do so….after this issue. We actually had well over 200 hits last week.

A buddy of mine sent me some facts and figures from the Sprott Financial Group. These guys have made a lot of money so they must be smart. They have addressed in a very meaningful way something I have spoken on and off about for three years. Healthcare.

It’s getting a little spooky out there. Right now we spend about 22% of our $12 trillion GDP on healthcare. $2.7 trillion last year. That’s bad but it will rise to 25% by 2020 and 30% by 2030. Babyboomers and those over 65 will account for 60% of that total. We will spend approximately $7,000 for every man woman and child in our country on healthcare. An average family of four will spend $19,000 on insurance and out of pocket cost this year.

We spend more than any other industrialized country on the planet. It doesn’t reflect in our statistics. We are by no manner of scorekeeping anywhere near the top in longevity or health birthrates. Our time around here is pegged at 77 years but our healthy time is 71 years young. That’s six years of sickness of some sort.

Let’s not go on about healthy lifestyles. Let’s not rant and rave about drug companies or high priced specialists. Medical mistakes and unneeded procedures are just more of the numbers. Let’s just talk about a crazy but integral concept….there is a finite amount of money we can throw at this. That’s right we cannot and I repeat cannot give everyone every last bit of treatment possible.

Right now we have 75 million people who say they are owed. They have a lottery ticket called their Medicare card. They are walking into the Columbia Presbyterian Ritz or the Cedars of Sinai Four Seasons and saying let it rip. Money is no object. I don’t care what it takes. Pull out all the stops.

Experimental? Go for it. Chemo? Dialysis? Transplants? You can get me another 70 days for $1,000,000. Hey, I am worth it. There are of course complicit professionals from the docs to the hospitals to the drug companies who say welcome. I spoke once of a woman in Hancock Hospital at Dartmouth who was end stage cancer and being seen by FIFTEEN specialists. This included a psychiatrist who was treating her for depression. The woman was 93 years old.

There are two dynamics at work here. One is the open chit mentioned above. The other is the shrinking number of wage earners that will occur over the next few decades. I say again who is going to pay for all this? I have often spoken of the end of life costs for 75 million. Let’s use a low number of $100,000 in the last year of life. Ridiculously small assumption but it still comes out to $7.5 trillion to say adios.

We have a guy at the wheel who will not even consider any change to entitlements. He should probably be charged with DUI. That would be fine but there are legislators of every stripe tearing up and down the streets of Washington with a breathylizer that would come in way over 2.0. The substance in their abuse? Power. Do you know what this would do to my reelection chances?

Okay let’s tax the rich. To be in the top 1% you have to earn at least $380,000 per annum. They pay a federal tax rate of 23.25% on average. That is in the neighborhood of $400 billion of $1.04 trillion collected. Can’t even come close if we increased it by 50%. Screw that, let’s make it the top 10%. To get there you have to make $113,000 per annum. Just try to go after them and you will have a rebellion that will make Cairo riots look like Cape Cod on a summer Sunday.

Look I have thrown out a lot of numbers because numbers don’t lie. I don’t have the direct answer but I will tell you my generation and their families have some soul searching to do. We have to install a meter in this thing called Medicare. We have to have commensurate amounts for age and condition. Sweet Jesus, the man is talking about rationing. Unfortunately with an air of realism I am.

We have to consider outcomes and quality of life. No, Sam or Mary we can’t keep you going forever because the family wants to have you around even in your comatose state. No, I am not Kervorkian but I believe at some time in our lives we have to let nature take its course.

I don’t want to rob the stricken of hope. I don’t want to be Solomon for the Grim Reaper. But in a very real way we cannot rob our children and theirs of prosperity just to salve our egos or make one last try at immortality. No one has ever beaten the rap.

I am going to work my shift today at hospice where the cost of care ranges from $230-450 per day. Just compare that to the cost of an ICU bed. There are no monitors or IV’s. They are waiting for God or whoever. They are leaving a legacy. And a good one. I hope I have the guts to do the same.

As always
Ted The Great

Factoids:
1% of the population uses 27% of the expenditure on healthcare. 5% uses more than half. The bottom 50% uses 3%

We rank among other countries 50th in life expectancy and 48% in infant mortality despite spending more than any other nation.

More than half of those patients who survived a prolonged critical illness are dead within one year. Only 10% of those are able to live at home independently.

In a particular study of 323 dementia patients, 50% went through a major medical intervention in the last 18 months of their life.

CBO has found that ½ of the increase in medical costs is the result of advanced technology.

Quality of life…the ability of the patient to enjoy normal life activities.

One thought on “How To Lose Friends……..

  1. Ted ; Good Morning ; If you remember , there were three proscribed topics in the Wardroom , women , politics and religion . To these , may we now add , defense spending , gun control , entitlements and health care ? In keeping with the title of you subject , would it be possible to total the cost of health care i.e. not only direct health cost but also the cost of insurance (buildings , salary etc.) , lawyers (whatever thay do) , companies that facilitate (?) services( assign,argue about coding procedures etc) and compare to a National Health Care system ( I actually said it!) similar to Europe ,Britian and Canada BG

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