Trimming the Cost of Medical Care – Part I

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Should there be a cap on lifetime medical benefits or should they be unlimited?

The following is an excerpt from my Draft Book, The Next Golden Age of America – We Can Give our Grandchildren a Better World.

I propose that a lifetime limit of $1 million (typical for most health care policies, before the Health Care Act) is reasonable.  For those who support the “No cap, no limits” clauses in the HCA or think $1,000,000 is too small, here’s the math.  There are presently over 300,000,000 Americans.  If each used $1,000,000 during their lifetime, that would be $300 Trillion, or $4 Trillion per year for the next 75 (+/-) years.  Janet Ademy, “Health Law Augurs [foretells] Transfer of Funds from Old to Young,” Wall Street Journal, July 26, 2010, “Left unchanged, Medicare and Social Security will consume half of all federal spending by 2035, up from about one third today,  according to the Congressional Budget Office.”  John C. Goodman, echoes Ademy in “How Seniors Will Pay for ObamaCare,” WSJ, September 23, 2010 when he states, “In many areas, Medicare Advantage enrollees will lose about one-third of their health insurance benefits. The cuts will finance new subsidies for younger people.” Our country is already in trouble fiscally and needs to reduce the $790 Billion per year presently spent on Medicare/Medicaid.  Maybe the $1,000,000 lifetime cap is too generous, but I’ll stay with it as a proposal to start the discussion.  I can already hear many saying, but what if I need more medical care than that!  Sorry, that’s entitlement thinking and we as a country have to get away from entitlement thinking and return to opportunity thinking.  Anyone one who uses their $1,000,000 lifetime of taxpayer (or fellow insurance customer) subsidized medical care should be saying, “Thank you for the gift I couldn’t afford myself,” not “Where’s more?”  Their families should be saying, “Thank you friends and neighbors for the $1,000,000 of medical care that we didn’t have to pay for.”  (Note: I’ll share some ideas for providing extra help for the most needy in a later blog.)

Here’s an example of a patient who would use his lifetime max – from the Georgetown University Health Care Policy Institute blog site.  I’ll call him John.  John is a hemophiliac and requires $50,000 – $60,000 per month for drugs and treatments.  He has burned through his own health insurance lifetime limit, his special extended limit, his wife’s policy’s limit, and his state’s extreme need limit.  In short he has exhausted all the medical insurance available, and would be out of funds soon, except that the HCA will require his insurance to remove the caps and lifetime limits.  The thrust of the article was, “Poor John has had to jump through hoops every couple years to maintain medical coverage for his treatments.  Fortunately the HCA is about to spare him that torment by requiring his medical insurance to cover his expenses without limits.”  This is entitlement thinking. “John is entitled to whatever medical treatment he needs.”  But ultimately, the faceless insurance company is not paying for John’s medical care; his family, friends, and neighbors are, through higher premiums and taxes.  His children and grandchildren will be paying for his care, probably long after he has passed away.

We can all empathize with John and his family.  Without the treatments and drugs he would likely die within a year or two.  Is it moral for us to limit his treatment at some point to whatever he can afford on his own?  However, here’s the moral flip side question for John (and us): Is it moral for him to accept this gift?  Would the community be better off using that money to fund more collage science majors?  Would it be a better use of money to fund research into cures, or less expensive treatments, for hemophelia?  Would it be a better use of that money to fund, for instance, more terrorist bomb detection equipment and personnel to prevent terrorists from smuggling a nuclear weapon into New York or Los Angeles?  Is it moral to burden our children and grandchildren with a budget deficit in the future?  Per the GU blog, there are approximately 20,000 hemophiliacs in the U.S. That computes to approximately $1 billion per month in treatment and drugs.  This would fund a lot of medical research.  This $1 billion is not just nine characters on a page.  It is food, products, and services paid to drug companies and medical providers rather than used for some other purpose.

How do we meet our moral obligation to care for the sick, while meeting our moral obligation not to burden our Grandchildren with debt?  I’ll share some ideas in future blogs.

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