The Callahan Solution for Spiraling Health Costs: Put Seniors on the Ice

This is from David Henderson’s review of Daniel Callahan’s Taming the Beloved Beast:

In reaching his major conclusion—that people beyond about age 80 should just accept death—he seems unaware of how elastic the concept of “old age” has been across the centuries. But this does not stop him from advocating that the government step in and make it difficult for people beyond a certain age to get life-saving health care, even if they are willing to pay for it or for non-subsidized insurance to cover it.

See also Henderson and Arnold Kling at Econlog.

Comments (12)

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  1. Ken says:

    I assume you were speaking metaphorically about the ice.

  2. Larry C. says:

    Ken, it’s called ObamaCare.

  3. Joe S. says:

    Other countries ration health care for the elderly and if we run out of money I expect that we will do the same in this country. Do you suppose everyone in the White House is reading this book?

  4. Stephen C. says:

    This is something that Callahan has been saying for quite some time. It appears that he is becoming more explicit, however.

  5. artk says:

    To Joe: Every country, including ours rations health care. I contend the best indication of health care for the elderly is life expectancy at age 65, ie how long you live once you hit age 65. Life expectancy at age 65 for females in the United States is 20.3 years, the UK that is often claimed to be health care hell is pretty much the same at 20.1 years. Switzerland at 22.1, Japan at 23.4, Italy at 21.8, France at 22.3 and Canada at 21.4 all exceed the United States. By that metric, those terrible universal health care systems are delivering better care for then elderly then we do. Once again, the problem with our health care system is not the care it’s capable of delivering to Bill Gates or Warren Buffet, it’s what it actually delivers to the rest of the population.

  6. Virginia says:

    Arnold Relman also hints at Callahan’s work in his book, A Second Opinion.

    I have not read all of Callahan’s work, but of all of the health literature I have read, mentions of his work have aroused the most ire.

    On the one hand, I feel that if the government is going to be in the business of providing health care, it is only prudent to place some limit on spending. But (and this is a huge “but”), seniors should have the right to self-finance as much heroic medicine as they please.

    Furthermore, the idea that we should “stop trying” to find new technologies is tantamount to intellectual suicide. Imagine someone telling Newton, “We’ve already figured out that if you put a cart on a hill, it will roll down the hill. There’s no need for you to do any other fancy calculations. Go get a job as a shoe salesman.”

    You’ve just pushed yourself back into the dark ages. (Tell me, would Callahan be advocating bloodletting as the preeminent technology if he were alive in the 1800’s?)

    Innovation is the life engine of humanity, and for anyone to suggest that we become complacent with the status quo is repulsive. Surrender of the mind is the calling card of collectivism.

  7. Robert says:

    artk: What is the the care that is delivered to the rest of population? How is it different from what is delivered to Bill Gates or Warren Buffet? How is it different from what is delivered to “Joe Six Pack” Are you implying that the other counties you site are actually delivering the same care the Warren Buffets and Bill Gates get here, what ever that is?

    We ration every product not just healthcare, the ultimate question is who is going to ration it: Government allowing or disallowing procedures, not paying for new drugs and the like to control costs or an individual who can choose a product and service seek out someone to perform the service and exchange goods for those service through choice.

    Using life expectancy seems to be a pretty weak argument for judging healthcare systems as a whole, way too many variables factor into life expectancy. Even among the different states there are variations, even though they have essentially the same healthcare system.
    According to the 2000 Census: DC – 72.6, Mississippi 73.7, Hawaii 79.8, and Minnestoa 79.1 years respectively from Birth. Apparently if one is lucky enough to be born in Hawaii as opposed to DC you get an additional 7 years of life, perhaps there is more to a health care system than a countries life-expectancy number.

  8. artk says:

    Peter: You’re correct about using life expectancy at birth as a measure of health care. That’s why I’m using life expectancy at age 65. By then, all the social lifestyle choices that cause premature death are behind you.

    Second, our current health care rationing either because an individual can’t afford their care, or an administrator at an insurance company whose income is based on how much care they deny or the government. Satisfaction with Medicare is much higher then private insurance.

    You mentioned Hawaii, they have a different healthcare system then the rest of the country. They have mandated employer health insurance. One Hawaii factoid, they have a very high breast cancer rate, but the best breast cancer survival rate in the country because their mandated insurance system gives everyone good access to health care.

    As for the Bill Gates comment, the statistics are that that your chance of survival for a serious ailment is much lower in this country if you’re poor, we are unique in that disparity.

  9. Bart Ingles says:

    artk says:

    I contend the best indication of health care for the elderly is life expectancy at age 65, ie how long you live once you hit age 65.

    I could see using this as an indication of quality of health care, but “the best indication?” In other words, there are no better indicators anywhere? Perhaps something that doesn’t mainly reflect ethnic and socioeconomic factors?

    Not only is this far-fetched, it seems a bit convenient. If it didn’t contain numbers that you could show as marginally in your favor, I imagine you’d see faults with this “indicator” as well.

  10. John Goodman says:

    It’s been a while since I looked at this, but I believe as people get older (75,85,etc.) life expectancy in the US catches up with and then surpasses life expectancy in other countries. And I believe this is especially true for the nonminority populations of these countries. Anyway, this is what you would expect if health care mattered. We know that we are giving more end of life health care to seniors than other countries. So to the extent that doctors matter, our seniors should live longer.

  11. Robert says:

    Right the lifestyle choices that cause premature death, but not the ones that can stay with you for years, like smoking, obesity, and excessive drinking those would not have lasting effects on health. However it does not get rid of the genetic and/or socioeconomic ones, still seems weak.

    Also, Fascinating about Hawaii, however interesting that Minnesota according to the Kaiser Foundation actually has more people insured through employers than Hawaii as a percentage of the population and has a higher uninsured population so do the employer mandates that help or hurt?

    Income based on denying care? Hmm, will have to think about that one, not sure I am buying though and it could be said for any entity, government or provite However, even if they do, and I don’t like it I can always change insurers, and even persue leagal recourse. Don’t always have that option with the government

    Rich people get better care than poor people, big deal that get better things then a lot of poor people. Question: Are they also more healthy overall as well and thus more able to survive “serious ailments” or is the survival rate only due to insurance coverage?

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