Obama Wants to Spend Less Money on You at the End of Your Life
This is from The New York Times:
At New York University Langone Medical Center, for example, Medicare spending was $105,000 per patient during the last two years of life. During the last six months of life, when costs go up still more sharply, patients at the center spent an average of 31 days in the hospital and were visited by 77 doctors.
At Genesis Medical Center in Davenport, Iowa…Medicare spending was $40,000 per patient during the last two years, and during the last six months, patients spent 14 days in the hospital and were visited by 29 doctors.
Great post. Now we see the hidden danger in the last post. This gives a whole new meaning to the phrase “he who pays the piper calls the tune.”
The government’s ability to gather and analyze data today is far greater than it was even a couple of decades ago. This has different consequences than it does in the private sector, because it neglects the obvious if it doesn’t serve the government’s interest.
It’s clear that wages and rents are higher in Manhattan than in Iowa, and there’s nothing that Medicare can do about that. My residential rent is higher in the San Francisco Bay area than it would be in Iowa. Is President Obama going to “fix” that?
One of the reasons for the success of Hong Kong was its long-serving Financial Secretary, Sir John Cowperthwaite, who during his long tenure at the tail-end of British rule (1961-1971) absolutely forbade his bureaucrats from collecting any but the most basic data. When bureaucrats from Whitehall (London) came to chastise him for not feeding enough data back to imperial HQ, he sent them packing. His reason? If the government has information, it will use it to interfere with peoples’ choices.
But how many doctors live in Davenport, IA?
Health care experts have long said we need allocate lifetime medical spending away from end of life to earlier periods when it will do more good. What sounds obvious in theory is impractical in reality. For the most part, doctors do not know which interventions will prolong life in one patients versus be useless in another. In practice, the only way health policy makers can allocate resource away from end-of-life is play the odds — which means ignoring those patients that might actually benefit from costly interventions near the end of their life.
Bart I., you bring up a good point. There are two key ratios here: doctors per population, but also population density (which is obviously higher in Manhattan than Davenport, Iowa). These are probably not independent variables. Common sense demands that when doctors and patients are more closely packed (as they are undoubtedly in Manhattan versus Davenport), more doctors will see each patient.
Which brings me back to my previous point: What can the government do about it? Move people out of Manhattan? You actually do see a lot of proposals like that, along the lines of “forgive medical students’ debts if they agree to practice in rural areas for five years,” from people who do not understand the deadly consequences of government planning peoples’ lives.
John Graham makes a good point. Years ago my brother-in-law agreed to practice in a small town in return for forgiveness of a medical school tuition loan. As I recall, he agreed to work in “small town” Jenks, Oklahoma for three years. Jenks, which is located in Tulsa County, was a fast-growing suburb of the second largest city in Oklahoma. He located his office on the far northern edge of town next to affluent, south Tulsa.
Would a “death panel” by any other name be as deadly?
Why mince words. I think they want to pull the plug.
Bart I and John Graham………Do you really believe that many Dr.s visit a patient in the hospital? I know seniors who have been in the hospital and their bills say they had many Dr. visits, but they can’t remember most if any of them.