Video: Are the elderly cost effective?

posted at 2:35 pm on May 12, 2009 by Ed Morrissey

Greg Hengler at Townhall captures this revealing moment in the Senate Finance Committee hearings on health-care reform. The speaker, Professor Stuart Altman of Brandeis University, tells the committee that resources get wasted in the American health-care system, especially for one segment of the population. Professor Altman says he’s reluctant to mention it, but why waste money on in-depth treatment for people who won’t live long anyway? Better to warehouse them and save the resources for the young:

Remember, our population is aging. And with the very, very elderly, the costs go down, so that percentage should be falling, and it’s not. Second, the cost of care is growing by so much, so at the same percentage, it’s worth a lot more. So let’s go back to the issue of comparative effectiveness, which we’re supporting. That’s where that can have a big impact. It’s not only there, but that’s where the waste is. That’s where people are using technologies that really either don’t work at all or keep people alive for for very limited [time] and [at] very high cost.

Hospice is one option, but we do need take account of the cost — you know, I hate to say it, the cost-benefit of some of the things we do. And either we can do it directly, or we can do it by bundling the payments and let the delivery system deal with it. So it’s a combination of the delivery system dealing with it, or, and/or providing more information for people to make the right decisions, both for themselves and for the care.

Once again, we have people taking the shortage, rationing approach to its logical conclusion. In a non-shortage, free-market approach, people can choose for themselves whether to pursue cost-effective strategies based on their own resources, and the free market would incentivize the creation of enough resources to meet the demand. Only by restricting choice and setting prices will resources become scarce, which we have seen gradually for the last several decades in our own heavily-regulated health-care system, and seen dramatically in the various single-payer systems around the world.

What happens when the state controls all the resources? New resources do not develop, and the government winds up rationing care based on its own priorities, and not the priorities of the patients or caregivers. Professor Altman’s suggestion that the elderly get hospice treatment to save scarce care resources is exactly the kind of decisions the state will make for its citizens, and it won’t be limited to the elderly, either. Anyone whose value does not show a positive “cost-benefit” ratio to the state will also likely wind up without the kind of care necessary to stay alive and healthy.

Progressives who back this plan get offended that people with more resources can get better care, just as they can get better housing, better food, and better entertainment, among many other things. Like in all other arenas, their prescription for equality of result will mean that everyone gets treated equally poorly, and that we will eventually start culling out the weak in favor of the strong. We’ve essentially returned to the eugenics arguments of the early 20th century, a dark period of human history we should be avoiding rather than embracing on the floor of the Senate.

Breaking on Hot Air

Blowback

Note from Hot Air management: This section is for comments from Hot Air's community of registered readers. Please don't assume that Hot Air management agrees with or otherwise endorses any particular comment just because we let it stand. A reminder: Anyone who fails to comply with our terms of use may lose their posting privilege.

Trackbacks/Pings

Trackback URL

Comments

Comment pages: 1 2 3

Somehow over the years I started getting “newsletters” (I call it propaganda!!) from democrats.org and moveon.org. I decided to continue with them to see what the other side was promoting. Yesterday each group sent out a newsletter regarding healthcare – no where in either commentary is the topic of “selective” care ever mentioned. I’m fairly certain that most sheeple will hear these key points and think it’s a good idea! I apologize for the length of this post, but I thought this was interesting and wanted to share.

democrats.org wants people to sign an online petition to support healthcare reform and the president. They close with this little blurb

Reducing costs, guaranteeing choice, and ensuring care for all are ambitious goals, but they are nothing less than what the American people deserve. And passing real health care reform this year is nothing less than what the American people need.

moveon.org is telling people about a Frank Luntz memo to Republican leaders

Luntz wrote a confidential memo that laid out the Republican strategy: Pretend to support reform. Mislead Americans about the heart of Obama’s plan, the public health insurance option. Scare enough people to doom real reform.

then goes on to say this:

Since most people don’t know much about the public health care option, these lies could take root if we don’t fight back. Can you send this out to all your friends and neighbors?

5 THINGS YOU NEED TO KNOW ABOUT OBAMA’S PUBLIC HEALTH INSURANCE OPTION

The choice of a public health insurance plan is crucial to real health care reform. But right now, it’s being smeared by conservatives and insurance-industry front groups. Here’s what you really need to know:

1. Choice, choice, choice. If the public health insurance option passes, Americans will be able to choose between their current insurance and a high-quality, government-run plan similar to Medicare. If you like your current care, you can keep it. If you don’t—or don’t have any—you can get the public insurance plan.2

2. It will be high-quality coverage with a choice of doctors. Government-run plans have a track record of innovating to improve quality, because they’re not just focused on short-term profits. And if you choose the public plan, you’ll still get to choose your doctor and hospital.3

3. We’ll all save a bunch of money. The public health insurance option won’t have to spend money on things like CEO bonuses, shareholder dividends, or excessive advertising, so it’ll cost a lot less. Plus, the private plans will have to lower their rates and provide better value to compete, so people who keep their current insurance will save, too.4

4. It will always be there for you and your family. A for-profit insurer can close, move out of the area, or just kick you off their insurance rolls. The public health insurance option will always be available to provide you with the health security you need.5

5. And it’s a key part of universal health care. No longer will sick people or folks in rural communities, or low-income Americans be forced to go without coverage. The public health insurance plan will be available and accessible to everyone. And for those struggling to make ends meet, the premiums will be subsidized by the government.6

We all need to speak out to make sure we get real health reform. Please pass this email on, then call your senators and ask them to support the choice of a public health insurance plan.

Candy coated information….. what’s not to like?

IF this debacle of healthcare is passed and this idea of just who should receive resources, it won’t stop with determining that our elderly or terminally ill people aren’t cost effective. It will snowball. Maybe high blood pressure or diabetes or something else equally controllable (and the patient is still a viable contributor) but yet expensive is not worth the resources.

ladyhawke53 on May 13, 2009 at 6:36 AM

Nothing infuriates me more than the prospect of Obamacare. Dirty rotten s.o.b.’s will stop at nothing to run my life… and death by health care rationing.

petefrt on May 13, 2009 at 8:01 AM

Every piece of our freedom we surrender is attached to another piece by an almost unbreakable string. We started giving up these pieces long ago and the state continues to pull the string, relieving us or more and more “burden” of choice and responsibility. I fear that the string can only be broken by the blood of the perpetrators of this crime or by the concerted efforts of a majority of Americans who love freedom more than the comfort of a false certainty.

SKYFOX on May 13, 2009 at 8:47 AM

Ghouls.

The GOP needs the following ad campaign.

[scene of a person signing an advanced health-care directive appointing a family member to make medical decisions if the person is unable]

Narrator: “Do you realize that when you sign an advanced health-care directive appointing someone you trust to make health-care decisions for you when you are unable that the decisions of the person you appoint will be subject to federal-government control? Welcome to Obamacare.”

BuckeyeSam on May 13, 2009 at 8:51 AM

The Dems are pushing health care as an inalienable right which, according to my limited understanding of the Constitution, it is not.

The nightmare that is this administration is emboldening the worst of the liberal progressive agenda. Be afraid; be very afraid.

redfoxbluestate on May 13, 2009 at 9:00 AM

Mike Gallagher is reporting on this right now and he is playing the audio of this testimony.

ladyingray on May 13, 2009 at 9:10 AM

ahh Government-run healthcare. Here’s what Governement-run healthcare is doing so far.

http://news.yahoo.com/s/ap/20090513/ap_on_go_ot/us_med_medicare_virtual_colonoscopy

johnnyU on May 13, 2009 at 9:17 AM

T-4, Hadamar. Let’s start ridding the country of the non-producers. They’re nothing but a drag on the economy.

James Dobson put forth this scenario 20 years ago, but no one wanted to listen.

oldleprechaun on May 13, 2009 at 9:38 AM

Who needs hearings, the solution is so simple, kill off the old people and take their money. : )

/

Angry Dumbo on May 13, 2009 at 10:00 AM

A lot of people here need to get over the paranoia and read “What If Medicine Disappeared?” by Gerald E. Markle and Frances B. McCrea. Exactly how much benefit is medicine–not public health measures and not inoculations?

Also, I notice an extensive use of the word “eugenics” on this thread. May I suggest using a dictionary before using a word that you don’t know the meaning of? And, anyway, why is this word so scary? Evolution is a four billion year old eugenics program after all.

thuja on May 13, 2009 at 10:16 AM

I’m actually in for this, but only if we can start with David Crosby.

/startdust my a**

bluelightbrigade on May 13, 2009 at 10:17 AM

startdust = stardust.

errrr whatevs.

bluelightbrigade on May 13, 2009 at 10:17 AM

A lot of people here need to get over the paranoia and read “What If Medicine Disappeared?” by Gerald E. Markle and Frances B. McCrea. Exactly how much benefit is medicine–not public health measures and not inoculations?

Also, I notice an extensive use of the word “eugenics” on this thread. May I suggest using a dictionary before using a word that you don’t know the meaning of? And, anyway, why is this word so scary? Evolution is a four billion year old eugenics program after all.

thuja on May 13, 2009 at 10:16 AM

There really is no other word that comes close so I guess we’ll commandeer that word – it will just have to evolve too, accept it.

Perhaps you will be satisfied if/when genetic testing of couples is mandatory so they don’t procreate when faulty genes are present. Not quite the same, but perhaps mandatory prenatal testing for “less than perfect” babies might satisfy you, so they can be terminated prior to becoming a burden on the system.

Yes, the word “Eugenics” will just have to evolve.

Candy Slice on May 13, 2009 at 10:45 AM

Ever notice there is always long term shortages of any commodity that is controlled buy the government.

darktood on May 13, 2009 at 10:50 AM

Evolution is a four billion year old eugenics program after all.

thuja on May 13, 2009 at 10:16 AM

Most of us trust “Mother Nature” or “God” a bit more than Uncle Sam to direct this program wisely.

cs89 on May 13, 2009 at 10:50 AM

cs89 on May 13, 2009 at 10:50 AM

Second that.
For instance-some ‘harmful’ genes are good in some instances, especially in small amounts-like the Sickle Cell gene affording near immunity to malaria.
Guess God does know what he’s doing.

Badger40 on May 13, 2009 at 11:04 AM

Perhaps you will be satisfied if/when genetic testing of couples is mandatory so they don’t procreate when faulty genes are present. Not quite the same, but perhaps mandatory prenatal testing for “less than perfect” babies might satisfy you, so they can be terminated prior to becoming a burden on the system.

Candy Slice on May 13, 2009 at 10:45 AM

My sister in law is pregnant and had the genetic tests. She would have aborted with my complete approval if the fetus had carried bad genes. I want a happy or whole niece or nephew, since this is as close to human reproduction as I’m going to get.

thuja on May 13, 2009 at 11:10 AM

Take my father-in-law… please!

Mr_Magoo on May 13, 2009 at 11:31 AM

I have a label which I attached to mis-delivered mail I received during the Clinton administration:

This letter has been mis-delivered by the same government which wants to control health care. If this had been medicine, two people would be dead.

I guess it’s time to reprint a supply of these…

landlines on May 13, 2009 at 11:34 AM

I want a happy or whole niece or nephew, since this is as close to human reproduction as I’m going to get.

thuja on May 13, 2009 at 11:10 AM

Best news I’ve heard today. Thanks thuja.

DFCtomm on May 13, 2009 at 11:46 AM

Best news I’ve heard today. Thanks thuja.

DFCtomm on May 13, 2009 at 11:46 AM

Truly.

nico on May 13, 2009 at 12:19 PM

I pay more for health insurance than I do for my house payment. Obama thinks he will pay for the uninsured, so I promise you I will become uninsured.

saiga on May 13, 2009 at 12:44 PM

My sister in law is pregnant and had the genetic tests. She would have aborted with my complete approval if the fetus had carried bad genes. I want a happy or whole niece or nephew, since this is as close to human reproduction as I’m going to get.

thuja on May 13, 2009 at 11:10 AM

I’m sad for your sister-in-law. Heaven forbid something happen some time after her baby is born.

By the way – my son is both happy and whole. His genes are just fine, he just carries and extra set on the 21st pair.

Candy Slice on May 13, 2009 at 1:34 PM

My sister in law is pregnant and had the genetic tests. She would have aborted with my complete approval if the fetus had carried bad genes. I want a happy or whole niece or nephew, since this is as close to human reproduction as I’m going to get.

thuja on May 13, 2009 at 11:10 AM

So what is defective to you? An illness that may have a cure, albeit expensive, annoying, etc?
Down syndrome baby? Those people are extremely loving, but a challenge. Too much effort to put up with?
I could go on & on. What is whole, happy, & healthy to you?
Having 10 fingers & 10 toes?
What is deserving of life & love?
Only “whole” & “healthy” children?
Does fetal testing ever result in false positives or negatives?
Are babies born healthy that were diagnosed to be be ‘un-healthy’?
Life is life, even if the quality or quantity isn’t what you wish.
It’s a sad day when we can rationalize the death of another individual.

Badger40 on May 13, 2009 at 2:10 PM

my son is both happy and whole. His genes are just fine, he just carries and extra set on the 21st pair.

Candy Slice on May 13, 2009 at 1:34 PM

And I’ll bet he brings a lot of joy to your lives, even if he brings an extra set of challenges all children bring to parents.
I’ve always wondered if God rewards the most deserving with such children, who tend to be so much more loving than us ‘healthy’ & ‘whole’ people.
God bless you & yours.

Badger40 on May 13, 2009 at 2:12 PM

Down syndrome baby? Those people are extremely loving, but a challenge. Too much effort to put up with?
I could go on & on. What is whole, happy, & healthy to you?

Badger40 on May 13, 2009 at 2:10 PM

My six year old with Down syndrome is proving to be much less of a challenge than my 15 year old highly intelligent daughter who plans to be a doctor. I love how parents (not you, Badger) kid themselves that prenatal testing and termination can get rid of a problemed child.

If you can’t handle what comes up, you shouldn’t be a parent. There are no guarantees at the beginning of life and most definitely none as that life goes on. They are all a challenge in their own right.

Candy Slice on May 13, 2009 at 2:15 PM

And I’ll bet he brings a lot of joy to your lives, even if he brings an extra set of challenges all children bring to parents.
I’ve always wondered if God rewards the most deserving with such children, who tend to be so much more loving than us ‘healthy’ & ‘whole’ people.
God bless you & yours.

Badger40 on May 13, 2009 at 2:12 PM

Right now he brings the same joys and challenges as my other kids have brought to this point. We’ve learned that small accomplishments can bring sheer joy though.

There is nothing more deserving about my husband and me. We’re just your run-of-the-mill parents and it really doesn’t take any extra “anything” to raise a child with Down syndrome. That’s something I like to emphasize because I really don’t want prospective parents to be scared into terminating their own babies thinking they don’t have what it takes. We’ve all got it in us and it’s pretty much like raising any other child.

Candy Slice on May 13, 2009 at 2:19 PM

We’ve all got it in us and it’s pretty much like raising any other child.

Candy Slice on May 13, 2009 at 2:19 PM

I have seen that. I know of a ranching family in E. MT with a Down Syndrome daughter-Hope. She is probably about 19 or so now.
I remember seeing her at my bro in law’s branding, how she made time to visit with each & every person.
She was so fun & happy that day! I’ve also seen her throw fits & she wasn’t any worse than the HS kids I teach, as well as my own daughters.
I just can’t believe there’s people in this world that consider perfection above murder.

Badger40 on May 13, 2009 at 2:28 PM

Hey, why feed them, they’re going to die soon anyway.

roux on May 13, 2009 at 2:28 PM

Just wait, soon they’ll want to process us into Soylent Green.

scullymj on May 13, 2009 at 3:09 PM

It’s time to start scaring boomers really bad, if they’re not already. Managed care is a slippery slope.

If you accept the premise that health care is inherently in short supply, then you must ration it. If you can’t understand markets, then you must and will be motivated by fear, starting now.

You will die of a treatable illness at the whim of an administrator. Buhbye.

bbhack on May 13, 2009 at 3:42 PM

Comment pages: 1 2 3