Friday, January 25, 2013

My View

Random ruminations from your resident curmudgeon...

Taro Aso is the 72 year old Deputy Prime Minister of Japan, and he made headlines this past week for remarks he made at a panel in his country to discuss social security reforms. His comments? The elderly should be allowed to "hurry up and die" to reduce the financial burden on the country that is responsible for their medical expenses. That is not the first time that Aso has gotten into some hot water over his remarks about the elderly and their medical care. In 2008, while then serving as Prime Minister, he called the elderly population in Japan a "feeble group" and said, "Why should I have to pay taxes for people who just sit around and do nothing but eat and drink?" To be sure, Japan, like the U.S. and other countries with an aging population, are faced with serious financial issues in delivering quality healthcare, and the high cost of care for the elderly is an issue that stirs many emotions and passions. There are those that feel as Deputy Prime Minister Aso does: why should limited tax resources be used to pay for those who typically have very costly medical care and a limited number of years in which to live? And lest you think that this is a phenomenon that happens only in other countries, know that some of those same sentiments are stirring here in the United States. Former U.S. Labor Secretary Robert Reich recently told an audience, "We are going to have to, if you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you going for another couple of months. It's too expensive, so we are going to let you die." The discourse today on healthcare has turned to government controlled healthcare- that is Obamacare- and government controlled healthcare creates a monopoly on treatment. This monopoly leads to rationing, and that leads to end of life decisions being removed from individuals and families and placed in the hand of the government. And that is not healthy.

I have a friend that is addicted to drinking brake fluid. I told him I was worried about him, but he said it was okay and he could stop any time.

The problem with government sponsored healthcare is the inhumane notion that the state has the discretion as to who lives or dies. The individual has no right to self preservation. Cloaked in the garb of developing and preserving financially a flawed health delivery system, the state has interjected itself into very personal decisions about healthcare and the intensely emotional decisions about the treatment of an individual at an end of life event. Where family and loved ones look at costs and potential outcomes through the lens of relationships and emotion, the government brutally bludgeons these individuals and families with a solely economic decision. I for one do not want the government telling me- or any member of my family- that I am "drain" on resources or on society and therefore I must die. As a society, we are not there. Yet. But know that the rationing of health care services, the establishment of the federal Independent Payment Advisory Board (which Sarah Palin called a "death panel" to great derision. Turns out she was more right than most knew), and the insinuation of government into private medical decisions, moves us closer to the establishment of a government monopoly on healthcare. And as history has shown, having a monopoly in any industry leads to higher costs and poorer service.

I have a friend who is Buddhist and he recently had a root canal without any Novocaine. When I asked him why, he said he wanted to transcend dental medication.

So if the federal government does eventually control most if not all of our health care system, it will operate in the best interest of all of us, right? Not so fast, my friends. Here is just one example of the imbalances and distortions that occur when the heavy hand of government gets involved in anything. Massachusetts Senator John Kerry added a provision to the Affordable Care Act (Obamacare) that allows hospitals in Massachusetts to increase their Medicare reimbursements by a factor of ten. TEN! Under Obamacare, hospitals in urban areas have to be reimbursed at the same level as rural hospitals. Massachusetts has only one hospital classified as a rural hospital, and it is a small 19 bed facility on Nantucket Island. Because the community is so wealthy and has such an extraordinarily high cost of living, it sets the floor for reimbursements to other hospitals. So over the next ten years, reimbursements to Massachusetts hospitals will rise from $367 million to nearly $3.5 billion. And under Kerry's provision, hospital reimbursement payments come from a nationwide pool of funds. So Massachusetts' windfall is going to come at the expense of reimbursements under Medicare to other states. By increasing control of the federal government over the healthcare system, Obamacare has made it easier for these types of imbalances to occur. And we want the federal government involved in our individual healthcare decisions?

I bought some furniture that was delivered and that I had to assemble. They should have called it "Divorce in a box".

And that, my friends, is my view.

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