A Medicare reform we all could agree on?

[EinsteinsGhost]

Originally Posted by NSHL10

Start a trial program of allowing poeple who buy non group policies to buy into Medicare at true actuarial cost. The premiums paid will help make Medicare more solvent and supposedly will reduce premiums for those buying into it (at least that has been the argument for govt healthcare is more cost effective than for profit health insurance comapnies).

If it works, then offer businesses the chance to buy in for their employees.

The potential problem with that idea is that only high risk (generally uninsured as a result) might be the only ones to join the plan. So, it would only add to the pool of high risk/cost consumers and the prices may not come down at all. It might help reduce number of uninsured however, technically a public option.

I think the ultimate solution will have to at least consider single payer. And going back to my earlier suggestion, Medicare/Medicaid should be modeled after VA clinics/hospitals.

[Wapasha]

Originally Posted by marcopolo

The Ryan Plan has provoked a lot of controversy, and the sorry state of Medicare's finances indicate the status quo is not sustainable, and Obamacare potentially has coverage limitations built in via "efficacy committees." But here is an idea that would save a LOT of money with a lot less argument.

When someone signs a "Do Not Rescucitate" order or indicates in a living will that certain life-prolonging procedures are NOT to be used, it is common for medical professionals to talk family members into approving these procedures anyway. This has been a source of personal anguish to me, as procedures that were explicitly rejected by a dying but competent person one day were inflicted on him the very next day, causing more pain and agony but not even extending life. The hospital and doctors rang the cash register one more time, but everyone else lost.

The idea: Make these orders a binding limitation on Medicare and insurance coverage. If I put in writing no ventilator, no feeding tube, no more surgery etc. then no money would be paid for these procedures. The overselling of expensive and stupid end-of-life treatments would stop in a flash.

Since a high fraction of health expense occurs in these situations, this would help a lot.

What do you think? If you are a health professional, or have gone through similar circumstances, I'd like to hear your perspective.

So.... more dead old people..... woot........ problem solved.

[marcopolo]

Originally Posted by Wapasha

So.... more dead old people..... woot........ problem solved.

Guess what? The mortality rate is 100%. I started this thread because I saw painful treatment inflicted on a person who did not want it, had no chance, and ultimately did not survive the last intervention. He had a progressive condition that made survival impossible. On Friday and Saturday he told eight close relatives that he did not want, under any circumstances, to be intubated. Sunday? They jammed it down his throat, while he was dying, unable to speak, only to groan and moan. If you think that fruitless pain is somehow preferable to death, you are part of the problem.

The fact that we would save money is a by-product of my desire to see and feel less unnecessary pain and suffering.