NYC Letter: Soylent Green Is People!*

Day 114 of CHOPE

THE YOUNG EAT THE OLD
Making A Dog's Breakfast Of Health Care

Free health care, soon to be the next entitlement. Everything from brain surgery to wart removal will be free. Free in the sense that the government will have already taxed you for it like it or not, need it or not. But even having paid for your free health care, you may find yourself on the stingy side of cost/benefit rules of distribution where a bankrupt government assesses the benefit to you is not worth the cost to the government. It is worse than rationing, because in rationing everyone gets a little if insufficient bit. This is eugenics-of-necessity, a bankrupt government placing its bets on the high percentage plays, the productive young, the moneyed, and the powerful. Once sensible eugenics becomes established policy, the government will get busy with sensible euthanasia to clear out the dead wood.

Anyway that's the sense -- and our extrapolation -- of testimony given Tuesday by Stuart Altman, a health policy professor from Brandeis, before the Senate Finance Committee on Health Care.

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.

"Letting the delivery system handle it" is a euphemism for culling the low percentage plays -- scil., the poor, the weak, and the elderly -- from the high -- scil., long-term or high-value contributors to the commonweal and the powerful. If you're working, not to worry, you'll get your knee replacement surgery before granny gets a new hip. Unless she's got pull with Jay Rockefeller (D-WV) or Orrin Hatch (R-UT).

With free health care the important thing will be to stay healthy.

CHOPE.

Free. Allocated. And privileged.

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* For the oh-so-young, here is the reference. The money quote comes at the end of the film when Detective Thorn (Charlton Heston) passes on the disturbing truth: