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Leon Trotsky 2012 posted:Most of the money isn't in children's services in Medicaid. It is in chronic diseases and disabilities among older and impovrished adults. I think this point is right at the heart of what's gone rotten in American healthcare, not just in Medicaid but generally. Too much time and effort being spent in the healthcare sector extracting every possible dollar from the old and insured (or Medicaid protected) and not enough keeping the population healthy throughout the majority of their lives. Naturally you're going to spend more on healthcare for the old and sick, that's just how people work, but a rational system would put a lot of resources into extending the healthy portion of peoples lives to save money later. It's a uniquely free-market issue where the healthcare industry wants to keep old, sick, brain-dead people alive on machine assistance and painkillers for as long as possible, but kicks young people out of the clinic to die of a treatable infection. I don't think you're going to get single-payer or socialized medicine in the U.S. The population, the industry, the entrenched powers just won't accept it without guillotines. But maybe some kind of insurance system than incentivizes health rather than sickness might be possible. Maybe some system where you can sign up to a low-cost insurance plan that covers all the expected healthcare complications of life, but with some contractual commitments. First that you'll look after yourself, and second that you'll agree to have the good grace to request the machines be switched off rather than sit rotting mindless in a hospital bed for the last eighteen months of your life. Of course that's only one lovely nugget of the stinking edifice of American healthcare, and does lean a little far in blaming the victim without addressing the corruption in the industry itself, but it's something we're going to have to face as expensive technologies for extending sick life become the norm.
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Mar 7, 2017 17:58
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| # ¿ Apr 28, 2024 23:25 |
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