Where Are Medicare Stories at BarackObama.com?

As a Boomer rapidly approaching the elder age group I heartily disagree with a growing Democratic premise that care for the aged is the source of our health care crises.

First, thousands of frivoulous lawsuits filed annually force doctors to practice defensive medicine.......on EVERYONE. However, lawyers are a protected group, like banks, AFL/CIO Union thugs, credit card companies and hedge fund insurers. Malpractice does occassionally occur, however, these cases should be sent to mediation and resolved without multi-million dollar lawsuits for minor errors. The larger gross malpractice might be referred or determined eligible for litigation.

Second, caring for Medicare and Medicaid have become a dumping ground for the young permanently disabled from drug, alcohol and substance abuse, birth defects, chronic and permanent illness and accidents. Their expenses are far more costly than that of seniors and require longer care. Because they are all lumped into what was once senior programs, it is assumed that all are over the age of 65. This is unfair to seniors.

Third, providing free medical care, both acute and chronic, for twenty million illegal citizens has to be paid by someone. In San Joaquin County California, a state of the art County Hospital and Clinic is available for all citizens. Care is provided on ability to pay. 95% of the patient load is illegal immigrants who offer no ability to pay. Additionally, because California is so generous many illegals and poor opt to take the option of private hospital via the emergency room, with a free ambulance ride for a sinus headache. Gross abuse of California's free health care has bankrupted the state. Obama and the Democrates aren't even talking about this problem.

Please do not blame medical costs on the senior citizens who have worked and paid taxes for nearly their entire lives and in good faith invested in a government administered program. You can terminate services for every single person over the age of 65 and you will still have a health care crises until the top three problems are fixed.

Using weak and vulnerable seniors as scapegoats is abhorrent. What will be government's excuse when all the elderly have been killed and the bureacracy's appetite remains unquenched? Obama and the Democratic Super Majority have no soul. May God have mercy on us all.

I love the Medgadget blog and appreciate all the time and effort that you've put into it, but you should really avoid political posts. The problem is that everyone making political posts thinks they're going to be "unbiased" or "non-partisan," but they come off partisan the vast majority of the time.

There are two parts to your post that made this apparent to me:

1) You talk about not wanting to use fear, but then you cited obviously extreme examples like hundreds of thousands being spent on patients that "practically hit the walll." As scientists, if you are going to claim that you're professing the truth and not simple using anecdotal data for fear, you should rely on studies on precisely this.

It's true that, as the one study you cited states, that cost of care increases with age, but you are not merely limiting yourself to this hypothesis. However, that study says nothing about how effectively the money was spent.

Most of the things you mentioned are very invasive and the patient wouldn't want it just for the sake of "trying every last thing," especially when they're already feeling very bad due to their condition. While some families might have power of attorney, you are still making a guess as to what extent families are willing to expose their loved ones to such an extent (if you could somehow get combined data with respect to power of attorney and medicare costs you could study this).

There is also the issue of Medicare/Medicaid underspending, which neither the link, nor this post seem to address. Doctors constantly hear stories of the pains of having coverage under Medicare/Medicaid and difficulty in getting the treatment they need approved. Another major problem is that a lot of practices don't take Medicare/Medicaid due to the amount of processing involved, but this was not mentioned. One thing that can be done, and can only satisfy all sides, is to further measures that force standardization of insurance and medical forms/handling.

I see you as relying on fear just as much as the link you posted. In a battle of anecdata vs. anecdata (anecdotal data), both sides are almost guaranteed to lose. If it turns out that most of the contributions to this post were those who are opposed to Obama as president and especially his health care plans, you should probably rethink making political posts altogether, especially in a "medical gadget" blog.

2) This particular statement caught my eye:

"And that is how the tax payer's money are being spent nowadays. For all the talk over at the Health Care Stories for America, there is indeed little substance but lots of fear. And that is from the administration that has promised us hope."

This is a clear attack on the incumbent president, making this post clearly of a partisan nature. One could easily outline the problems with the current system without this. Pointing fingers at Obama in particular makes little sense, as the current system is primarily Bush's system. Obama hasn't been in office nearly long enough to make any serious changes to the healthcare system, especially after the start of a major recession. The current system doesn't represent the form Obama proposed system would take, anyway.

You don't like the president and his political goals? That's fine. But you should write about it in a political blog/publication, NOT in a blog like this. One of the reasons I like blogs of this type is that they focus on nothing but what their blog is about. Stepping outside that almost inevitably reduces the quality.

This is reminds me of the trend of network TV channels rebranding themselves because they have since introduced a lot of unrelated material and can't legitimately go by their original name. Not that a single post constitutes a similar trend; this is just an example of why mixing in unrelated subjects in some form of meda is bad. Recall The Learning Channel becoming TLC due to unrelated content like "flip this house" shows, Sci-Fi soon to become SyFy due to horror and paranormal content, CourtTV to TruTV due to mixing in non-legal relaity shows, etc...

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In response to tightloops' post:

"Please do not blame medical costs on the senior citizens who have worked and paid taxes for nearly their entire lives and in good faith invested in a government administered program. "

You can't deny the reality for the sake of being "politically correct" toward the elderly. All of the studies (including the one linked in the blog post) definitively prove that the older someone gets, the higher their healthcare costs rise. It's even common sense: older people tend to have more issues and more serious ones at that.

"caring for Medicare and Medicaid have become a dumping ground for the young permanently disabled from drug, alcohol and substance abuse, birth defects, chronic and permanent illness and accidents. Their expenses are far more costly than that of seniors and require longer care."

What are you basing that assumption on? Because all of the statistics and scientific analysis point to the contrary. The elderly are far greater in health issues than young people. The Baby Boomers are just going to make things worse.

"Care is provided on ability to pay. 95% of the patient load is illegal immigrants who offer no ability to pay."

I'm skeptical of this given your prior, provably false statistical claims. What is your source? This seems like it's just an excuse to complain about illegal immigrants. Don't they need to prove that they're a resident of California to use the free healthcare? Sure, some illegal immigrants might be able to successfully fool them with false identification (fooling a hospital is harder than fooling others because they check multiple forms of identification), but enough to make them comprise 95% of the cost? That's absurd.

njyoder:

This post was not designed to be unbiased. And you are right that we make statements that we don't back up with scientific data. However, we do back up all of the statements with our clinical care experience. The truth of the matter is that you don't address our main point in this post: Medicare, a gov't program, is a disaster: for patients, physicians and the society. In it we have rampant corruption, financial waste, and a growing fiscal deficit. The Medicare problem is huge.

So for all the stories about insurance companies, where are the stories about Medicare at BarackObama.com?

Instead of rolling out such a big change like universal healthcare, shouldn't we try it on a smaller scale first to see if it works with lower costs and better quality of care?

We could try it on a specific group of recipients. We could give them free healthcare and their own hospital system. The most deserving group that should get this is our men and women in the military and veterans. Give them free healthcare because they deserve it for their service to our country. We could laso have hospitals dedicated to their care all over the country. Lets try that for several decades and see how the experiment goes before we give this solution to the entire country.

Dr Scottymac,

I completely agree with you that any experiment should be first trialed on a small scale before getting the entire society involved. As far as providing free healthcare, the veterans indeed should be the first in line. The very fact that they have still not have gotten proper care in a lot of places throughout the country should make us make that commitment first, before we move on to larger things. If we cannot provide proper care for our veterans, how is it that we can do it for the entire population free of charge?

This is a little late, but I had forgotten about this post. What you calll "clinical care experience" is just a code term for "anecdotal evidence," and in this case it's anecdotal evidence of something different than what you're addressing, which makes it even worse. It's not even expert anecdotal evidence, because medical doctors aren't experts in medical insurance models/systems. At best, it's some kind of of "tertiary expertise."

As I stated previously, medicare is a system run under a different administration (Bush and those before him), under a completely different model. Your argument seems to be that "if one free health care system fails, all will fail." That kind of reasoning is unscientific and illogical. The model proposed under the Obama administration is not the same as the Medicare one, which has been around for eons. There are a myriad of different ways to run these systems and to suggest that they're all the same as medicare doesn't make sense.

As for this "lets try it out for a few decades" idea, that's a few decades of people suffering and dying while you wait. It wouldn't be free, either, as not only would it simply be a perk of the job (many jobs have crappy medical insurance, it's nothing special), but they are already supposed to have decent medical care. It's also going to be run within a special system that is not at all representative of the general population. so what would the point of such a test even be?

"If we cannot provide proper care for our veterans, how is it that we can do it for the entire population free of charge?"

Because they were doing it wrong? Of course, this question is asking something a bit different within this context: "if we can't FIRST provide good healthcare for our veterans, then how can we do it for the entire population?" Then answer to that is that there's no particular reason why we have to provide it to veterans first to get it right.

It would make far more sense, for a trial run, to choose a randomly selected segment of the population (at least within certain geographic regions to test it near people with access to decently sized hospitals). That would, by and far, be the most scientifically representative sample and would avoid sentimental notions of "group A deserves it first! No, group B does you nitwit! group A! group B! [ad infinitum]"