This is a great piece. I encourage everyone to join MedPage Today. It has fascinating content. This little poll on ACA is an example: The comments — but for gi doc — are interesting. Par example
“03.12.2017— Dr Dave (H+N Surgical Oncology)
The medical model is totally different. Less then 5% of the public will die unexpectedly and therefore EVERYONE will eventually use the system for something.
There is no way to amortize an individual’s use over their individual lifespan because even that is insufficient in most cased to pay the expenses. A typical cancer patient will use in excess of $400K in the treatment of their disease and some as much as $1M similar if not greater costs go toward cardiovascular diseases/diabetes. Take an assumption of 500 working months for the typical person that would be at MINIMUM of $1K per person per month for JUST payments and nothing for administration or InsCos expenses or profits etc.. How many people can afford $1K per month from age 26 on?
The current system is nothing more then robbing Peter (future payers) to pay Paul (current users). We are simply moving money around today in HOPE that tomorrow will some how be different and the balance will be achieved
HOWEVER we are doing absolutely NOTHING to lower future usage. The current use is unsustainable. We must re-educate the public to PREVENT the need for future care and NOT continue to worry about paying for today’s expenses
ALL anyone is willing to listen to is “I need care how can I afford it.” No one talks about how in 10 years do we have a smaller NEED for care. The healthcare system MUST include incentives to lower need both carrots and sticks. Penalties for failing to follow Dr orders carrots for doing proper things like vaccinations and or weight loss or smoking cessation should lower premiums while failing should increase. The HARDEST part is not the future or the present it is the shift in between. How do we pay for sick people today while kids are educated?”