The CMS released a staggering estimate for Medicare spending a decade from now– $2Trillion. And yes, on Medicare alone (not counting SCHIP, Medicaid, or any semblance of “universal healthcare”).
Are we willing to sacrifice the solvency of the taxpaying public so that the elderly can eat freely at the “free” table of medical expenditures? In my mind, this figure alone highlights the insanity of a defined benefit for medical care– and knocks any thoughts around expansion of government “insurance” programs out of the water.
Its a paradoxical situation– government control of medical costs per visit (via the RVUs and billing through CPT based claims coding) has systematically swapped out thought-driven primary care for technology driven specialty care. As overall cost increases, government hits cost/ time units harder and harder, incenting physicians to dispense with talking to patients at all, while freely paying for diagnostics and expensive specialty procedures. We’re now at a point where the strong controls on primary care time have made that practice virtually unaffordable and the specialists are driving us faster and faster to bankruptcy.
Is this the system we should bolt all future health expenditures through? Seems the low administrative costs of this pass-through system have allowed the wolves to raid the henhouse. Were it not for taxpayers being forced to pay into the system, it would have been tossed on the scrapheap long before, with something better at managing overall spend (likely through enhanced access to primary care and increased controls on specialty medicine) in its place.
Mark Cuban has an interesting take on the power of transparency in general, in response to Warren Buffett’s suggestion that the rich should pay more in taxes:
And I want 1 more thing. I want transparency. The way the government publishes information on money it spends ,receives and owes is a joke. No one in this country has any real knowledge of how much our country really owes. There are so many hidden and unpublished liabilities that if our country were a public company, someone would go to jail.
The accounting data of this country is public domain information. There is no reason why it can’t be published if not in real time on a government website, than at least quarterly. Money coming in . Money going out. Money that is owed to us and from us. It is currently being recorded somewhere , and someone has responsibility to collect it or pay it. So it can be published.
Then every quarter, our federal government can publish an Income Statement and Balance Sheet according to GAAP principles. It wont be perfect, but it will be a hell of a lot better than what we have today.
Without complete transparency, politicians will do what politicians always do. They find ways to play with our hard earned tax dollars and to put a lien on our current and future earnings, and that of our kids and grand kids just so they can get elected and re-elected. That’s just wrong.
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A NYTimes article highlights that the FDA reaffirmed its stance on a lifetime ban on gay men as blood donors, a policy it has kept since the 1980′s. While the AIDS epidemic and poor quality of testing made that policy make sense from a public health perspective, the heavy-handed nature of the decision makes much less sense today.
In March 2006, the Red Cross, the international blood association AABB and America’s Blood Centers proposed replacing the lifetime ban with a one-year deferral after male-to-male sexual contact. New and improved tests, which can detect H.I.V.-positive donors within 10 to 21 days of infection, make the lifetime ban unnecessary, the blood groups told the F.D.A.
In a document posted Wednesday, the drug agency said it would change its policy if it received data proving that doing so would not pose a “significant and preventable” risk to blood recipients.
The agency said the H.I.V. tests now in use were highly accurate, but still could not detect the virus 100 percent of the time.
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