Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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New topic 2016-03-29 20:37:09 description

Expanded Health Savings Accounts

Insurance-Like Financial Retirement
There are other ways to support retirement, but most retirement plans before the public are based on the insurance model.

Here are some insurance-like ideas to add to the discussion. The longer we dither, the more we get driven toward ways to have many healthy people support the cost of a few sick ones, the insurance model. We need a better balance. Curing disease lengthens longevity, but it also provides more opportunity to get sick again. We can't be sure what that will do to overall costs. The possibility exists that research has first selected the low hanging fruit. That is, treatment and research for the few remaining diseases may become progressively more expensive, thereby increasing costs as fast as, or faster, than extended longevity reduces them. We are forced to gamble that curing common diseases will further reduce costs, knowing it may not. Among other things, we need to make extra longevity more worth-while.

First Two, and Last Two, Years of Life

Before we get too deep into slicing average lives into average medical partitions, the reader should remember there is another way of viewing health care. Declaring we simply can't pay for everything because there are limited resources, we imply we agree on life's priorities when we really don't.

If this were a contest on TV, no two people might rank priorities the same way. But physicians would come closer. Reflecting common professional experience, most of them would give a special place to the first two years of life, and the last two. Health care costs concentrate there, and special reverence is paid to the patients. The rest of life has long quiet periods, but just about everyone is seeing or trying to see a doctor, during their first two and last two years. If we really must ration care, these are the years to be spared. These are the four years of maximum helplessness. We must keep it in mind. Special consideration is in order.

 

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