Death and Budgets

John Caldwell tombstone

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On July 14, David Brooks wrote a column for the New York Times
entitled, “Death and Budgets.” In that article he argued that the
majority of the nation’s health care costs are incurred by treating the
illnesses of old age. If those illnesses are treated successfully, the
result is merely the extension of a pain-filled, diminished life for a
few months or a few years. His argument is that the nation could put
its fiscal house in order if the ill decided to forgo expensive
treatment in their terminal years. Of course but unstated, is the wish
that others than friends and family adopt that course.

Alan Grayson on the floor of the House of Representatives demonstrated
with two charts the Republican health care policy, “Don’t get sick.”
And if you do get sick, “Die quickly.” What Grayson put into two brief
charts, Brooks used two pages to restate in more words.

Since the Republicans want the ill to “die quickly” and since they
believe in free market solutions, I propose the following solution to
run-away health care and Medicare and Medicaid costs. Every individual
in the US would be allocated a lifetime cap on what the government will
spend on a person’s health care. When that cap is reached, no more
government assistance would be available.

For illustrative purposes, let us use $100,000 as a lifetime cap. Each
individual could decide how to use that money, to buy insurance or to
forego insurance and spend the money directly to pay for health care
services when provided. As an incentive not to overuse health care and
thus keep costs down, any unused balance in a person’s health care
account would go tax-free to his/her heirs after death. If I had used
$50,000 of my lifetime cap and faced an illness at age 70 or 75, I
could decide to spend the remaining $50,000 on prolonging my life, or I
could decide to forego treatment and leave the $50,000 to my heir(s).
Of course, the wealthy among us could continue to purchase and pay for
expensive treatment out of their own pockets.

Please see US versus Canada healthcare