I started a folder.  What else can I do.  259 days to go.  I’m not going to think about the choices until about 60 days before my birthday.  My hip has stopped hurting so the taxpayers can relax a little.

btw You are eligible for Medicare on the first of the month that your birthday falls in so I’m eligible on July 1, 2012.  Only 247 days to go.  Should I change the counter?

Christine Leventhal

A very wise woman on the Prager Israel Trip during a conversation about taking care of elderly parents.

I can’t decide yet whether I will get the hip replacement or the bypass surgery first.  But one thing is for sure.  America can’t afford my (and the other 70 million baby boomers) medical bills.  I’m just glad I’m near the front of the line.

My Posts on Aging

The Countdown Timer

So lets do the math.  Knee replacement surgery costs about $30,000 and about a million of us will need at least one hip or knee in the next few years.  That comes to Thirty Billion Dollars just for the orthopedic needs of people born in 1947.

What can you do about it?  If you are looking for a career go into the orthopedic supply business.  If you are an investor buy stock in the companies that supply this industry.  If you are a taxpayer hang on it is going to be a rough ride.

BTW It might be a good idea to let in a lot more immigrants to help pay for all of the above.

This just about expresses my concern about the government taking a larger role in the healthcare system.

I spent some time in the Emergency Rooms at Huntington Hospital and two different Kaiser hospitals this week helping my Father-in-Law through his latest crisis so I had lots of time to think about review panels, triage and allocation of resources.  In fact I also had enough time to read The Hidden Symbol, Dan Brown’s (author of The DaVinci Code) latest thriller.  I agree with President Obama that it is a bad allocation of resources to give a new hip ($40,000) to a ninety year old with a bad heart but I also agree with Obama’s critics that I don’t want “death panels” to be deciding if I get to live.  BTW by calling the “review panels” “death panels” the critics won this one on the name.  Think “homeless” vs “bums” we help homeless people we didn’t help bums.

I’m not sure that we will get to review panels and I’m not sure if they can work unless the incentives to providers, receivers and allocators of medical services change significantly.   For instance in the current model: If Medicare is paying, who at Kaiser would benefit from not putting another stent in a ninety year old bedridden man?  How would the man or his heirs benefit from not having it since the stent is free?  And what allocator would be able to defend withholding the stent against a crying grandchild on CNN?

We will need to change the incentive to all of these groups before any progress can be made toward controlling medical costs.  But don’t lose heart (we have stents for that),  I have devised the ultimate triage test and I will share it with you. (By clicking on the read the rest of this entry button I agree that Simon is writing what follows as a thought provoking joke and that without training I will not try to apply the test to real world situations)The Ultimate Triage Test

1.   Can the patient wipe his or her own ass?

If yes administer the expensive life extending procedure.

If no proceed to question two.

2.   Does the patient add value to the lives of those around them?  In other words are there people who benefit from this persons existence?   This would include intangibles like happiness and love.

If yes administer the expensive life extending procedure.

If no administer only appropriate pain reducing medicine.

This is something to think seriously about.    Will I Live to see 80?
I recently picked a new primary care doctor.  After two visits and exhaustive Lab tests, he said I was doing ‘fairly well’ for my age. (I just turned 60.)
A little concerned about that comment, I couldn’t resist asking him, ‘Do you think I’ll live to be 80?’
He asked, ‘Do you smoke tobacco, or drink beer or wine, indulge in chocolate or coffee?’
‘Oh no,’ I replied.  ‘I’m not doing drugs, either!’
Then he asked, ‘Do you eat rib-eye steaks and barbecued ribs?
I said, ‘Not much…. my former doctor said that all red meat is very unhealthy!’
‘Do you spend a lot of time in the sun, like playing golf, sailing, hiking, or bicycling?’ He asked.
No, I don’t,’ I said.
He asked, ‘Do you gamble, drive fast cars, or have a lot of sex?’
‘No,’ I said.

He looked at me and said…  ‘Then, why do you even give a shit?

On the day my friend Peter turned 65 he had knee replacement surgery.  I’m already starting a list of my own.  In 1993 P. J. O’Rourke said “If you think health care is expensive now, wait until you see what it costs when it’s free.” He was right.

The countdown timer on the upper right of my blog should be a warning to all of the people who are trying to finance more free health-care.  We can’t afford free.  Peter’s knee and my allergies and 30 million more maladies are coming at you.

The NHS is the UK’s National Health Service and they are not going to allow doctors to prescribe a new drug for Rheumatoid Arthritis because it is to expensive.  Will that happen here?  It already does to some extent.  But the bigger problem is that if drug developers can’t make money investment will dry up and development will stop.  On the other hand if we don’t change the way we are paying for health care now we will go bankrupt.  My post about Medicare finances.

MyDoctorIsInIndia.com

The Snail Medicine System:

If you get sick in the USA and you don’t have insurance.  The process goes like this:

Call Doctors office for an appointment

Doctor visit for an examination

Order tests

Revisit Doctor for test results, diagnosis and treatment recommendations

Get prescriptions

Total elapsed time two to five days depending on urgency

Total cost without the prescriptions in the range of $250.00

The I-Medicine System

If you get sick in America and you go to MyDoctorIsInIndia.com the process will go like this:
Mail in test kit

Get email from your doctor in India for consultation

Answer email inquiries and receive diagnosis and treatment recommendation

Get prescriptions filled and mailed to you by a pharmacy in Canada.

Total elapsed time two to five days

Total cost without the prescriptions in the range of $75.00

Many of you will say “but we have to see the doctor.”  Okay for you but the system above streamlines the process saves money and should be allowed for people who want it.  Think of MyDoctorIsInIndia.com as email or text mail.  They have some short-comings compared to meetings or telephone calls but are dramatically cheaper. MyDoctorIsInIndia.com is an idea worth trying.