In article ,
Han wrote:



That seems very similar to my own slant on healthcare. Make everyone
pay for a certain amount of basic and catastrophic insurance, then have
available additional insurance for those willing to get heart, lung,
kidney transplants (including dialysis), etc, etc. Start out with
everyone paying the same rate for the additional insurance. Perhaps
increase rates for accident-prone people like me grin.
The problem is that everytime that gets tried, we get bogged down on
what is "basic" insurance. Dialysis is the least of our worries
personally (FWIW) since you automatically qualify for Medicaid if you
need dialysis.


I think your 20-80 rule is indeed much too rosy. I think it is
generally accepted that 80% of the average person's healthcare costs
come in the last year of life. Now, I don't know whether that is
because of the high cost of cancer treatment and resuscitation of just
about dead people, but it does make you wonder whether the decisions of
what to do have done to oneself towards end of life is something people
should be forced to consider. I have made "living will" etc decisions
...
Checked around: 1 percent of the population accounts for 30 percent
of the nation's health care expenditures. ABout 30% of MCare's budget is
spent on those in the last year of their life. It is largely because you
are sickest before you die. Sorta hard to argue.
I have thought (though never have had the money to actually finance
such a study--maybe if I hit Powerball tonight) that this was a little
skewed.
I had an Uncle that died of a heart attack. The last year of his
life he had expenditures of around $50,000, with 90% of that being in
the time frame from when he came to the hospital to when he died about 6
hours later (including a chopper ride from rural Arkansas to Little Rock
to try a bypass). I have always wondered how much of that 30% is acute
treatment (he was still alive when he landed at Little Rock, but died
during surgery because of the damage) giving the guy a chance and how
much was essentially PR/CYA treatment of someone already gone. I
obviously have a much different view of the latter than the former.

--
People thought cybersex was a safe alternative,
until patients started presenting with sexually
acquired carpal tunnel syndrome.-Howard Berkowitz