More than a few people on this site have claimed or denied that healthcare rationing will occur under Obamacare. Those who claim it will not, refer frequently to the CBO estimate that it will cost only (ONLY) another 1 trillion dollars over ten years. To grasp what is happening here we need to recognize what is happening in different govt. programs such as Medicare and Medicaid. As usual, demographic realities define what will happen.

Medicare, like social security, was built on two assumptions. The first was that life expectancy would hold relatively constant over time. The second one has been generally ignored. That is recognizing that the monies you pay into Social Security and Medicare is intended to pay for your parents grandparents, etc. Unlike a private insurance program, the money you pay IS NOT for you. You did not deposit money into the system for your care, you deposited children, so they could pay for you.

To use my family as an example, my parents had six children – three each to support them in their elder years; my wife and I had four kids – two each to support each of us. Three of my four children are married and have completed their families at two children each – one child to support each adult. With Medicare scheduled to run out of funds in seven years, something has to give.

Medicare serves those of us in our ‘golden years’ It continues to be held steady, or nearly so, in the face of its coming demise. Medicare and its companion, Medicare Advantage are accepted by virtually all hospitals, outpatient clinics, etc. as well as the vast majority of physicians. The over 65 vote is a real danger to any politician who calls for a reality check. Just consider how George W. Bush was attacked when he advocated a policy that might allow our children and grandchildren to actually have a hope that they might receive something in their retirement. His plan may or may not have been the right one, but at least he recognized an unsustainable situation. The reception it received from those of us receiving Social Security doomed any chance of reform. ‘Just elect me one more time, and I’ll look after you’ is the clearly stated message of our representatives.

Medicaid, on the other hand, is intended to provide funds for the poor and their children among us. Most physicians will not accept new Medicaid patients. They need to make a living and Medicaid reimbursements are insufficient. As a result, young people are not receiving care that they need and us, old fogies, are receiving care that is of dubious value. Do any of us believe that paying for a brain cancer operation, when the outcome is clear, is an intelligent use of resources? Guys, when do we admit that an operation for prostate cancer will not prolong our lives? What we are doing today is denying needed care to the young and promoting essentially unneeded care for the elderly. Does this provide support for a government option? No, quite the opposite. Government has demonstrated that it cannot or will not make the needed decisions, but will continue to chase voters by promising what they cannot deliver. Let’s move as quickly as we can to private health insurance with a wide variety of choices and let the marketplace sort it out.

Cost reduction is a necessaty and that can be achieved through a number of ways, including but not limited to such ideas as community care, tort reform, high deductibles, medial savings accounts, etc. The free market is again, the right place to sort these ideas out. If nfp organiuzation can deliver better healthcare for the buck, then they will prevail. If for profit organizations do the better job, then let them do it.

To you BBQMAN: Amen Amen Amen!!!!!