Wednesday, October 14, 2009

Letter to Union Tribune

To the editor:  Re: Grandma pickpocketing the young, 11-26-09-

As a proclamation of the official beginning of the United States Generational Civil War, I would say it's good to have this out in the open, with the caveat that the unfortunate accusational tone, "pickpocketing the young, economic assault on the young by the old"  marks the low point of the dialog rather than setting a standard.  First a correction of this: "Medicaid...primarily dedicated to the elderly."  Not principle or in actuality.   Unlike Medicare, created to address the lack of minimal health care of those beyond working age in a system that merged health insurance with employment; Medicaid was, and still is, designed to aid those in poverty, old and young alike.

Samuelson's ad hominem attack on a generation distorts the serious issues that must be addressed by comprehensive health care reform.  It exists on partly because of the demographic time bomb,  that the birth rate in the early second half of the last century has now created an imbalance between beneficiaries and contributors to Medicare and Social Security. 

While it has been clear for decades that Medicare was on the road to insolvency, our political system refused, or was unable, to tackle the ineffeciecies and inequities of our massive powerful Medical-Industrial complex, that has resulted in health care being unaffordable for so many Americans of all ages.  Sadly, given the evidence of the developing Health Care Reform pending in congress, it still lacks this ability.

As someone approaching 70, the very last thing I want for myself or for my cohorts is a disproportional share of the health care pie, yet the current House passed bill, oblivious to Mr. Samualson apparently, would actually place those on Medicare closer to the back of the new longer line of subsidized claimants for a fixed supply of medical care.  Somehow the powerful "better organized" seniors couldn't prevent both Medicaid and the proposed private option from being able to pay equal or more than they do to providers.

This reform bill, is primarily a rearranging the order by which those in desperate straits can board the life boats, without increasing the number of seats.  Those writing this bill choose to fund token "demonstration projects" that could, perhaps in decades, actually provide the additional capacity to negate needing to  decide  who gets care and who goes without.   Even in the clause that acknowledges an improvement of malpractice, objective certificates of merit being required before court access, the writers of this bill refuse to mandate such efficiencies.

Ultimately for health care in America ever to be affordable, available enough to care for old and young alike, radical changes are necessary.   This means, as much as many may object, actually putting government between a patient and his or her doctor to prevent futile treatment that saps the resources that could be used to meaningfully prolong life.  Far from being "death panels" such entities would ensure the existence of a health care system that can actually enhance and save lives.  These "Life Panels" are the only one thing among other shocking changes to what we have become used to that can difuse the battle between young and old, male and female,  rich and poor, healthy and sick....that is inevitable by ignoring tackling the supply side of health care.  

Blaming our current health care problem on "Grandma," or any single industry or profession is as silly as it is destructive.  We have a health care complex, that is as unique as our own history as a country.   Creation of false villains is no substitute for addressing this social-political issue that is ingrained in who we are as a society, and will only be improved by accepting the pain of major surgery to our body politic.

Al Rodbell
Encinitas California

  Editor:  I know this is long, but if you need to edit, give me a shot at trying to select what can be removed.   Or if you want to feature this as an OpEd, my education is a M.Phil from Columbia University in Social Psychology and Public Health.


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