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Bad Choices
If two people are dying from liver disease, one 25, the other 65, and there’s only one liver available for transplant, the old one dies.
There’s one economic variable that’s highly predictable; demographics. In all of the industrial countries the aging population is now weighing on the economic outcome. Japan was the first country to go down the tubes from this phenomenon. Europe is behind Japan, but rapidly catching up.
The US has a huge headache with an aging population. The number of oldsters is big, and rapidly rising. Add to the size of the aging US population the fact that the promises made to these people are enormous. Other countries, like Canada, Russia and even China are struggling with the problem.
The USA is in now in year three of what will prove to be a twenty-year mega-trend of an aging population. These facts have been know for a long time, I’m amazed that the US has been so slow to come to grips with the implications of what is clearly in our future. Thanks to the Fiscal Cliff debate, the financial implications of the graying of America are now being discussed, and Washington is talking about “solutions”.
So what are the solutions that the deciders are zeroing in on? Simple. The proposals (and what we will get) are extensions of the ages that benefits become available. Both sides have suggested that pushing out the age for Medicare and Social Security benefits for an additional two years is appropriate. The Administration has said it would be willing to do this; John Boehner (and other big Republicans) has flat-out insisted that it happen.
At some point in the next year (I don’t think this will be part of the fiscal cliff resolution) the eligibility changes will take place. The changes will be phased in over 10-15 years. When the ink is dry on the new laws, the bean counters in Washington will declare success. The end result will be a 3-4 year extension of the lives of both the Social Security and Medicare Trust Funds.
Where does this “fix” take the country? That’s easy to forecast. Older people will be forced to stay in the workforce for years longer. The retirement age will be pushed out, the benefit checks will also be smaller on a relative basis. (There will be cuts to inflation adjustments) Once again, the deep thinkers in D.C. are “okay” with making old folks wait for a few years for benefits; the thinking is that people live longer, so make them work longer.
My fear is that the solution to one problem is going to spill over and aggravate another problem. The fix on retirement benefits will cause a long-term erosion of youth unemployment. That outcome could prove more devastating than the aging problem.
Its not hard to find evidence that these big trends are already moving the needle. Last Friday’s NFP is a case in point. Zero Hedge has the details (Link) and (Link). This chart shows what happened in November. A disaster for those 22-54, the 55-69 group were the winners.
It wasn’t just November. Consider the changes since 2009.
What does a government do when it is faced with high youth unemployment? It sends them to school with borrowed money. This won’t work much longer:
This is the worst kind of whack-a-mole problem solving. Washington will take steps to address the fiscal consequences of the aging population, but those steps will create a multi-decade drag on what is already a serious problem.
We are far from the point where rules on transplants should apply to choices on economic policy, but we’re getting closer. The policy choices that are being made today are running counter to the rules on transplants. They favor old over young. We are a long way from being balanced on this issue; longer still toward policies that actually tip the scales to the next few generations.
If you asked the question, “How do we create opportunities for younger workers?” The answer would be to lower the retirement age. Create the opportunity for upward mobility. We are on a path 180 degrees in the opposite direction.
I don’t see a way around this. Demographic changes are powerful forces. The problem is we are on the third rung of a twenty-foot steep ladder, and we’re already making bad choices.
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Acrimony? I think the majority of posters here are in a dream world. It's over. We do not have a lot of time. The old and young anywhere near a city are going to end up as fertilizer.
Grandpa better sell the golf clubs for a shotgun, some beans, bullion and a farm. Old people are going to get rationed for healthcare fairly soon. Many of them voted for it. Enjoy.
There used to be a protocol at fast-food joints that when you stepped up to the counter, the help would say "Can I help you?"
I've noticed that now the (young) help just stand there and stare at you.
I have taken to staring back for a sufficiently awkard period and then saying "Are you ready to help me?"
Whoa, I'm getting old. When I started to work at Arby's at 15 we were instructed to say " May I help you" because English mattered and we were to look professional. We had to take a class on proper make up. Boys weren't allowed earrings or facial hair. Man, I'm getting old.
Miffed:-)
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yeah, gender roles, that's not cultural or anything. . .
lol, +1
I'm guessing that there were not enough transgendered 15 year-olds back in the 1970s to make anyone uncomfortable about possibly offending their hypothetical, oh-so-delicate sensibilities.
For added fun with the slack-jawed Hope for Our Future working the counter, hand 'em a $5 for a $4.78 order. Wait till they ring it up, then say, "oops!" and hand 'em 3 more cents. Then watch 'em start to panic, as they realize they're faced with, like, *math*. Don't help 'em: just stare at them exactly the way they stared at you when you stepped up to the counter.
Even better yet, go prepared with an assortment of Eisenhower dollars, Susan Anthony dollars, Sacajawea dollars, two dollar bills, and half dollars, and various minor coins to add up to let's say 80 cents over your total (just for fun!) .
I did this recently at a gas station to a scarlet-haired-and-nose-pierced twenty-something --- I thought her head was literally going to explode.
Lol. All you guys owe me a new keyboard.
What would be really cool is to have a system where if you wanted to live a really long and healthy life, you actually took care of yourself, Invested in yourself, making sure you worked for your goal. Save for your financial and health security, while pursuing the means to do so. OR we could have what we have today, where we are only becoming poorer and sicker. I don't want affordable healthcare. I want the best damn healthcare, home, food, car and anything else that i can afford. I want to have the ability to work for what i want, not be "given" what someone else seems to think I need. I believe in charity, not entitlement. If someone is down on their luck they should be willing to ask for help and I should be able to say no or yes without coersion.
Some of us die young, some of us get old and die, but we all die.
The real story is how much it costs to needlessly keep us alive.
Why do we believe that death must be defeated?
How do you defeat the inevitable?
Death is not tragic.
Life is.
When checkout time comes, I only hope I still have what it takes to pull the flush valve myself.
When my time comes, I only hope I still have the money to buy a pound of Crystal Meth, several cases of Heineken and lots of rubbers..
A Rep. Congressman wanted Medicare to pay for a well visit end of life/advanced directive/health care POA discussion for Seniors with their Primary Care Provider so they could make a decision when they were feeling decent and were lucid rather than have a decision made by them while critically ill or by some guilt ridden family member.
This was to be included in the Health Care Reform Act.
Tea Party fucks got a hold of it and claimed Obama was trying to pull the plug on Granny and killed it.
That one provision would have gone further to advancing the cause of patient self determination and cutting needless Medicare spending than just about any other idea advanced so far.
https://www.deathwise.org/2011/03/24/respecting-choices/
>>>Today, 96 percent of the people that die in La Crosse have made their decisions and documented them with advanced directives, by far the highest rate in the country. At the same time, less is spent on patient care in the last two years of life than anywhere else in the US – $18,000 in La Crosse compared to the national average of $26,000.
Is this cost savings the result of denying care? Not according to Hammes. He says the difference is that people have thought out their wishes in advance. They get exactly the care they want, while avoiding excessive and unwanted care.<<<
Thanks for nothing Tea Party fucks.
It could be years filled with needles suffering and expense before any sane politician tries this on the federal level again.
At my age I have known plenty of people who have died including both parents. They determined what medicines they received and decided when and where they would die, more or less. I just can't figure how government has anything to do with it. The problem is a medical society that feels incumbent on pushing the latest drug or technology, selling hope to the hopeless. My parents saw through that crap. did what was required and no more. If your idea is that there is a bunch of dumb asses out there there are just too damn stupid to figure it all out, I'm sorry but i have no pity for them. Like with all other bad choices, they should suffer. But if you feel you need a little gov money to get some therapy, by all means go for it. I think they call it dissability.
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this.
it's been my experience that many amrkns cannot have that conversation, and the result is their families suffer with the decisions at a time when the drama is maximum.
people need to do the responsible thing, and make their "living wills" or even just a simple conversation with a few trusted friends/relatives.
death with dignity is a passing that has been considered in advance.
Sure, because people couldn't have these talks with their PCP the next time they are in there for whatever, or even make an appt and pay for it themselves.
If Medicare doesn't cover it, it doesn't exist!
You're a fucking stupide dickweed, get your head out of your ass.
>>>Sure, because people couldn't have these talks with their PCP the next time they are in there for whatever, or even make an appt and pay for it themselves.<<<
If it were THAT easy and people were THAT aware, everyone would already have one. We wouldn't even be having this discussion.
So yeah, pukeface, it takes money, time and staff to have these discussions and fill out the legal paperwork.
>>>But it's expensive to spend time with patients filling out living wills. Medicare doesn't reimburse for the time the hospital's nurses, chaplains and social workers do this. Bud Hammes, the medical ethicist who started the program, called Respecting Choices, says it costs the hospital system millions of dollars a year. "We just build it into the overhead of the organization. We believe it's part of good patient care. We believe that our patients deserve to have an opportunity at least to have these conversations."
And that's how La Crosse unexpectedly got in the middle of the national debate over health care and the so-called "death panels."<<<
http://www.npr.org/templates/story/story.php?storyId=120346411
It's not happening because it is cost prohibitive, jerkwad.
This is a Lutheran affiliated hospital which chose to bear the burden of the cost all on it's own.
So you do see first hand what over-regulation does to cost and quality of service?
Over regulation? Completing the basic legal paperwork that any patient would have to complete for a Living Will/Advanced Directive/Health Care POA?
The process chosen by this hospital gives the patient access to professional advice and no doubt insulates the hospitial from legal liability.
This is what quality service costs, moron.
All power is rooted in fear. You really don't have to create much in life to have power, other than fear. The fear of not being cool or the fear of death. All it takes is a good sales job. I think Muslims probably don't have a healthcare/ insurance crisis as it seems many don't seem to fear death as much as us westerners. They seem to see what they do with their life as more important than how long they live. While suicide bombers seem to take it to an extreme maybe we should be more concerned about quality over quantity, and that usually has very little to do with money or what it buys. But I'm sure if they were offered ever lasting life on earth, they might well be tempted!
Life is unfair. If there is one liver and two recipients, someone doesn't get a liver.
Used to be, no-one ever got a new (used) liver. If your liver crapped out, you died, endofstory.
if the market is left to decide the allocation of scarce resources, then the resource goes to the high bidder. This might suck to those who didn't get the resource, but in the big picture, if the resource goes for a premium price, that puts greater return value back into the economy. At least then, that resource when sold, generates the greatest economic rewturn, thus having the potential to cascade dowen throuigh the economy with the greatest benefit to the most people.
When the gov't gets involved and forces the gifting of scarce resources at minimal prices to people who are too stupid or too lazy to generate the economic means to obtain those resources on the open market, general bankruptancy and gross inefficiencies are achieved.
Good god people, take a trip to Russia and take a look. The legacy of communism ios that everyone still lives in the projects.
The only remedy for Obamacare is that you'd better eat right, exercise, get plenty of rest, develop stress management techniques, keep the bad habits to minimum, and wear your seatbelt. Bottom line, you ain't gettin' no medical care- we're back to the 1840's, try Christian Science, it's free.
"What does a government do when it is faced with high youth unemployment? It sends them to school with borrowed money."
What does a government do when it is faced with high youth unemployment? It sends them to war with borrowed money.
More likely....
Bruce,
Who should get a transplant? This fine young man in his prime: http://media.comicvine.com/uploads/5/50532/2164405-bundy.jpg
Or this 65+ year old used up relic: http://en.wikipedia.org/wiki/Michael_Tilson_Thomas
Who ever shall have the funds to pay shall receive. Pretty simple ain't it.
Bismark, is that you?
Single payer, baby. Instead we get crony capitalistic obamacare. Single payer would allow older workers to retire, help businesses be more competitive by not having to provide healthcare benefits and cost less per capita, putting us more in line with what the rest of the developed world spends.
The solution is to get government out of healthcare entirely.
"Everything government touches turns to crap." Ringo Starr
It destroys people, their lives, families. businesses, economies, nations, and civilizations.
And yet some people are so stupid as to want more of it.
You and your ilk are the problem.
/
Yeah, let the govt handle it. Nice. just one more entitlement when the others have driven us off the cliff. Brilliant.
You want cheap. Let the market in. No health insurance (except for Major treatment) = the cheapest/less expensive possible health care costs.
I need some stitches, I pay for some stitches. Imagine that.
You need some stitches, you got no money, you die. Imagine that.
YOU and others are free to provide charity as you wish --- just don't point a gun at my head and demand that I provide 'charity' in the name of some misguided and hypocritical notion of compulsory 'compassion'.
Your goin' to HELL with that UNchristian comment! Anti-Christ!
:)
Your dog from Sirius is dead, DEAD I tell you!
The power of the Ford compels you to bury him.
I have seen the light now. YOU are condemed to a GM bailout vehicle from hell...forever!
And the aspirin wouldn't be $8/pill. The problem with that solution is that some people can't afford stitches when they need stitches. In that case, I think they should visit their local elder and have some super glue applied. It might not heal as pretty but it'll get the job done, if not more painfully.
Super Glue was originally designed for the defense dept. for use on battlefield wounds in place of stitches.
WD-40 was made for the defense dept to keep missles from rusting.
No, the aspirin wouldn't be $8 a pill. Of course you talk about suddenly all these people don't have enough for stitches. I bet they have cell phones and cable and a car. Who pays for that when it breaks down? Insurance? I can tell you one thing, if insurance did cover car repairs, and oil change would be $250. Good thing we just pay out of pocket, so the competition keeps the cost down.
If aspirin were regulated like some other drugs it would be $8 a pill now.
Yes, the road to hell is paved with good intentions, and with a little more efficiency we will ge there all the sooner. I mean, afterall, what could go wrong with a government run healthcare system?
Obviously. BTW, although I did not read every coment, the quality of thinking here is part of the problem. Lashing out at elders is not going to solve a thing. Unless we want to really employ soylent green tech. Then who would eat the crackers?
I had to search down to rec this post, spooz. One good answer to this question again a plethora of vindectives.
Real research supports your conclusion - Scientific American came out with a great article on this some five years back, illustrating your point. And, just because the single-payer system has been corrupted in other countries does not mean that the idea is not sound.
I almost want to laugh but probably want to cry. Game over. You will have no choice going forward now.
Game Over!
http://www.youtube.com/watch?v=dsx2vdn7gpY
The 2008 and 2012 elections were totally rigged. You have no say. We know how they feel about the elders especially white elders. Jamie Fox wants to shoot them. Alec Baldwin wants them to die.
Dick Cheney got a transplant. Since he did I took myself off of the donor list. Must everything be corrupt in this country?
Dicky got more than one. Seems like any new heart that finds residency in that quagmire of evil decides it doesn't need the aggravation anymore. Poor thing.
Robert "I'm not Rick 'Sweater Vest' Santorum" Casey, Jr's father (PA's governor at the time) finagled a heart/liver transplant just days after it was found out he needed one.
Kasting takes off the mask and goes geriatri-cidal.
In a health care econ class I took in the 80s, the classic example of the failure to find a way allocate limited medical resources was the dialysis machine. When they first came out they were: life saving, expensive, rare and there was no substitute. There were no centrally mandated rules for determining which patients got life-saving time on the machine and which died; it was left to the states. Everything was tried. In Washington State, Seattle I think, they actually had a panel, comprised of an ordinary citizen, a philospher, a clergyman or something like that. They reviewed cases and made qualitative judgements. It was never a simple as age: you might have, say, a sociopathic young person vs a 65 year old grand mother of 6, school teacher; a mentally challenged young person vs a working 65 year old medical doctor. Who's making a greater contribution to society? And who decides? In the end it defaulted to predominately random selection. Since then, the allocation of scarce or very expensive treatments has stayed that way--with the exception that some pigs are more equal than others: consider Steve Jobs getting bumped ahead in the liver transplant waiting list, i.e. money talks.
Why should older people in the Dell Webb or any other neighborhood pay school taxes? They already educated their chilidren. Why not exempt the childless from school taxes, give a pro-rated tax credit to landlords who rent to them? Screw this whole intergenerational thing. Fair is fair, eh, Bruce?
My grandfather used to get into scraps with his higher-ups in the army during WWII over penicillin which was brand new and in extremely limited supply at the time. He always wanted to favor the guys who had infections due to battle wounds but the senior officers always wanted to give it to the fresh soldiers who had managed to contract VD in the Italian whore houses. Needless to say my grandfather lost that fight time and again...although I do have a cool, wooden caduceus given to him by an African chieften after he was magically cured (of some infection or other) by the stuff.
Anyway, rationing will ultimately be the main function of Obamacare just as soon as they change all the medical care rules...except supply & demand.
From what I hear Steve Jobs would have almost certainly had a better outcome if he hadn't insisted on new age, alternative medicine therapies early on in his sickness.
See my note below on liver transplants.
And no, I don't agree with you on the school tax issue.
I firmly believe that the scales are tipped heavily to older generations today.
I believe that what is coming will tip the scales futher.
And I also believe that it is in the best interests of older generations that America is still the land of opportunity for those who are entering the work force. 30% youth unemplyment is a very bad result, including the consequences to older people.
So you know, I advocate means testing benefits in a very heavy way. This would be hurt me, but is the only "fair" way out of this mess.
I'm sure you will not like any of that.
However, I loved the term; geriatri-cidal. I've not seen this before. Did you make it up? I like the label.
What is "fair" about denying benefits to those who have paid for them for 40-45 years?
Fair is a favorite word of liberals, who either don't understand or don't care that property rights are the foundation of political freedom. Increasingly the Marxist idea that property itself isn't "fair" is going mainstream Isn't it "fair" that a person of color should be given preference, ceteris paribus, because they have been disadvantaged by racial prejudice? Actually, taking it a step further isn't it fair that person with 2 kidneys be compelled to "donate" one? Why shouldn't the idea of the state's ultimate claim to all property extend to living flesh? After all, we've already made some exceptions to habeus corpus. To paraphrase our Great Leader: Hey, that kidney? You didn't make that kidney.
"I firmly believe that the scales are tipped heavily to older generations today."
Too vague to mean anything. Elders are often abused, defrauded, burglarized by younger pedators. With people like you stoking the intergeneration fires, they'll be getting elbowed off the sidewalks soon enough.
Land of opportunity? When I was 16 I was a yard boy for three homes - two sons in their 30s and their father. The two sons were pricks but the old guy was a gem. He built the company where they both made their living. He also made wine in his cellar. Once he invited me down to "help" him transfer wine from one barrel to another. This went on for an hour or more and involved extensive "tasting." A very fond memory.
I've also lived in a village where some families had been living for centuries. Old people and their lives were part of everyday life, not ghetto-ized as they most are in urban society. Many were well loved, all were looked out for. One old guy was so mean you couldn't talk to him but he always had a 4 cords of wood piled up when winter came. I found out how that happened when one of my buddies came by one Sunday morning after a night of country hell-raising, banged on the door and said: "Come on, we're gonna cut some firewood." We were in our 20s.
You didn't address the problem of allocating scarce medical resources, by the way. You might read up on the early history of dialysys it and try to learn something from the experience of your elders, eh? Your "screw the old first," approach is embarassingly inadequate and simple-minded.
The school tax scenario was rhetorical--an example of tit-for-tat on what's "fair" - you know suggesting there is a balance of intergenerational equities as opposed to addressing issues with categorical goonery.
You want means testing? SS was not supposed to be a welfare program. But OK I'll support means testing if: the govt stops manipulating the price of precious metals and the Fed stops ZIRP so people can earn something on their retirement investments.
Yes, I made that word up, on the spot, in spite of being near expiration on your scale.
Bruce, as someone who has hired a lot of folks I watch these conversations with a sad amusement. It seems many pundits just don't seem to understand that small business owners want to hire folks with the best skill set to help their business become or stay profitable.
Arbitrary allocation of the labor pool based on age is absurd. This isn't about young vs old, it's more a who's skilled vs unskilled. It's also about potential. When you hire someone for the long term, as opposed to the churn and burn of the hamburger flipping jobs, you want the candidate to be able to grow and meet the responsibilities coming down the road.
30% youth unemployment is a product of many factors. The insidiously poor education system that has been cramed down Americans throats is partially to blame. Taking all the old folks out of the workforce doesn't help the skill set gap one bit, and does very little to employ younger folks with zip skills.
This young vs old is just another divide and conquer distraction in a society where the bottom line trumps a healthy society. The elimination of jobs in the desire to maximize profits only works for the short term and only for a tiny fraction of the population.
I would suggest we need to stop catering to the bottom line and start looking at ways to allow our society to maintain a decent level of employment for all ages. This would entail changes to the tax code that favors off-shoring jobs, as well as removing regulatory burdens on small businesses where those regulations do nothing for society but do stifle entrepreneurship.
Screw this young versus old sideshow. Let's grow the pie and stop fighting over the scraps left in the tin.
Let's grow the pie and stop fighting over the scraps left in the tin.
In an ongoing global depression, "growth" is not an option.
As long as the financial sector is allowed to choke the system and suck up the resources needed by the population of this planet I agree. But that is basically a self-inflicted wound that can be remedied. Not easily done, but no doubt worth the effort.