I was listening to a BBC documentary on health care last night and it got me thinking about a topic that I have not considered in a while. One of the concerns expressed in the program was that the cost of medical intervention is increasing especially for care later in life. This, combined with people living longer creates a crisis for government funded health care providers.
Indeed this does seem to be a problem. Here is my relatively simple solution. As long as you are of working age, you are entitled to whatever care is available. As soon as you retire, the deal changes. You will be entitled to receive for free, whatever care was available on the day of your retirement. In the future, if you want a treatment beyond what was available when you retired you will have to pay. The entire cost if it is a new treatment, or the difference between the cost of the new and old treatment if it is an improvement on an existing process.
Some may view this as overly harsh, but those same people will probably not be willing to carry the tax burden for providing the most cutting edge care to any and all who may request it. There are a lot of people who will soon be retiring. They are the ones that have received the benefits of rising national debts in the rich world. They were the ones who choose not to have enough kids to replace themselves in the workplace. We shouldn’t let them mortgage our futures even more by getting us to pay for their fancy new designer drugs and expensive hospital treatments. If they want to live well into their 90s, they should have been saving both their own, and the government’s money in the lead up to their retirements instead of spending it like it was going out of style.
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6 comments:
Um, no.
Either you have universality or you don’t. As soon as you start to create tiered health care you’re going to run into problems maintaining the entire system. Say, for example, that I work until I am 65 and incur few health care costs, despite paying large amounts of my own money into the system to benefit others. Within 5 years of retiring I start to incur larger medical bills, only to be informed that I will have to pay them partially or totally by myself if I want to be receiving the same treatment that I would have provided I was still working. Given that seniors vote in droves, I suspect that support for such a system would erode quite quickly.
Or, imagine a circumstance in which someone’s elderly parent could live a longer or happier life because of advances in technology, but that parent lacks the means under your system to pay for this treatment. I think in most cases their children would be inclined to foot the bill here (seriously, can you imagine taking the decision not to?). At this point the burden of the health care costs has not shifted from one generation to the other, but rather simply from society to the individual. Can you imagine that this person – who is simultaneously paying into the health care system AND digging into their personal savings to finance health care for one or both of their parents – is going to be inclined to support such an arrangement?
This on top of the fact that such a scheme is morally questionable, if one considers health care as a right, rather than a privilege tied to socio-economic status.
Finally, there is no firm agreement on the proposition that demographic shifts are going to ‘mortgage our future’ through huge rises in health care costs. Costs will rise, but the extent of the increase is still very unclear. Check out the Globe article below. I particularly like this quote:
“the presumed stresses boomers will inflict on the system are a kind of red herring, trotted out by groups that favour injecting more private care and private capital into the system.”
http://www.theglobeandmail.com/servlet/story/LAC.20080809.SAFETYNET09//TPStory/Focus
Well warren, I think you are way off on pretty much all of your points.
"Say, for example, that I work until I am 65 and incur few health care costs, despite paying large amounts of my own money into the system to benefit others."
People pay into EI all the time and collect nothing. They are not refunded after the retire. No one seems to have a problem with this.
"Or, imagine a circumstance in which someone’s elderly parent could live a longer or happier life because of advances in technology, but that parent lacks the means under your system to pay for this treatment."
Could you imagine being a parent that forces this on your children? I'm glad you aren't my dad.
"This on top of the fact that such a scheme is morally questionable, if one considers health care as a right, rather than a privilege tied to socio-economic status."
Basic health care is a right. Living until you are 110 is not.
As for you link, I have 2 comments. Yes, the costs per capita for treatment may be coming donw, but the number of capitas on the cost side are rising, and the number of capitas on the funding side are shrinking. While there may be some math that balances this out, I'm not sure I'm willing to put my faith - and the future of Canada's finances - in John Lorinc Toronto journalist who is writing a public-policy column for Zoomer Magazine, which launches this fall
“Basic health care is a right. Living until you are 110 is not.”
On what grounds are you drawing the distinction between “basic” and “non-basic” healthcare coverage? More specifically, how precisely are you determining the age at which life expectancy becomes excessive? I suspect that the citizens of classical Greece or Rome, for whom the average lifespan at birth was somewhere between 20-35 years, might find expecting to live until 60 somewhat outrageous. People in the late 19th and early 20th century, when the average life expectancy was somewhat higher - approximately 40 I believe - might well feel similarly about living until 80. So unless you can come up with some reason why the expansion of life expectancy from 40 until 80 is qualitatively different from 80 to 100, I’m not sure what your justification is for this statement. And with many people working well past the retirement age, please don’t give me some bunk about capacity to contribute to society.
And on the subject of the article – I’m more willing to put my faith in the estimates of a UBC health economist (cited in the article) than in the Fraser Institute. But maybe that is just my bias showing.
Brilliant!
"And with many people working well past the retirement age, please don’t give me some bunk about capacity to contribute to society."
This is exactly the goal of my plan! As long as no one retires, it's no problem! Everybody wins!
Our society is all about putting arbitrary age restrictions on things, drinking, driving, gambling, voting, pronography, retirement, on and on and on. Who comes up with those values? They aren't set in stone and they can change. We just need to reframe the healthcare debate.
"This is exactly the goal of my plan! As long as no one retires, it's no problem! Everybody wins!"
Provided your comfortable viewing human life in strictly economic terms.
Moreover, people may retire and still continue to contribute through part time work/volunteer work/helping with children to free up time for working age adults etc.
“Our society is all about putting arbitrary age restrictions on things, drinking, driving, gambling, voting, pronography, retirement, on and on and on. Who comes up with those values? They aren't set in stone and they can change. We just need to reframe the healthcare debate.”
Though I would probably argue in another venue that some of these ages are silly and unnecessary, I think there would be others who argue that they are not at all arbitrary – i.e. we restrict underage drinking (to the extent that we really do) because alcohol can impede development etc. In any case, my argument isn’t that everyone should retire at 65, it’s that you shouldn’t restrict their health care coverage if they do. And I still haven’t heard a justification for the proposition that living to 110 is somehow excessive in the context of huge expansions in life expectancy throughout human history.
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