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Column

Don’t steal from young Peter to pay old Paul

In health care area, oldsters use a large chunk of the system

Jim Nowlan
Jim Nowlan

As I near 77, I find myself on a treadmill, you might say, of visits to doctors, specialists, clinics, hospitals. Ditto for many contemporaries I hang with. I worry that our society can’t afford all the health care that we oldsters enjoy.

In just the past few years, I have had procedures or operations for Lasik, cataracts, hernia repair, depression, prostate cancer, arrythmia, and more, plus many medications and endless checkups.

I have no idea what all that costs, because we are shielded from the numbers. I did read that the new-fangled proton beam radiation treatments for my prostate cancer cost $100,000, several times the cost of traditional radiation for prostate cancer. But Medicare covered the treatments, and I was told there wouldn’t likely be any important side effects (there were), so who cares?

As a result, I am in relatively good health, and thankful. Yet still I worry that we are robbing Peter to pay Paul for all this.

Some background. The U.S. Department of Health and Human Services reports that 5 percent of the population consumes half the costs of health care. This nickel slice isn’t all for oldsters, but much of it is.

One of five dollars in our economy goes to health care. Health care costs have been rising faster than economic growth since about the end of World War II. PWC (the former Price, Waterhouse, Coopers) is a national accounting firm that follows this industry. PWC notes that health care costs are expected to grow 6 percent next year (which is lower than the 9 percent to 12 percent annual growth of recent years), while the economy putters along at 2 percent growth or so each year. Unsustainable.

What careers do you encourage your children and grandchildren to pursue? Health care is near the top of the list, I’ll guess, because it’s a growth industry, pay is good, and security seems assured.

At the same time, we are spending less on children, higher education and infrastructure, all critical to our future, while the Chinese pour massive dollars into all these fields.

From 1978 to 2014 (the last year Illinois had a real budget), spending by our state for higher education, in inflation-adjusted 2014 dollars, declined from $283 per capita to $189. In contrast, that for Medicaid (health care for the low-income, disabled and those in nursing homes) quadrupled, to almost $1,300 per capita!

Spending for our state children’s agency is also down, and Illinois hasn’t had a real infrastructure program for our highways since 2010.

I am not, of course, proposing that we cut off all health care to oldsters. Those in our “golden years” deserve to reap some benefits from all we contributed earlier.

And yet, we cannot steal from the most productive elements of our society to pay for inexhaustible health care.

What to do? We could, as most developed nations do, ration health care. We prefer to think we do not have to do this, although we do informally ration a great deal – poor people receive lots less of the best health care than rich people.

I propose that, at the least, the U.S. and our states develop annual spreadsheets, maybe titled “How’re we doin’?” The spreadsheets would tabulate expenditures, and ideally outcomes, for each of the major functions of society: education, children, colleges, basic research, infrastructure, and health care (this last maybe broken out by age categories, that is, young, working age, senior).

That way, if we spend ever more on health care for oldsters like me, we can see that. But we should ring alarm bells if the breakout shows we are investing less on the more productive functions in order to do so.

We cannot steal from young Peter to pay old Paul.

Note to readers: Jim Nowlan of Toulon can be reached at jnowlan3@gmail.com.

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