This week I participated in the medical care of an 89-year-old with a weak heart and kidneys who was in the hospital for a week, three of those days in the ICU. She died a day post discharge. I also treated an 88-year-old with a weak heart who went home and is, as far as I know, still alive at the moment. If he’s not as accommodating (in a pecuniary fashion) as the lady, I anticipate multiple subsequent hospitalizations over the next couple of years. I covered for a 90-year-old woman whose heart is struggling through its last gasps. I don’t know if she’ll make it home. I rounded on another 90-year old man in the same precarious state. It’s likely he’ll need a transitional care facility if he makes it out. I saw another poor fellow in his late 80’s who requires dialysis and whose heart is trying desperately to check out with electrical disturbances that, for the moment, we’ve managed to suppress. 

None of these people would be alive a few decades ago. The cost of our success is high, in monetary terms. The aggregate cost to society as the number of very elderly infirm skyrockets with the injection of the baby boomer generation into the system. I think reality will dwarf the best estimates of the “experts.” Remember, with all their wisdom they failed to foresee or ignored the circumstances leading up to the recent crash of the economy. 

Insurance portability is good, and coverage without regard to pre-existing conditions, laudable. But legislation that guarantees these things for less, like campaign promises, should be looked at with a critical, nay, cynical, eye.

I like unicorns, too.

May you all have a  happy, and healthy, New Year.


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