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Do you believe in Santa Claus, Tinker Bell and the Easter Bunny?
Author: Cleaves M. Bennett MD FACP
Monday, January 07, 2008

(If you still do you need to read the following)

The Democratic hopefuls for the presidential nomination in 2008 and most other local and national politicians all are talking about “universal health insurance”. Although we have 78 million (give or take a few million) covered by their place of employment, many millions more by Medicare and Medicaid, Federal Employees Health Insurance, the VA health care system, as well as state, county and city hospitals for our poorest, there are still 10’s of millions of people who are not receiving adequate medical care for themselves and their children because they can’t afford to pay for it. No politician who wants to be nominated and elected will speak out against “health insurance and medical care for everyone”. That would be like damning Santa Claus, Tinker Bell and the Easter Bunny. Let’s face it, acting like the proverbial Grinch does not win elections.

What are the politicians thinking? We are drowning in health care entitlements right now and it is only going to get much worse as the baby boomers age. Bad example #1: The most famous baby boomer, ex-President Bill Clinton has already had his first heart attack, despite the finest health care available to him for free all of his adult life. What does that portend for the rest of the “boomers”, especially for the poor and the under educated?

The Comptroller General of the US, David Walker, is the nation’s chief accountant. Interviewed on CBS’s 60 Minutes March 4, 2007, he described the fiscal “tsunami” headed our way. The recent passage of the Medicare drug benefit only made things much worse. This is what he said:

“The fact is, we don't face an immediate crisis. And, so people say, 'What's the problem?' The answer is, we suffer from a fiscal cancer. It is growing within us. And if we do not treat it, it will have catastrophic consequences for our country." The cancer, Walker says, are massive entitlement programs we can no longer afford, exacerbated by a demographic glitch that began more than 60 years ago-- a dramatic spike in the fertility rate called the "baby boom."

Beginning next year, and for 20 years thereafter, 78 million Americans will become pensioners and medical dependents of the U.S. taxpayer. "The first baby boomer will reach 62 and be eligible for early retirement with Social Security January 1, 2008. They'll be eligible for Medicare just three years later. And when those boomers start retiring in mass, then that will be a tsunami of spending that could swamp our ship of state if we don't get serious about reform."

What would happen in 2040 if the U.S. maintains its current course and fulfills all of the promises politicians have made to the public on things like Social Security and Medicare? "If nothing changes, the federal government's not going to be able to do much more than pay interest on the mounting debt and some entitlement benefits. It won't have money left for anything else – national defense, homeland security, education, you name it," Walker warns.

Walker says you could eliminate all waste and fraud, and the entire Pentagon budget and the long range financial projections barely change, in what's shaping up as an actuarial nightmare. Part of the problem, Walker acknowledges, is that there won't be enough wage earners to support the benefits of the baby boomers. "But the real problem is health care costs. Our health care problem is much more significant than Social Security."

"By that I mean that the Medicare problem is five times greater than the Social Security problem." The problem with Medicare, Walker says, is people keep living longer, and medical costs keep rising at twice the rate of inflation. But instead of dealing with the problem, the president and the Congress made things much worse just three years ago when they expanded the Medicare program to include prescription drug coverage.

The goal should not be helping seniors pay for all their medications, but teaching them to take better care of themselves so they won’t need any medications at all! One very big caveat: The earlier in life they start, the more effective prevention will be. Right now we have an epidemic of “diabesity” (obesity + diabetes) in children, as young 8 or 10 years. Kids with type 2 diabetes!! That’s the type of diabetes in which you’ve worn out your pancreas from eating a diet recommended by the TV ads you watch all the time instead of playing outside. These kids aren’t going to make it to be on Medicare. They’ll have kidney failure by the time they’re in their 20’s or 30’s and have to go on dialysis. The average length of life on dialysis is less than 2 years. The average wait for a transplant is 5 years. Do the math.

This is not just a tragedy in the making, it becomes a very, very expensive tragedy for all of us. And it is completely preventable, not by inventing and prescribing more and more medicines, but by learning to live and eat in a way that more resembles our remote ancestors, Paleolithic hunter-gatherers. In the USA that would be the native Americans, who were mistakenly called “Indians” by the early Europeans who sailed here.

Diabetes is not preventable by taking medication. Once diabetic, taking medication does not cure the problem but only delays the inevitable consequences: blindness, amputations, kidney failure, dementia, heart attacks and heart failure. The disease totally takes over your life and slowly destroys your body. Medications neither prevent the disease nor prevent the destruction it brings about. At best the destruction is delayed, but it is inevitable. Almost all diabetics taking oral medications end up taking insulin shots, if they live long enough. Don’t depend on medications. They are no substitute for living and eating healthy.

Back to the problem of universal health insurance for everyone. It is not going to happen. True, the politicians are going to talk about it at election time. But as the Federal and State governments are forced to chip away at Medicaid, as the reality of the fiscal crisis we are in becomes more and more obvious, even the most pandering of the candidates will have to face reality. We can’t afford another health care entitlement, especially for non-voters.

If you can’t afford auto insurance, you had better drive very carefully!

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