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I support decentralizing the Gov’t role in health care, as it gives at least some people some choice. Unfortunately, long term, from a monetary standpoint, that’s really almost an irrelevancy. If we don’t somehow get back to a highly competitive, efficient system, in which health care gets back down to, oh, say, 10-12% of GDP, our economy will struggle vs. most of the world. We have to at least be competitive with countries like Germany, while still avoiding some of the negatives of their system.

I’ve been POA for health care for both my Mom and Dad the last 3 years, dealing with many different caregivers and facilities, with my Dad especially needing a lot of care, and our system is just so screwed up with excessive red tape, bureaucracy, one hand not knowing what the other is doing*, non-continuity of care / rotation of caregivers (a different “hospitalist” in charge of a patient each week, and much worse when it comes to nursing staff), and so on, that it largely negates the wonderful medical technology now available, to say nothing of the efforts of the individual caregivers themselves, at least 75% of whom I have tremendous respect and gratitude for. Other than the aforementioned technology and knowledge available, the “system” is much poorer than it was 30-40 years ago, when I went through a lot with it, when my Mom nearly died and then had a very long recovery. There have been multiple times the last few years that I was so PO’d that I wanted to sue the bleep out of somebody (and I am in general very loath to do that sort of thing.) But, the problem is not an individual or a particular facility, the problems are endemic in the system: How does one sue a system?

*I’ve discussed this with multiple friends, in similar situations, too, and their usual reaction is to see where I’m heading and say something along the lines of “Yeah, like nobody knows what the f*** is going on!”

This is to say nothing of my own gripes with Obama-McCain Care, which is bad enough, but I think its effect is somewhat like a pneumonia in a patient who vomits and aspirates in a vicious cycle.

You mention reducing Medicaid roles, but, what is the answer? To receive Medicaid one has to be dirt poor / with basically no money or assets. No one supports just abandoning these poor people, who indeed are often NOT poor in the beginning, but have simply exhausted their finances on medical care, Independent Living or Assisted Living or Nursing Home care, etc. These things are horrifically expensive. I know this story all too well, because my parents, who started off in retirement fairly well “set” (certainly better than I will be, it appears), have lived this horror story, and me with them.

Paul, there aren’t a bunch of quick solutions to the Medicaid problem.

For poor older folks, I’m not sure there will ever be one. Some form of bidding process might help, with health care players bidding as low as possible to get that business. Other than that, I don’t see a fix there.

As for folks who are financially strapped and still need health care on the government dime, I’d say the best way to reduce the Medicaid costs in the fifty states, is to create more jobs, get people back to work, and let them start picking up the costs of insurance, either personally, or through work.

We should be able to reduce those Medicaid rolls for 25-50% of the people on it. Some of the folks aren’t seniors. They can work, and should.

I am sorry to hear of your situation. I know that it is replayed in millions of households across the nation.

I wish there were quick fixes, but there aren’t any.

It seems to me that careful planning would alleviate part of this. We need to overhaul our SS and retirement service programs. We need to make people owners of their plans, and more responsible for their long term situation.

Of course some folks will always fall through the cracks. I still think we can minimize those numbers over time.

We need to get to work on this, so in 10, 20, 30, 40+ years on, we don’t have anywhere near this type of situation any longer.

Best of luck to you.