The Federal promise to pay unlocked a cornucopia of medical innovation - chemotherapy, dialysis, GI endoscopy, eye surgery, interventional cardiology (your stents), support for respiratory failure, critical care, the list goes on and on.
What's wrong is the idea that all those things are desirable because they save money - they don't.
23 days in a 1965 hospital, with a bed with a crank, nurses to sit at your side with pain medicine, and hot food three times a day is cheaper - a lot cheaper - that mobile coronary care, cath labs, and stents.
Those things cost money, and oodles of it.
When Medicare was being debated, I was 13 and 14, and when my doctor Dad had his friends over I listened to everything they said.
My Dad was one of the first interventional cardiologists in America. He worked out of a ranch house near the hospital with one employee (what back in the day was charmingly called a "one girl office"), and he forgave bills to people who couldn't pay. Sometimes he accepted food as payment, or a doll for one of my sisters. The year he died, his cardiologist made $13 million dollars.
Congress modeled its Medicare cost estimates on expenditures by or on behalf of over 65s from 1954-1963.
Based on this, they could confidently declare that 25 years out, in 1991, Medicare would cost $8 billion.
In fact, it cost $800 billion, because the government paying for pacemakers and cataract surgery turned out to be a lot different from families choosing between the children's college fund and the small chance of harm to grandpa from foregoing a device that might cost $100,000 or more.
If Congress had chosen to pay for the $800 million with real money, and not debt and inflation, we wouldn't have needed "Obamacare".)When Ponce de Leon landed in Florida in 1513, he was looking for the Fountain of Youth. With Medicare and all of its children, Åmericans still seek it, and trust me, money is no object as long as someone else is paying.
An operation takes place in a room.
There is a surgeon. He has gown on. He will refer to an imaging display device.
This is a nurse with a gown on and a cart with a set of scalpels, some hand tools such as clamps, some suture material and sometimes a stapling device and staples. She also has a suctioning device.
There is an anesthesiologist. He has an anesthesia machine, a heart monitoring machine, some gas tanks and tubing, and a mask. He will also have a syringe and a tube with a pre-induction drug. He will have a few other syringes and off-patent drugs in case there is a problem.
Sometimes, there will be a heart bypass machine and a nurse to man it.
The patient is placed on a bed and draped.
It might take about 15 manhours for these people to do their work on the patient, on average.
The patient might have worked 80,000 manhours.