Hurling Day cancelled?

For a change, I woke up to some good news. The Republicans lost a special election in New York state, the one to fill the seat vacated by the sudden resignation of Congress critter Chris Lee following his exposure as a Craigslist-trolling sleazoid, so maybe their plans for Hurling Day have been put on hold for awhile.

Hurling Day, as the S.O. reminded me yesterday, was the occasion when elderly dinosaurs hit the age (72) when they were considered past their sell-by date and were ritually hurled into the tar pits.

The woman who won the election, the Democratic candidate, isn't exactly a flaming liberal -- not surprisingly, given what a solidly conservative district it is, she gives every sign of a natural alignment  with the corporatist Blue Dogs in Congress, except she's not quite as openly willing to toss old people over a cliff as some of them, and she was also smart enough to claim she's not as evil as the Republicans. And that's what got her elected -- the willingness to say no to Hurling Day.

I do find myself wondering just when politicians will be able to grasp reality and approach the Medicare and Medicaid problems without getting bogged down in sound bites and fantasies. Because the naked truth is there is a problem, and it's growing: the proportion of the population who are the frail elderly, the octogenarians, nonarians, and geezers heading into their second century, is expanding, not shrinking. We've got more and more people living into their 90s and, let's face it, overall they're not a particularly healthy bunch. The geezers you see climbing mountains or going surfing are the exceptions, not the rule. Far more typical are the nonagerians who are frail and suffering from a multitude of chronic conditions: arthritis, congestive heart failure, chronic obstructive pulmonary disease, Alzheimer's. . . another sad truth is that the longer a person lives, the more likely it is he or she is going to slide over into dementia. It's all very well for politicians to bloviate about forcing people to retire later, but just how late in life can they realistically expect anyone to keep working? Even Walmart doesn't want 95-year-old greeters who are so frail from osteoporosis that a sneeze can crack a rib.

I lump Medicaid in with Medicare because it, too, has financial woes caused by an aging population. Medicaid is generally thought of as the welfare program that pays medical bills for the poor, i.e., those useless slackers on the dole. What most people don't realize is Medicaid is increasingly the program people rely on to pick up the tab for Grandma's nursing home care. Republicans have done a lot of talking about cutting the program -- I wonder how many of them have considered the backlash that's going to hit when more and more families get told to come pick up Gramps, he's being booted out of the nursing home for nonpayment? The alternative to Medicaid could be a hospital bed in an adult child's living room, which is definitely not a happy prospect for anyone.

Still brooding about health care

It's a good thing the S.O. isn't here. He might have had heart failure this morning. The idiots on C-SPAN and the morning news shows had me feeling so frustrated and pissed off that I resorted to doing actual housework in order to burn it off. You know I'm feeling frustrated when I'm on my hands and knees mopping the kitchen floor the old-fashioned way, with a scrub brush and a rag.

I think the one thing that had me wanting to reach right through the screen and strangle someone was the repetition of a flatout lie, over and over, that the problem with Medicare and Medicaid is the horrendous paperwork, just how incredibly inefficient the government is at processing claims. The Medicare program spends less than 5% of its budget on administrative costs, i.e., the paper shuffling, while the private insurance companies are spending well over 30% on administration.

Of course, there is one huge difference between Medicare and Aetna et al: the person running the Medicare program works for us. No multi-million dollar CEO salaries driving up administrative costs. Medicare is part of Health and Human Services. People may bitch about bloated government bureaucracies, but you can get an awful of lot of GS-5 clerks for the price of one private sector executive. Yes, the chief administrator for Medicare is making 6 figures, but not dramatically so. The senior executive service tops out at under $200,000 annually, although there would be locality pay adjustments on top of the base salary. Compare that with the over $15 million that the CEO for Travelers carried home in 2006.

Nonetheless, Medicare is derided for being expensive, cumbersome, and poorly managed. No wonder I felt like scrubbing floors -- the alternative was brain bleach, and that's hard to come by.

(The other thing that drives me right up a wall, of course, is hearing over and over that we don't want government bureaucrats making decisions about which medical procedures are necessary. Given that the first words out of my doctor's mouth every time he's contemplating ordering a lab test or prescribing a different drug are "I'm not sure your insurance covers this, let me check first," that argument doesn't have much traction with me.)