Monday, September 21, 2009

A Proposal for Preventing Health Care Reform from Burdening Our Country

A Proposal for Preventing Health Care Reform from Burdening Our Country

Every day 14,000 Americans lose their health coverage. More than 46 million people are without health care. But maybe many of these people really do not deserve and should not receive health care. Just because someone is poor or ill or disabled does not mean he or she deserves health care.

Similarly, many of the remaining millions of people who are already paying for private health insurance or are receiving publicly funded health care do not deserve the benefits they take for granted.

We must cut costs and the only fair way is to deny health care to all people who do not deserve to receive it.

Throughout the current health care debate, we have worn blind folds. In darkness, we have each touched a part of the health crisis, like the elephant’s tail, trunk, or ear. Based on what we touched, we thought we understood the problem and had the answers.

But just feeling up part of the animal is not enough. The trick is to figure out how we decide who really should not receive health care. Who is unworthy of receiving it? How we can persuade them not to request or receive health care? Once we figure this, we will significantly reduce our health costs.

The goal: Increase the number of people among us who should not receive health care because they do not worthy.

We have assumed that there is a health care crisis because of the health care insurance companies, the pharmaceutical drug companies, the doctors and hospitals, and the lawyers. But these folks represent only part of the trunk and the elephant’s left front foot.

No, the cause of the health crisis is much bigger. It’s them - those people who do not deserve unlimited health care – for themselves, for their children, for their parents.

Let’s look at some categories of them, where we might be able to increase the number of people who should not receive health care, leaving more for the deserving ones.

The Oldest People

In this category people over 90 and maybe even over 85. But the years are not the crucial criterion. We know that in the last year or two of their lives is when most health care funds are expended per person. Health care in these years is extremely expensive, and for what? A few more years. A few years of what? Visiting doctors and hospitals? Pain, worry and discomfort? Cost?

Most older people want all the health care that exists, and if it doesn’t exist, it should be invented. Don’t discuss costs. Ask this group if they deserve to receive unlimited medical care and bankrupt the rest of the country for their health care and they’d not flinch - “we earned it.” Well, maybe many of them did not pay into the system anywhere near what they’ll get out of it, but why quibble. And anyhow, the deserve equation is not just a money-in/money-out calculus.

These older geezers sound like they’re against any change. So what would they accept?

Here’s a deal that many seniors might accept, and will save trillions in medical costs. When your doctor thinks your last few years have arrived, you become eligible for a month or maybe two of free room, board and transportation to anywhere in the continental USA. If your doctor believes that these last few years could be especially expensive medically, then we’ll consider Alaska, Hawaii, and Puerto Rico. If the old person will agree to a three year program, then we’ll provide a free two month cruise and funeral expenses. In exchange, the senior must agree to forego any non-routine medical care for the number of years bargained for. Pain medications will be provided gratis.

The “Preventable Chronic Disease” People

The following people should be denied health care because their diseases are their own fault. Given modern medicine’s advances in genetics, if a person can genetically establish “no fault,” then we’d give them a pass.

The Obese People

Now we all know that anyone who really wants to control their weight can do so. There is no excuse for people stuffing their faces with greasy hamburgers and french fries, or drinking soda with all the added sugars. If they eat like that, why should they expect our health care system will cover them? Stuffing oneself should have consequences.

Isn’t it time we stopped blaming the food industries that just want to make money? Attempts to change consumer eating patterns have failed. Therefore, let them eat whatever and however much they want, as long as they agree to live with the consequences and we don’t have to pay their health care.

OK. Obese People have heard of the deal we made with our grandparents and even though they might not deserve it, let’s see if we can make a deal, so we can save medical costs. We agree to pay for one year in a gym of your choice. In return, unless you lose by the end of the year an agreed on number of pounds, you will receive no medical care for the next two years that can be related in any way to obesity.

Shouldn’t the same principle apply to children who are obese? It’s never too early too deny health care to a kid who keeps eating and does not exercise. Let them learn early in life that there is no free health ride; suffering will benefit them later in life, if they survive.

But since parents are in control of what their children eat, or at least are supposed to be, then parents of obese children should also be punished and denied health care for themselves. It’s also never too early to make parents act like adults.

The Smoking People

Smoking has been a recognizable cause of “preventable chronic diseases” for many decades. Since this has been known for many years, we should “just say no.” Sorry. You smoked knowing the potential adverse effects and now you want us to pay for your choices? You’ve got to be kidding. No deals.

The No Immunizations People

These parents are a real problem because their choice not to have their children receive immunizations affects their kids, who have no say in the matter. If their children come down with a preventable disease, maybe the only option is to take their children from them, involuntary relinquishment of parenthood, and then we treat the children. Harsh, .sure, but what are the options?

The Avoidable and Unnecessary Hospital People

Hospital costs make up the bulk of the health care system. Sure, many people need and deserve to receive care in a hospital, and the present proposal will not impact them. But what about people who do not manage routine conditions that with minimal proper care will avoid hospitalizations? For example, people with asthma or bacterial pneumonia often just don’t follow their doctors’ rules. They don’t use their asthma inhalers, don’t refill prescriptions on time. Then why pay for their hospitalizations? In this group, let’s not forgot those No Helmet People and the Car Drivers Above Speed Limit People. No medical care for their follies.

The Hypocrite People

Let’s not forget those federally elected officials (and other federal employees and their families) who use and accept a publicly funded, single payer health system that they agree is the best. Yet, among them are elected officials who fight against any public option for the rest of us. Have they forgotten the Golden Rule? These officials should either entirely relinquish their and their family’s public option health benefits, or let the rest of us share the benefits.

Our senior citizens, who have worked so hard and long, receive Medicare health insurance, another public option. They want to keep their public health care and are afraid that if non-seniors had a similar option, then their Medicare benefits might be reduced. They want to keep what they have. The seniors should be told that they taught us as children to share our toys with other children, and yet now they forget their teachings. They too should be reminded of the Golden Rule.

The Oldest People, The “Preventable Chronic Disease” People, The Obese People, The Smoking People, The No Immunization People, the Avoidable and Unnecessary Hospital People, and especially the Hypocrite People, under my plan these folks will do fine without health care, and anyway, they don’t deserve it.

Stephen F. Gold, Esq.

An attorney who specializes in disability

Phila., Pa.


C -215-498-0689

H – 215-232-2228


  1. Mr.Gold:

    Extremely perceptive and hits the proverbial health care reform "nail" right on the "nattering nabobs" head.
    Another suggestion to build on your ideas is to convene "darth vadar" panels for people of various ages and health status and select those to be "rationed" by using a lottery system so it wouldn't be perceived as discriminatory.
    This could bring about amazing cost savings. Instead of using expensive medical professionals and technology to implement the lottery selectees, use the private sector corporation Terminex. They are experts in what they do, have a proven track record and would not only save money but boost employment. Other benefits of this approach are population control, less stress on resources and maybe even climate control. Your tome opens up a pethora of opportunities for postive social engineering. May the Force Be With You!

    Yoda Alive in a Wonderland Nation (YAWN)

  2. Not since 1729, when Swift took pen to paper have we enjoyed such insight.

    Keep Blogging!

  3. Great essay, Steve!

    No pressure, but I linked this on the NDY blog, put it on my Facebook page - and told everyone that you would be doing this on a regular basis.

    (OK - the first part is true, but I didn't make any predictions or promises about how often you'd post.)

    Hope you can find the time to do this on a regular basis.

  4. Linked via Not Dead Yet, Stephen Drake's latest
    posting. I had a bit of trouble (CFS/ME cognitive) at the start, irony - in understanding. Some good points. Welcome to the blogosphere. I bookmarked it.
    P.S. Am a big "fan" of lawyers; worked for LCDC,
    Lawyers Constitutional Defense Committee in NOLA, mid1960s. Am artist. Did research (former teacher), art and general office work as needed.

  5. There's a missed category: people who fall and hit their heads frequently, necessitating emergency room visits, and multiple neurological exams for follow-up.

    Surely, they should receive those expensive ER visits and follow-ups only on a random basis, to reduce the cost of their care. Of course, they would benefit by not waiting 12 hours in the ER for doctors to treat trauma victims (which they once were).

    Thanks for your Swiftian Modest Proposal!