Public's Psychological And Emotional Impediment To Fixing Medicare

If you talk to adults whose parents, one or both, are still living, many would tell you that it is worth spending money to treat parents' illnesses and extend their lives, even if the parent is severely ill and will only gain a few months of extra life. How could you deny a person a few more months of life or the possibility of a cure so that they could live a little longer, the adult child(ren) would likely say. Most of Medicare dollars are spent on the very old, those in their 80s and beyond, often in attempts to provide the elder patient a few months of life. How can money be an object, this is my parent and my children's grandparents, the adult children will say.

Yet, doctors have been in situations where Medicare has refused to pay for an elder's treatment. I have spoken with a few physicians, clearly not a statistically valid sample, and they have told me that adult children act differently and make different choices when it is their own money (or their inheritance) that will be spent versus government dollars.

While grown-up children will often fight for Medicare paid treatment, when Medicare will not pay, the children are given the option to get the treatment for their parent at their own expense. Invariably, when it is their own funds that will be spent on an expensive medical treatment, children are much more willing to forego treatment for their parent and to let the disease take its natural course.

Spending someone else's funds invokes no compromises. Spending one's own money involves setting priorities and making compromises, even about medical treatment for an elder parent.

People who work in hospices, where the goal is comfort and quality of life, versus curing an incurable disease or illness, will tell you how happy the patients (and staff) generally are.

Many people who have not faced an incurable illness will often underestimate their willingness to accept the inevitable. Adult children overestimate how much of their own funds they will spend to extend a elder parent's life a few months.

Of course, in all cases, people are more willing to spend other people's money and the government's money more freely than their own. If their there is not enough government money, just take more of other's money through taxes.

If people are not willing to spend their own money to extend their elder parent's life a few months, why should the government spend other people's money to do it.

With no skin in the game for adult children or their elder parents, there is a tremendous emotional and psychological barrier to reducing the most expensive part of Medicare.

To do it successfully, there needs to be a transition phase. Unless adult children and seniors get the experience of making medical choices using their own funds, having skin in the game, politicians will face a tough go in trying to curtail spending on very ill and medically expensive seniors.