Friday, September 26, 2008

Health Train Express reaches the end of the Tracks

Quote of the day:

The best way to predict the future is to invent it. - Alan Kay


Today several health blogs are beginning to write about what is happening to the American and perhaps World Economy.

We have been looking inward in healthcare, and most surgeons, and physicians are so busy with patients they at times don't even want to know what is going on in the world about them.  This is more than foolishness from a group of people who are far and away more intelligent than most others. ( I don't equate being smart with high intelligence).  Physicians need to be strong leaders not only in health care but in matters affecting finance, public policy, community health, education, and social welfare.  Physician leaders in the past were always at the center of their communities, on school boards, in advisory capacities to city and county and state councils.  We are not in control...nor should we be, but we certainly can influence and exert leverage on those who do make these decisions.

In todays Covert Rationing Blog ,Dr Rich elaborates:

"That tipping point, it appears, came last week.  And so, the American taxpayers, many of whom take great pains to live within their means and don’t borrow money they cannot pay back, are the only ones left to rescue the greedy and the stupid and the craven.


Assuming our economy does not actually collapse

over the next few months, and thus does not wipe out our entire social contract (to the extent that we will have to start all over, and thus render moot any concerns over any future fiscal crises our current social contract promises to bring us), DrRich would like to point out that, compared to what is coming, the economic crisis we are now experiencing is merely a trifle."

I think this is very well stated..

The only reason congress might announce a solution to the imminent collapse would be to placate and avoid a financial panic.

Tonight will be an indicator of the future. If congress 'passes' a bailout plan it will be no assurance it will happen as announced.

If it does not announce a plan, a rapid freeze of the financial system could become apparent over the weekend. WAMU  was the second largest commercial bank, and FDIC could not afford to insure their deposits without itself being imperiled; fortunately they found a private buyer. The system is more than stressed.

Whereas the newly-burst mortgage bubble has left us with an unfunded liability of merely (we think) something less than $2 trillion, our unfunded liability for Medicare alone, over the next several decades, is estimated to be between $25 trillion and $55 trillion.  Considering the fatal damage our current, relatively trivial financial crisis apparently came within a few hours of triggering, this sounds like a lot of money.

When this massive bubble bursts, not even the stolid American taxpayer will be able to backstop the crash. Unfortunately, heading off this coming healthcare tsunami will require us to acknowledge that healthcare rationing is unavoidable


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