Some Simple Economics

I am not qualified to discuss more than simple economics. As we near the election, there is some discussion of Medicare and other senior related issues.  It’s a good idea to have our own thoughts on these issues. I wrote about some still good ideas following the last election. Here are more.

Before we get to solutions, what facts make problems (remember- simple)?

• More Older People.
• Higher costs for medical care.
• More use of medical care as we age.
• Fewer payers into the social systems/tax base, especially per older person.

Those few facts tell us we have to do something. As we see in companies recovering from the recession, successful turnarounds are not about silver bullets. They are about a series of incremental changes. That is a good model to expect for helping our housing and care systems. It is not about cutting benefits OR raising taxes. It is about incremental changes to the system so we use our resources more effectively. We can institute changes like wellness, prevention, applying what we can afford when it has significant impact, helping ourselves by self managing our conditions …and over time our current problems will fade. New problems will emerge. Bank on it.

Aging in Place 2.o describes one part of the new system.

People often ask me “Where will the money come from?”

My answer has been, “in the end it will come from the savings of a good and responsive system.” I now recognize that is quite a leap. Our healthcare system is too large to change in increments small enough to test. And the budgets for medicare and medicaid are too tight for experiments. We need to build and test and experiment on many fronts. Small tests. Succeed and fail. Learn. From knowing we can build a better system.

Where will it start? In smaller communities of identification, responsibility and caring. We have many self identifying communities in this country- unions, pensioners, service organizations and religious affiliations are some. These are communities, and small enough to recognize their intra-responsibilities (caring).  They are large enough to exercise group buying power. They are also large enough to spread risk. That gives providers small capitated groups of middle income and higher payers over which they can offer quality service. Together buying groups and providers- partnerships– can experiment with the wishes, parameters and metrics of successful service delivery.

I am pretty sure this will not become campaign fodder. Besides, it is not up to the government. It is about responsibility- in groups – community.