Costs - Lifestyle Maintainance Costs

Each morning, I have coffee with a small group of a dozen or so older gentlemen in our town. We discuss domestic, foreign, and health affairs.

I’m the only doctor in the group. The others come from other layers of society – politics, law enforcement, small business, corporate America, insurance, and skilled workers.

Most are on Medicare, have company health benefits, or supplemental plans. Most trust their doctors. All expect prompt and immediate attention should they come down with health problems. Their ages range from 60 to 91. All function at high levels - at home, socially, and on golf and tennis playing fields.

They share with me and each other their medical problems. They’re grateful to be so active, able, and willing at their ages. Almost to the man, they have active lifestyles because of medication support, CT and MRI scans to diagnose their conditions and medical “repairs” of their aging joints or organs.

• Three cataract procedures

• Five removals of skin cancers or suspicious lesions

• Ten on various drug regimens for lipid control, hypertension, cardiac problems, pain, gout, or GERD.

• A unilateral partial knee replacement

• Bilateral total knee replacements.

• Two total hip replacements.

• A lumbar disc fusion.

• A cervical disc fusion

• Metal rods in the sternum and vertebra

• A coronary bypass

• A coronary stent

• A common iliac prosthesis

• A rotator cuff repair

• A shoulder replacement

• A periodic bladder “wash” to treat in-situ bladder cancer.

As I have talked to these gentlemen over the years, I have come to grips with three realizations.


1. They think of these drugs, scans and repairs, and prompt access to them, as the expected standard of care in America.

2. They’re grateful to be alive, kicking, pain-free, and productive at their ages.

3. They’re only dimly aware, nor do they care, that much of the cost of medicine in America goes to keeping folks like themselves functional.

How can Medicare rein in these types of costs? Should it? I have no idea. I know these gentlemen well, and in my opinion, the procedures done upon them were indicated.

They have paid their dues during their working lives, and they expect returns on investment for their blood, sweat, and tears.