Friday, July 29, 2011

After the Debt Crisis Resolution, The Deluge

After us, the deluge.

Attributed variously to Madame Pompadour and to Louis XV, after the crushing defeat of the French at Rossbach, 1757

July 29, 2011 - What comes after the debt crisis, the resolution of which all the politicians and the President tell us today is inevitable?

I am not so sure about the resolution, but I am sure of this.

After the debt crisis ends, the deluge will be a deadlocked heated debate over what to do about how, how much, and when to cut from Medicare and Medicaid.

The first salvo came this week in the form of ubiquitous TV ads featuring three people – an older white man, an older white woman, and an older black lady. The three are saying, ”What were you thinking when you decided to cut $100 million out of hospital care for Medicare and Medicaid? What were you thinking?”

What they, the politicians, were thinking, of course, is that hospital costs for Medicare and Medicaid patients are the biggest single force driving government health care costs and the national debt.

Unfortunately, what government giveth is very hard to taketh away.

The demographics of aging, the influx of baby boomers into Medicare in 2011, the coming of a guaranteed 32 million and probably millions more into Medicaid in 2014, the continuing demand for access to medical technologies the increasing desire for more physician services, the shrinking physician supply, the accelerating physician shortage, and the Great Divide between Democrats and Republicans on how to avoid certain Medicare and Medicaid bankruptcy and default will dominate Presidential debates leading up to November 2012.

The debate will be all about supply and demand - with demands – of money, programs, physicians, political will, and truth – exceeding the supply .

The three D's - Demagoguery, Demonization,and Demographics - will dominate the deluge debate.


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