Tick, Tick, Tick by Pat Conrad MD

time bomb

According to the Kaiser Family Foundation, Medicare payments for 2013 were $492 billion, and are projected to reach almost $900 B by 2025 (an annual growth rate of 5.3%, consuming about 15% of the U.S. budget).

A sister organization, the Commonwealth Fund told us in 2000 that “Elderly Americans fare surprisingly well compared with the elderly in other countries… Medicare goes a long way toward assuring access to health care for older populations—in stark contrast to adults under age 65, where the U.S. lags behind other countries.”

Well, its been a fun 14 years, and Commonwealth is singing a different tune. While grandpa was partying largely at taxpayer expense this century, the folks at Commonwealth have been ciphering and keeping tabs – now they tell us, “American Seniors Number One in Poorest Health Worldwide.”

Commonwealth surveyed 15,000 older adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.


  • 87% of U.S. adults who are 65 and older suffer from at least one chronic illness, and 68 percent have at least two illnesses.
  • 53 % of older Americans take at least 4 meds.
  • Both of these numbers are the highest in the surveyed nations.
  • 57 percent of U.S. seniors said they were able to see their doctor the same or the next day when they were sick, compared with 83 percent in France and New Zealand, and 81 percent in Germany.
  • Americans use of emergency rooms was one of the highest, at 39 percent.
  • 86 percent of U.S. seniors and 82 percent of seniors in Switzerland were able to see a specialist within four weeks. Senior Canadians, Norwegians, and Swedes fared the worst.

The study also states that our golden group pays the second highest annual out of pocket expenses (you beat us, Switzerland).

I didn’t read the study mechanics, but don’t we have to I wonder what the average longevity is in these respective nations. I wonder how we compare to the other survey nations in terms of Alzheimer unit, skilled nursing facility, and ICU occupancy rates. Yes I’m sure our pharmaceutical expenses drive up our numbers – so the Europeans are happy with generics? I wonder what the average testing expenses are per capita in nations with less trial lawyers, compared to ours?

The Harvard School of Medicine has built quite the legacy of graduating troublesome and meddling grads. One I’ve written about before and quoted by Commonwealth, Dr. Steffie Woolhandler, co-founder of Physicians for a National Health Program, is still chasing the butterflies of government compassion: “We need to be providing much more comprehensive coverage to everyone, including lower co-pays and deductibles,” she suggested. With what, Dr. Woolhandler?

With a largely flat economy and disrupted health care financing system, made worse by the increasing inflationary pressures of the Medicare/Medicaid systems? A professor of health at CUNY School of Public Health, Woolhandler doubtless has a different perspective than a lot of less quoted colleagues who have to worry about overhead.

“The retirement of baby boomers means pressure on Medicare will intensify,” said Dr. David Blumenthal, president of Commonwealth (which is not assuaged by Kaiser’s claim that there will be no major increase in per capita spending).

Studies like those of Commonwealth, and proponents of (more) nationalized care continue to advocate doing more with less. They have not yet explained how this alchemy will be performed, nor who exactly will do it, but the national debt is growing, and the clock is ticking.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]medicine.com 

  2 comments for “Tick, Tick, Tick by Pat Conrad MD

  1. Kurt
    December 3, 2014 at 4:11 pm

    Fp’s are expected to be nursemaids, guardian angels and health policemen. We’re not paid enough to do the first two and do not have the tools to be health policemen.
    People don’t care, they eat, smoke and drink what they want. In a rural area, 70 to 80% of the problems are brought on by lousy behaviors that none of the patients are being held accountable for. EHR doubles and triples the time it takes to “process” a patient. I tell medical students to stay away from straight internal medicine/family practice as they’ll will only be doing nurse practitioner work and get paid commeasurately lower.
    Better to specialize. Don’t have to worry about begging people to change their habits worrying about whether or not you’ll get canned with the latest “patient survey”. I have some really great anagrams for AAFP and ABFP but don’t want to give Doug reason to censor.

  2. Jay Cooperman
    November 28, 2014 at 11:04 am

    This problem will NEVER be solved by the health care system per se, because it is based on a lifestyle so toxic that only expensive drugs and medical interventions allow us to have longevity anywhere close to that in countries whose culture incorporates regular exercise and healthy nutrition. Until doctors and others people trust for advice begin seriously motivating Americans to get off the couch and shift to plant centered eating, we will not be able to stem this tide of chronic disease. We don’t need terrorists to destroy our way of life…we are rotting from within.

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