[Tobra]

Angela, whenever I think about the medical challenges your father is confronting it makes my heart ache a bit. I have never met you, and I guess technically don't really "know" you, but what I do know is that you are a right dame and you are dealing with some pretty heavy stuff with aplomb. Your everlovin' Steve being on the other side of the planet can't make things any easier, but you are a pretty tough chick. I only hope that when the time comes for me to start confronting that parental medical stuff, I do half as well.

I like what Dan says about getting the finances in order first, but the issues are interconnected. Such a huge chunk of the expenses that are eating our lunch are due to healthcare.

When employers were prohibited from raising wages after WW II, they put the benefit packages together, as these were not restricted like wages. When the person getting the service has one or two degrees of seperation from what the service costs, the spare no expense attitude is not even a little bit surprising. A huge percentage of the average person's spending on healthcare is in the last 30 days of their life, contributing little to their quality of life. We must make difficult choices regarding this piece of the puzzle.

If the healthcare expenses are going to be subsidized in some fashion, there must be a mechanism to reconnect people to what they are spending. Perhaps a cost share based on income. This might sort of chap Hugh's ass a little, but there is a cream for that. Of course, a 15 gm tube would cost him $1700, to make up for all the people who don't have much in the way of income, so he might just choose to live with the red ass. People who have skin in the game, are going to pay more attention than those that don't, human nature.

Shaun would disagree, but tort reform will have a huge impact on our healthcare costs. A tiny portion of this would be in reduced malpractice premiums for doctors; little to none of this is going to get passed along to the consumers, but that is not where the money is. It is difficult to say how much is spent on practicing defensive medicine, but it is a LOT. There has to be some way to hold physicians accountable for mistakes, I confess I don't really know what a good way to do this would be. Peer review boards to field complaints and sanction them as appropriate maybe.

There are a lot of tough decisions that will need to be made. I don't see how politicians will be able to accomplish what will need to be done, because job number one for those mugs is keeping their jobs. If everybody is mad at you, you are not getting re-elected, and if things go as I expect, nobody is going to be all that happy with whatever deal is struck. I guess we could do it like the California Redistricting Commission, but that looks to be pretty mobbed up too, so maybe not.