Ah, you're talking about lifetime costs. I was thinking in terms of per-incident.
You also seem to be thinking in terms of end-stage "keep them alive vs. let them die" issues. I was thinking more along the lines of toothaches, infected cuts, etc. Yes, it does get more complex - both medically and morally - as the patient gets older.
I'll agree with you on the "hellishly complicated" part though. The politics of elderly care are a moral minefield.
> Ah, you're talking about lifetime costs. I was thinking in terms of per-incident.
Lifetime is the only rational way to think about it on "govt scale".
Per-incident is really hard to sample correctly. Yes, if you can get someone to not be diabetic, you've saved money, but we're already trying a lot of preventative care so if you look at the incidents as opportunities, you're wrong.
Yes, we're already doing a lot of preventative care, and we're not seeing the results that its advocates claim. (Simple example - Every doctor already says "lose weight".) Most chronic diabetes folks are fairly resistent to preventative care, at least the inexpensive sort, and the expensive stuff isn't close to cost effective AND they backslide.
Here's a question - smoking has gone down by 50% over the past 20 years. Are we spending less on lung cancer?
> The politics of elderly care are a moral minefield.
Yup. 70% of US medical spending is on old people. If you're going to cut spending by 30%, a huge fraction of that has to come from old people.
You also seem to be thinking in terms of end-stage "keep them alive vs. let them die" issues. I was thinking more along the lines of toothaches, infected cuts, etc. Yes, it does get more complex - both medically and morally - as the patient gets older.
I'll agree with you on the "hellishly complicated" part though. The politics of elderly care are a moral minefield.