Republicans for Slow Medicine?

As of the last couple of years, biomedical engineering has seen explosive growth. Almost every university in the country now has at least a few faculty and a score of grad students in traditional engineering departments with "bio-" attached to their titles. The needs of an aging population are frequently cited as the impetus behind this effort, as the percent of the US, Europe and Japanese budgets and economies devoted to late-life medicine continues to rise.

This is hardly inevitable. Do-not-resuscitate orders are gaining popularity as people begin to assess the quality, not just length, of their lives. In addition to living longer, there's hints that large parts of the population might be making healthier choices about diet, exercise and entertainment (e.g., not smoking). Medicare is even encouraging doctors to have discussions about this with patients before they enter the painful, and expensive, portion of end-of-life care, so that the decisions are made by the patient, not family members under considerable duress. Slow medicine is a philosophy that incorporates these principles.

The House GOP 2012 budget makes sense in one of two ways. Either, they expect their tax structure to create superlative retirement savings for all seniors, that effectively the stock market's capital gains can displace the $38Trillion unfunded liability, or that seniors will chose to purchase less care than the government would provide for free. In other words, by capping the growth of Medicare spending, it guarantees that there simply will not be funds for both quality of and end of life care for beneficiaries, and lets individuals make the choice. Do they have perfect faith in the private sector to do what the government could not, or did the GOP officially embrace Dr. Dennis McCullough?

At first blush, I thought the primary goal of the new GOP majority was to increase upper middle class consumer purchasing power while maintaining social funding for elderly supporters. I also expected them to quickly move away from fiscal discipline and into social wedge issues that inflame more passionate support than actually cutting spending would do. If this new program provides both fiscal restraint and reballances the economy to invest in productivity instead of retirement, perhaps there is something to like about the new Congress. Not that any of this will matter, as recipients of Medicare today will smell a rat as an excuse to cut their services and see to it that it does not happen. Still, your pie maker was perhaps too cynical in his early assessment, and they do deserve credit for putting their careers on the line for a significant, if inadequate and politically unfeasible, change. (I still haven't read the thing in detail, and will have more to say once I do.)