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Thread: Should We Allow The Uninsured To Die?

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by OscarB63 View Post
    which would be fine IF, repeat IF, ALL the members of society pitched in. problem is, the ones getting the most benefit are the ones who pitch in the least.
    That may be true in this system, but that's because this system is poorly designed. Here's something to consider. A blue collar worker benefits from having universal health care, and he doesn't pay that much in taxes. A wealthy business owner pays more taxes to be covered by universal health care. But the business owner also benefits from having all his employees covered by universal health care, so he doesn't have to worry about them getting sick. That's why it's called the common good.
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by tessaesque View Post
    I would say, yet again, that mandating insurance for everybody doesn't solve anything. Prices are still high, people will still not be covered, the system will still be abused by idiots who go to the ER because their kid sneezed three times in 24 hours. Instead of avoiding the real issues, we want to allow congress to violate the limits of their authority because.....why, exactly?
    So instead, just get universal health care. Simple.
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by atrasicarius View Post
    So instead, just get universal health care. Simple.
    I took a neighbor to the ER Saturday night about 10:30 pm. We left at 4 am the next day. The place was about half full with babies....there can't be much more soul-crushing than not being able to get access to well-baby care.

    I'm tired of allowing the poor to go without care -- especially the children. Universal care is the only sane option to me.

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by atrasicarius View Post
    Right. Because making money is obviously a higher goal than saving children.
    That's not what he said.

    He said that raw emotion should not be our main driver when crafting policy because we could end up with a very ineffective system that will end up collapsing on itself in a number of years, perhaps because people will want to help everyone for everything when in reality that just might not be feasible.

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by RiverDad View Post
    Notorious Right Wing Propaganda Machine, THE NEW YORK TIMES:


    When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1. . . . .

    The rule was issued by Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services and a longtime advocate for better end-of-life care.

    “Using unwanted procedures in terminal illness is a form of assault,” Dr. Berwick has said. “In economic terms, it is waste. Several techniques, including advance directives and involvement of patients and families in decision-making, have been shown to reduce inappropriate care at the end of life, leading to both lower cost and more humane care.”


    More on Berwick:


    Obama has doubled down on his unpopular Obamacare. The President ducked Senate confirmation and instead used a recess appointment to make Dr. Donald Berwick administrator for the Centers for Medicare and Medicaid Services (CMS). Berwick will be responsible for implementing portions of Obamacare. CMS has an annual budget of some $800 billion and is responsible for the heathcare of 100 million Americans.

    Conservatives are angry that the President used his extraordinary power to avoid a public hearing, which would have generated testimony from Dr. Berwick and may have exposed him as being too extreme to run CMS.

    Berwick’s public statements often raise eyebrows. Regarding end-of-life care, he told the Annals of Internal Medicine in 2002 that “most people who have serious pain do not need advanced methods, they just need the morphine and counseling that have been available for centuries.” This troubling statement doesn’t give much confidence to seniors that, as a bureaucrat, Berwick will care about costly end-of-life treatment when rationing Obamacare’s “benefits.”

    The doctor also professed his love for Britain’s Socialist healthcare system and favors a single-payer government-run system for Americans. He wrote in 1996 that “I admit to my own devotion to a single-payer mechanism as the only sensible approach to healthcare finance that I can think of.” President Obama avoided a public hearing for Dr. Berwick when he used the special appointment power used by President Bush and objected to by Senate Democrats at the time.


    Background on QALY ("quality-adjusted-life-year") that Berwick is instrumental in popularizing in health policy circles:


    If you are under the impression that it is impossible to calculate the value of a human life, you are obviously not a progressive policy expert or health care bureaucrat. This calculation, so elusive for philosophers and sages throughout the millennia, is child's play for such people. They have, in fact, already devised a formula for pricing out your life. It is called the "quality-adjusted-life-year" (QALY), and it assigns a numerical value to a year of life. A year of perfect health, for example, is given a value of 1.0 while a year of sub-optimum health is rated between 0 and 1. If you are confined to a wheelchair, a year of your life might be valued at half that of your ambulatory neighbor. If you are blind or deaf, you also score low. All that remains is to assign a specific dollar value to the QALY and, voilà, your life has a price tag.

    And, lest you imagine that QALY is mere academic concept unlikely to be applied in the real world, it is already being used in countries burdened with socialized medicine. In Great Britain, for example, the National Institute for Health and Clinical Excellence (NICE) uses "cost per QALY" to determine if patients should receive expensive treatment or drugs. It was with this formula that NICE calculated the precise amount six months of an average Brit's life is worth. As the Wall Street Journal reports, "NICE currently holds that, except in unusual cases, Britain cannot afford to spend more than about $22,000 to extend a life by six months." In other words, patients whose country has guaranteed them "free" health care are in some cases refused treatment because the incremental cost per additional QALY is too high.


    Death Panel type decisions have already started:


    According to Sally Pipes, president of the Pacific Research Institute, the FDA’s decision is not based on the best outcome for patients but instead on the expense of Avastin, produced by Genentech, which can run as high as $90,000 per year for a single patient.

    “The FDA claims its decision had nothing to do with Avastin's cost and was based solely on the drug's medical effectiveness,” Pipes said. “This isn't believable. Every year about 40,000 American women die from breast cancer. Avastin is the last hope for many not to meet that fate. While the drug is costly, it often provides immense benefits to patients.”

    Avastin works by cutting off blood flow to tumors, and it has been used by thousands of women to treat late-stage breast cancer. Pipes points out clinical studies have shown improved survival rates for women who use the drug.

    “By restricting blood flow to tumors, the medicine can decelerate cancer growth. In one clinical trial, 52 percent of women saw their tumors stop expanding or spreading. Some have gained years of extended life.

    “Most major cancer groups think that's enough. Susan G. Komen and the Ovarian Cancer National Alliance urged the FDA to maintain approval of the drug, arguing that treatment choices should be left to patients and doctors—not a government agency,” Pipes added.


    As I noted above, I have no problem with the concept of rationing medical care, my problem is with the centralizing of that decision making authority. This is where I part company with conservatives who oppose ObamaCare - they pretend that we can continue to have a system characterized by no rationing. They're delusional if they actually believe that. My position is to put the rationing decision into the hands of the patient and/or immediate family.
    You do realize that what YOU are referring to as death panels is already fully extant in private insurance, right.

    "Lifetime limits" is one term used.

    End of life COUNSELING is just that. "Got your **** in order? How much effort do you want expended extending your life? Shall we spend just your entire estate or bankrupt your family as well."

    For profit insurance fulfills its legal mandate to its shareholders in one of two ways.

    Raising premiums.

    Reducing care.

    Everything else is peanuts.

    And the top payed CEO in health insurance earned $23,000 an HOUR one year. Authorized by stockholders. Tidy profits. Enough so ya gotta wonder how much waste would have to be commited by govt to affect actual cost of care, when profits justify salaries of this magnitude. How many thousands an hour OVER 23,000 are they pulling down to authorize a compensation package that large?
    Anyone wondering what I'm talking about start here:
    The Psychology of Persuasion

  6. #226
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by What if...? View Post
    You do realize that what YOU are referring to as death panels is already fully extant in private insurance, right.
    Having a 1,000 different "Death Panels" administered by 1,000 different insurance companies and regulated by a neutral referee (government) is a far cry from having, eventually, only 1 "Death Panel" administered by the entity which is supposed to be the neutral referee.

    When Government doesn't have a stake in the outcome it can be more effective in making neutral decisions than when the government benefits by restricting the provision of health care.

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by RiverDad View Post
    A social welfare state needs money in order to operate, just like a body needs blood to keep all the organs functioning. A rich person provides a lot of money for the social welfare state to spend. A poor person provides no money, in fact, they are the recipient of money provided by the rich person. In a social welfare state the rich person is more valuable than the poor person. If you could conduct a Gedankenexperiment and vaporize the top 100,000 income earners in the US or the bottom 100,000 income earners in the US and then measure the effect of those vaporizations on the rest of society, you'd find that all of the wealth that the top 100,000 generated via their talents has been lost to society and that society is now measurably poorer for having lost those 100,000 top income earners. On the other hand, with the bottom 100,000 income earners vaporized you find that society is now measurably richer because the wealth that is extracted from the NET CONTRIBUTORS of taxes can now be allocated to a smaller base of NET RECIPIENTS, thus making all of the recipients that much better off.

    In a non welfare state, that is in a society with no government mandated wealth redistribution, if you did the same Gedankenexperiment there would no spillover effects to the rest of society for governments don't redistribute wealth and because of this the wealth that disappeared would have no effect on the rest of society. In this society everyone's life is valued equally.
    Rent is government enforced wealth distribution. Encircling of the Commons. Started about the 14th century in Europe. COMPETELY a product of government. Without it, private property is limited to what you can personally defend. All the other things you rail against are ALSO a product of government.

    You pick and choose, as many do, what is "good" government and what is "bad". Landlords have nothing to sell without enforcement of various vagrancy laws, which obviously levy a tax of 25% or more of gross on ALL renters. Enforced by men with guns in the employ of the GOVERNMENT.

    You keep trying to divert with some kind of "that's the way its always been" argument which is false on its face. Then bitch about some OTHER function of govt you don't like like only THAT thing is subject to revision.
    Anyone wondering what I'm talking about start here:
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by Helix View Post
    Certainly seems a much better idea to expand Medicare to cover everyone. This is just one more example of an essential service with inelastic demand not being best served by for-profit companies.

    Mandating private insurance is one of the most inefficient ways to address the problem, but people think offering health services equals communism. So if you want to keep your "free market" for every non-communist under age 65, you'll have to buy in.
    An insurance mandate is the only semi-practical alternative the conservatives could come up with as an alternative to UHC that the rest of the industrialized world uses. It is far from ideal, and IMO will eventually have to be replaced with UHC.
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by tessaesque View Post
    Single payer doesn't address the problem either. All it does is set artificial pricing levels, which will lead to rationed care and limited access to the more expensive (but often best) diagnostic tools and treatmeant options.
    We already have rationed care and limited access to health care. What the statistics show is that more people have access to health care under UHC.
    Treat the earth well: it was not given to you by your parents, it was loaned to you by your children. We do not inherit the Earth from our Ancestors, we borrow it from our Children. ~ Ancient American Indian Proverb

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by RiverDad View Post
    Your Kung-Fu is strong but my Kung Fu is stronger. Hah. Hah.

    I have anticipated your response and that is why I referenced "income earners" instead of "wealthy people." The income earners are using their talents to create new wealth every year whereas the wealthy are riding into the future on the benefits that they've already earned in the past.



    This puts the state into the position of Death Paneling people. You note that it is in the "state's interest." That's the problem that people have with Death Panels.

    I don't want the value of my life to be calculated by some bureaucrat who looks at what I contribute to the state versus what I cost the state. When people become dependent on government's money and good graces then they are also at the mercy of government. I'd rather know that I have a fixed amount of resources available to me with which I have to provide for my expensive medical care needs and know that when it comes time to ration those resources that I, or my loved ones, will be making the decisions and that if there is money to be saved that it be saved and allocated to help my family and that if they don't want the money then they can decide to blow the whole wad on keeping me alive hooked up to machines for another 4 months. Society really has no business involving itself in my end of life choices and journey.
    Sorry, still don't see your cite from the ACA that rations care. What page and section? Sorry if I missed it in your wall of opinion.
    Anyone wondering what I'm talking about start here:
    The Psychology of Persuasion

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