I disagree with how you're presenting your scenario. I don't come at this issue from desperation or cost savings, I come at it from creating an incentive system and holding people accountable for their own choices. Providing full medical care to people who choose not to buy insurance is rewarding that choice - why should you and I buy insurance if we know that we'll get the same level of care if we skip it?
Exactly. Insurance is designed to cover rare events, not everyday expenses. The cockamamie system we have now is like having auto insurance which pays for every fill up, every car wash, every oil change, every tune-up, every tire balancing, every windshield wiper replacement, etc. Auto insurance covers rare events, like fender benders, like being sued for a million dollars for an accident you caused, like your hospital care if you injure yourself in an accident you caused, etc. These events don't happen to people every day.
Okay, now you have some points that are different from the original basic question.
Yes, part of the problem is a lot of people get very sick, nearly die, are saved by medical intervention.... but sometimes they don't simply get well and go back to work. They have ongoing issues that may render them disabled. If they lose their job they may lose their health coverage. (COBRA is a joke, if you're unemployed you can't afford to pay four times what you were paying before). They may end up uninsured, but with ongoing medical needs they can't pay for that are needed to keep them alive, or maybe to provide some reasonable quality of life. This describes most elderly person's last 2-5 years of life... but sometimes this can be a younger person and the situation may go on for decades.
Now, when society ends up paying this person's medical bills.... regrettably yes, there does come a point where the question has to be asked "is it worth it to keep this person alive a few more years at $____ expense?"
I really hate to say that... it sounds so ugly. Life is so precious it is appalling to have to put a dollar value on someone's remaining years. I lost both my parents in the past few years, so this sort of thing is fresh in my mind... but God knows I cherished the time I had with them, even in their declining years.
But still, we DO have to make that call at some point. If it is going to take a $750,000 for the treatments to keep Gramma alive in a nursing home bed for maybe another year or two, and she doesn't have the money or assets to cover it.... then we have to stop and think about how much we're asking society to shell out for this, and what the benefit is.
If $750,000 will restore some person to a productive working life and give them another 15 or 20 years, maybe it is worth it to society.
OTOH if $750,000 just means that Granny lays in the nursing home bed, struggling for every breath, trying not to take too much morphine for the pain, for another 12 months instead of passing away next week... maybe we have to ask if the time and the quality of life is really worth that much money out of other people's pockets.
I hate to put it that way; I hate to even think like that. But (no shock to those who know me), let me tell ya a true story...
My Mom was a little woman with a heart of gold, a whim of steel, and enough courage and determination for a longboat full of Viking warriors. :lol: She fought old age like a trooper. When she had to go on oxygen, she carried her small tank with her to the grocery store, the hair salon, church, family gatherings and wherever she wanted to go. She seemed unstoppable.
But no one is, in the long run. Three years passed and she was no longer able to drive herself. Another year passed and she could barely walk from room to room, and never left the house again except to go to the doctor. Life became a series of health-crises and rides to the ER that she barely survived, growing closer in frequency. She, who had always done for others, decided she no longer wanted to live as a disabled person utterly dependent on others. A few months more and she had another crisis, another trip to the hospital. They wanted to intubate her and put her on a respirator... they told us that this time, she probably wouldn't come off of it and would spend her last weeks like that. We said no... she'd been on it before and hated it. We called in hospice and made sure she was as comfortable as possible, and waited. In a few hours time, she passed away with her family around her.
I'm pretty sure she preferred it that way; in fact she'd told me things that lead me to beleive that she would've preferred to pass on around the time she couldn't drive anymore, almost two years earlier. The quality of life wasn't worth it for a woman who'd always been a dynamic powerhouse.
This shamed me, because the previous two times she'd gone to the ER in the past year, it had been because I
made her go... she didn't want to, she wanted to die at home.
Sometimes we hang on past the point of all reason, when what we need to do is let go.
Anyway... my 0.02
G.