"Wes" wrote in message
...
"Ed Huntress" wrote:
Somehow, there seems to be this idea that being able to pay for what you
get isn't
supposed to apply when it comes to healthcare.
Yeah, that's true. It's an ethical problem that's been unfolding for a
half-century. We're getting down to brass tacks now, and the issue is
going
to be an important one in the years ahead. We have more medical technology
than we can afford.
And if it means living or dying, everyone wants it. Politicians deal in
the world of
giving things to one group by taking it from another group. Well not all
but that seems
to be the normal Modus Operandi.
Now if I'm paying for mine and government taxes it to give it to someone
else thus
diminishing my ability to obtain something I need and could have paid for,
how is that
right? You can rob the rich and they still have something but when you
rob the middle
class, they don't have much left.
The Can of Worms is now officially opened! d8-)
It's a tough one, Wes. Nothing is going to work unless we get really serious
about putting medicine on a more rational footing and get those costs down
to something like the better examples in other developed countries.
Otherwise, we're all screwed.
FWIW, I don't think we're going to be able to do it, politically. In other
words, I think we're all screwed. Doing something really sensible, like the
plan they have in Switzerland, which doesn't interfere with *anyone's*
ability to get whatever care they can afford, but which still covers
everyone in the country with decent care, just isn't in the cards for the
US. I've been skeptical about the whole thing for a long time. It's
necessary, but probably undoable. We've screwed ourselves.
Doctoring and nursing doesn't look like a vow of poverty line of work.
There are huge
time and monetary costs involved in achieving competence. That needs to
be rewarded for a
continuing flow of new people to enter the medical profession.
Agreed.
So how do we do this? Every man on his own, no one has more than the next
guy, or some
rationing scheme?
The rational thing would be to have a board of experts who really know what
they're doing; who are invulnerable to lobbying interests; and who are
devoted to implementing the best possible medical care for everyone. Tell us
about such a board for *anything* in the US. Hahahahahoho...
It isn't worth getting into it again, but the "free market" approach doesn't
work with healthcare. For example, when you need a heart transplant and you
just can't afford it, do you say, "oh, well, I'll just do without, and die"?
It isn't like buying a new boat.
Perverse incentives are everywhere; real competition is almost nowhere. And
we're seeing how incapable the political process is of dealing with it. In
the US, markets and Congress are almost all we have. They're both incapable
of solving the problems. They can give us good care, but we'll all be broke.
As you mentioned, the technology is expensive. I've never had a MRI or
CAT scan. The
most high tech thing I have had was a ultrasound of my heart a few years
ago. Something
that I'm going to get done again before my deductibles reset since it has
been a few
years. So far I'm dining on the cheaper part of the medical menu. Couple
hundred bucks a
quarter for drugs and I'm hanging on.
May it remain so for a very long time.
I'd love to have the best cardiologist in charge of my care but you know
that isn't going
to happen and I'm afraid many people clamoring for the 'public option' and
other 'reforms'
think they are going to get the best at low cost. It isn't going to
happen either.
Right.
The one change that I'd have really liked to see would be to have access
to the same menu
of plans that government employees have. We would be still dealing with
an insurance
company but depending on how much we want to devote to coverage, our
level
of care would
follow our willingness to pay for it. We also could change insurance
companies once a
year if we picked a poor choice.
Well, it isn't going to happen as long as insurance companies have more
lobbying power than God.
Do you really think they came out of this in good shape so far?
They're hanging on tenterhooks, but if they get 10 - 20 million new
customers who HAVE to have insurance, there will be big doings in the yacht
clubs next summer.
As far as more lobbying power than God, where does the financial industry
rate? 
God's Other Son. g
I fear we are working towards no choice at all.
Wes
Insurance choices will be limited. That's inevitable. But it's not
inevitable that we'll be limited in *medical* choices. I don't see any
likelihood of a plan in the US, or in most other civilized countries, in
which you can't pay for extras on your own.
I thought Canada forbid private practices but looked the other way because
their system
would collapse without it. I'm not fully up on Canada other than
understanding their
health care is regulated at the Province level.
There are many myths about Canada's system. Around 30% of their care is
privately funded, either through private insurance or direct payments.
But it's not that simple. Wikipedia does a fairly good job of explaining it,
at least in the introduction:
http://en.wikipedia.org/wiki/Health_care_in_Canada
Also check the "Private Sector" heading in that article.
--
Ed Huntress