It's your Dime

I do think it's time to self-examine American values or the lack thereof. Here are some questions I have been thinking about.

Can free market principles work for healthcare when there is a moral imperative to treat those needing medical attention, whether or not they can pay?

How would government paid healthcare differ from insurance paid healthcare when both are designed to spread cost risks over a population?

well freeduck I am guessing that this thread will go nowhere, I don't really think it's enough of a topic to meed the needs of those that need to rant rather than actually try to face really difficult decisions about their own values.

FreeDuck has again gone to the core of the question. Is there such a moral imperative? Finite resources is right, as Dys says, but it applies to medical resources as well as dollars. We could well be close to the point of triage, at which time we just have to choose between treating comatose, terminally ill patient #1, or treating #2, who has a better chance of benefiting from the treatment.

dys- I think that you have hit on a very important question. I really need to think about it, and to couch my responses in a way that I won't start a war!

I definitely think the healthcare system is more broken than social security. But what to do, what to do? I researched this pretty thoroughly during the presidential campaign but not much seems to have stuck. I'll read along with interest and maybe re-do some research.

of course it's a national issue, but it's also a personal issue. For myself, I had my stroke last year and was able to cover the expense, I can't have another because I can't afford it. That does not leave me many options if you get my drift. I think Roger has made the point, we as a society are currently operating a triage health care system with dollars being the criteria, priorities must be decided and allocations made for those decisions we make above and beyond "moral" or "political" boundries.

BBB
I originally wrote this in 1978 when I was a representative of the Union of American Physicians and Dentists. We were trying to alert the medical profession of the dangers of HMO managed care and what doctors needed to do to continue to represent the interests of their patients in the face of control by profit motive organizations. I think this parody pretty much describes the status of our health care systom.---BBB

SCHUBERT'S COST-CONTAINED UNFINISHED SYMPHONY; A NEW PERSPECTIVE ON HEALTH CARE REFORM
By BumbleBeeBoogie

Have you ever wondered what would happen to the quality of your medical care under a draconian rationing program in your health plan? Let's look at it another way. Imagine, if you can, how a Bach fugue would sound with a harmonica instead of a pipe organ; a Sousa march without a booming tuba; or the Beatle's without Ringo's throbbing drum beat. Would the quality of the music be affected? Would you want to listen to it? Now, apply these examples to understand what could happen to the quality of medical care under the cost-containment goals of a health plan. Imagine Schubert's Unfinished Symphony as it would be performed by a civic orchestra under these circumstances.

The following memo from the symphony's treasurer may make you sick---but with laughter:

Under the Symphony's new cost-containment program, the attendance of the orchestra conductor will be unnecessary for public performances. The orchestra musicians obviously are required to practice. They have the conductor's prior authorization to play the symphony at a predetermined cadence and at an expected level of quality. Considerable money will be saved by merely having the conductor critique the orchestra's performance during a retrospective peer review meeting.

For considerable periods, the four oboe players have nothing to do. Reducing their numbers and spreading their work over the whole orchestra will eliminate peaks and valleys of activity.

Dispensing with either the snare drums or the kettle drums will eliminate an obvious redundancy and still produce the needed cadence for the musicians.

All twelve violin players produce identical notes with identical motions, an unnecessary duplication. The violin section will be drastically cut, resulting in substantial savings. Electronic amplification, with its high reproductive quality, may be used if more sound volume is desirable.

Much effort is expended by the musicians playing 16th notes, or semi-quavers, an excessive refinement. Most listeners can't distinguish such rapid playing. All notes will be rounded up to the nearest 8th. When this is done, it will be possible to use trainee musicians without loss of quality.

No useful purpose is served by repeating with horns, the same passage already been played by the strings. Elimination of all redundant passages, as determined by a cost-containment committee, will reduce the concert from two hours to twenty minutes. A great savings in salaries and overhead will be achieved. In fact, if Schubert had attended to these matters on a cost-containment basis, he probably would have been able to finish his symphony.

We could pay for a form of National Health care with "slight" raise of say $2.00 per fallon fuel tax like that of other countries in the world who have National Health care. A slight snag here is that those who have National Health care don't like the....QUALITY....of the health care they get

I personally favor raising the gas tax by $2.00 per gallon. Think of the benefit......there would be only half as much traffic because all SUVs would soon be in the scrap heap

It would force the development of alternative fuel.....maybe? I just happened to think of all the gas guzzlers doubling every year in Europe where the price of gas is already at least $4.00 per gal or more. Whe can't all those brilliant Europeans who want to tell us how run our country, come up with an electric car that works. Oh, I know, they are too busy making and selling bigger and better gas guzzlers for us to buy. What if we stopped buying?

It would also create an unstable economy and would drive prices for everything through the roof as shipping prices skyrocketed.

Perhaps what we need instead are doctors who aren't quite as qualified as they should be. Perhaps require less education and training. That way they wouldn't charge as much and people would be able to afford healthcare. It wouldn't be great healthcare, but who really cares, right? As long as it's free I mean.

You forgot to add: and/or those who want to indulge in sly humour, cynicism and/or sarcasm about other people's topics.

Actually, that brings up an interesting point. We all know that "free market" in this country means "mostly free market". There are acknowledged short comings to a completely capitalistic economy. The government has seen fit to regulate and step in when the effects of supply and demand impact the country negatively -- like price floors on agricultural goods and manipulations of gas prices when they start to climb too high (releasing reserves to bring them down). Is there an argument to be made that such measure could/should be taken with regard to health care?

Of course there is Freeduck. The first thing I would do is to make all hospitals and any product that has to do with health care.......NONPROFIT. Yeah, I know this is heresy but even Dys can be right some time.........something MUST be done about health care and the fact that some deserving folks are not ...... ELIGIBLE.

Medical care and treatment are still finite resourcses, as is money. We just haven't quite run into the barrier. Imagine a different situation. Suppose demand for organ transplants outstrip the available organs (it has.) Someone has to make some choices. The choice doesn't have to be based on ability to pay, and probably shouldn't, but someone does have to make a choice, and someone else is probably going to die as a result.

Don't quite get the reference to sly humor, cynicism, etc. rayban, but can go along with the fuel tax increase, though for reasons unrelated to the discussion.

PM to FreeDuck

Hmm. It's true that when determining how much of what kind of care to give to whom, someone has to make some choices. And not just one someone, either. Doctors, patients, administrators, and insurance companies all have to agree (more or less). I look at the case of organ transplants as being something above and beyond basic medical care as there is no way to do them without someone else making a sacrifice so there can be no fundamental right to such care. (Taking it on faith that there is a fundamental right to health care -- maybe not.) But perhaps we will get to a point where other kinds of care are limited as well, like vaccinations or hospice care for the elderly. In that case will we use the same criteria that we use for organ recipients? Does anybody know that criteria? I think it's actually pretty strict. For instance, if you've already gotten one new kidney you're not eligible for another. If you have other risk factors that make it likely the transplant wouldn't keep you alive much longer that would exclude you, etc...

An obvious stab at socialized medicine in Canada. Then, according to you McGentrix, most Canadian doctors are less educated, less trained, and don't offer good healthcare? And that nobody cares?

My, you know so much. Tell us more...

Unfortunately, we live in a staunch, capitalistic, market driven society, with not much concern for having government help to take care of it's citizens.

We boast that we are the greatest country in the world, and yet we cannot offer affordable healtchare, medicine, etc. to those less fortunate than others.

We criminize Senior Citizens for crossing the Canadian border to buy cheaper pharmaceutical drugs, because this administration has accepted tons of money from the industry. Imagine the revenues lost by these companies if we were ALL crossing the border in order to BOTH buy our crucial, cheaper medicines so we can feed our families as well.

I've always argued that America's number one religion isn't Christianity, Judaism, or any other combination thereof. It is the almighty dollar which ultimately drives our capitalistic belief system, and Republican neocons are currently trying to blur these lines, trying to get rid of tax exempt status' of churches, infusing money into faith-based programs, and gladly accepting corporate donations to further the corporate agenda in this Country.

Democrats do it, to. It is all about buying influence and power. Money is not something intangible that we pray to out of faith; it is real and green and determines our very existence in a developed society.

Wow! That even took me by surprise! I was talking about Canada? I'd like to know how you deduced that since I didn't even know I was writing about Canada.

The solution is to have universal health care for all of our citizens. A healthy citizenry helps everybody. Our government has not been able to set the right priorities for our tax money. We're spending four to five billion in Iraq every month, yet we can't afford to improve funding for our schools or medical care for our citizens. It's quite obvious to me!

C.I., you keep repeating that number like it means something.