Cheering to Let People die?...new question...Choosing to Let People Die?

It has been stated several times in several places that we are the only wealthy industrialized country that does not have some form of universal healthcare..... but don't we in a way, those that use the ER as a primary doctor (and some knowing they won't be payin - I do know some like this)

There's no such thing as a free lunch. That's all I will say on this entire topic. My grandmother has told me that phrase as far back as I can recall and it has yet to be proven false. She also says "You get what you pay for, so don't buy cheap shoes." Again... true words.

If you take free assistance from the government, there will be strings attached. If you have free or cheap healthcare, there's a good chance that it won't be cutting edge or preventative.

Oh... and the funding comes from somewhere... ME! Even more so, our children. The upcoming generations have to pay for all of this. So glad President Obama is willingly spending my 3 yr old's hard-earned wages. Building infrastructure? Really? That's all you have? Great- more union work and overtime. Tax credits? Okay, great. What about the next years' salaries, benefits, etc? Can't wait for 2012.

Health care rationing is an uncomplicated reality in most advanced nations that offer health care for all citizens. And the citizens of those nations recognize the reasonableness of those limits, and WOULD NOT WILLINGLY give up their government-managed health care. They gladly pay extra taxes to help maintain their systems for themselves and their fellow countrymen. They can count on hassle-free access to the basic services that are most likely to keep them healthy or deal with the most common health issues. They also know that IF they need extended services NOT provided by their government plans, they are NOT denied those services. They can still get them; they will just have to pay for them privately (just as we already do in this country). But their health care is FAR less expensive that what we pay in this country, so they can much more easily afford the extra services. They get more for less, they experience greater overall health, and their health is good and life expectancies are high.

Compare to the good old USA:

For-profit insurance companies make the life-or-death decisions on who gets treatment for what. People who have the right employers have superb insurance, with coverage for dependents and no restrictions for preexisting conditions. Folks can get just about any procedures and tests done that they need or desire, sometimes even plastic surgery. All fully paid. They don't even have to ask their doctors whether certain tests or procedures are really needed; they just go ahead and get them, because they can, thus driving up the cost of everybody else's premiums.

But those gold-plated policies go to a fairly small segment of America, because those corporations can only hire so many people. People who DON'T have the right employers or are self-employed have to pay part or all of their premiums plus extra to include dependents, and often carry large deductibles and copays for medicine and services, and therefore their access is largely limited to what they can afford. Or they get no assistance from their employers, buy wildly expensive private policies that may exclude all sorts of treatment. This is "rationing" and it already exists for a huge number of Americans. But it's based NOT on a best-practices policy, but merely on what people can afford to pay.

Because medical costs are rising wildly, fewer Americans can afford the care they need. More employed Americans will be paying a larger share of their employer-provided policies. Less-generous policies are being adopted by employers who can afford to pay less because of ongoing recession. Some employers are withdrawing health insurance as a perk of employment. Workers, still being laid off in huge numbers, suddenly find themselves either without coverage, or paying for wildly expensive Cobra premiums that may be cut off before new employment is found.

Meanwhile, the medical sector, much of which is purely profit-driven, provides ever more expensive tests, treatments and drugs and devices, continually driving up the cost of insurance and treatment, for all of us. And your local doctor's office must hire a squadron of clerical workers whose jobs consist of navigating the seas of red tape involved in billing insurance companies, securing the endless documentation required to prove eligibility, and re-billing for denied procedures. Everybody's medical costs are dramatically higher because of the paperwork and ever-changing qualifications demanded by for-profit insurance companies. And those insurance companies feel entitled to a higher profit than almost any other industry, paying out huge bonuses to top management. Until health insurance reform was enacted, there were no limits on that profit-taking besides common human decency, which exerts smaller and smaller influence every decade.

Government-managed health care has been a reality for decades in the Veteran's Administration and Medicare. Even though both are now suffering from the pressure of increasing medical costs, they have been largely well-managed and economically run. Both have always had limits to what care has been available to their clients, and reasonably so. But both have provided good basic care and essential services to millions of citizens who might otherwise not get that care, increasing their basic level of health, comfort, well-being and productivity.

And if those entities did not exist, MUCH more of the expense of caring for aging parents or soldiers who have served our nation would fall on the families of those people. Imagine how expensive that would become, and how many families would be forced to make difficult or impossible choices: accept the cost of Dad's bypass surgery or Brother's ongoing rehabilitation, or pay the mortgage?

Government-managed health care insurance would limit the runaway costs of medical care. Being the biggest customer of health services, the government would have tremendous bargaining strength in determining a fair cost for various procedures and drugs. Of course the for-profit sector, which has grown fat and entitled without any controls for decades, does not want those limits, and will say or do anything that might convince the public to help them fight it. The most entitled are, ironically, the ones who would least feel the actual pain that so many Americans are already suffering. One of their main tactics is fear: "Big Brother will deny you or your grandmother needed care, and you will die. Be afraid! Be very afraid."

Well, there are many Americans already living without needed care. Many are leading uncomfortable and diminished lives, and many are dying. It doesn't have to be that way.

Many will insist that it's not government's job to provide medical care. But that is not true in many enlightened nations, and if certain historical events had happened differently, it might not be true in the U.S., either. Those who are now well-insured don't want to do anything that might put their coverage at risk, Understandable. But as things are going, their coverage is at risk anyway. As costs go up, many workers will pay more for less coverage; it's just a matter of time.

How much 'healthier' it would be if we could take a realistic look at the trend, and deal with it before more millions more Americans fall into the reality of medical care that is rationed purely by how much money the patient has.

In the interest of NOT becoming a charity case and thus a burden on other policy-holders, I have had a private policy for over 25 years. Crazy expensive (it now costs about half of my monthly income), and I carry a $6000 deductible just to keep it barely affordable. That means that every medical visit I make costs me $200 or more, plus whatever tests and medications the doctor insists I need. That means that I forgo all but the most urgent treatment, and I have gone without some needed reconstructive surgery (childbirth injuries) for over 20 years. Since menopause, my condition has become worse by the year, and for the past 7 months, I have been essentially disabled by pain and nearly-impossible "elimination issues." Is this the fault of people who have great insurance policies?

No, and it's not my fault, either. For what I pay, I should have decent medical care. Consider a world in which we had a system that would give ALL of us the basic care we need, and cost ALL of us less in the bargain (even though it would probably increase taxes somewhat)? Then people with decent insurance wouldn't have to shrug off people like me with a "Gee, that's too bad, but it's really not my job to care." The fact is, none of us know whether our next routine office visit might result in a horrible diagnosis. None of us know whether a family member will get sick or have a terrible accident or need unexpected surgery. None of us know how healthy our bodies will stay as we age. None of us know for sure that the family breadwinner will be alive, healthy and working a month from now. These days, far fewer of us even have any real job security.

All this insecurity is something we can pretend to ignore – until it hits close to home. Then it's catastrophic. Medical expenses are the number-one cause of bankruptcy in American families. The medical system in this nation is badly broken. Medical care is something we all need, sooner or later, whether we still have insurance or not. People in other industrialized countries don't suffer that insecurity. Their systems don't necessarily give every patient every possible option, but they protect all citizens equally, and cover basic needs economically.

And finally, death is something we will ALL face someday. Life is 100% fatal. Just because an expensive medical procedure exists that might extend a life 2 months or 2 years, that doesn't mean that it's the best possible choice, once we take our proper and humble place in the great cycle of life.

There is an unbelievable amount of waste in medicine in the U.S. and a huge part of it is unnecessary procedures, from what I understand. Many of these procedures actually end up shortening the lifespan of the individuals receiving them and/or lower the QUALITY of life. But many doctors bow to their patients requests or fear lawsuits and so they order the tests/procedures etc. anyway. I know that putting more thought, common sense and guidelines into how we manage care would make a big difference in keeping costs down.

Along these lines, if not medically necessary, why should women -- or their doctors -- be able to OPT for a C-section out of convenience when the costs are much higher for C-sections? I imagine that something like an elective C-section would be considered an unnecessary procedure.

Thirty-two of the thirty-three developed nations have universal health care, with the United States being the lone exception. I imagine that studying what these 32 other countries have in place and what has worked and doesn't work would be where to start. Some of these countries have both public and private medicine.
http://truecostblog.com/2009/08/09/countries-with-univers...

Added: Also, 9 out of 10 Canadians approve of their Universal Healthcare:
http://www.irpp.org/po/archive/nov09/nanos.pdf

You post just doesn't hold water for me.
Without reading the responses all I can think is how right now private corporations (ins. companies) make the decision for all of us as to what care they will cover. All kinds of important and vital (often life saving) treatments are denied people everyday. People who have paid their premiums consistently for years and who may die without that medical intervention.
How would the government deciding be any different? We need to look to other countries who have universal health care, their systems aren't perfect but at least thousands of people are not losing their life's savings, homes and future finanical security because of hospital bills. Your example of someone being taken off life support or at the very end stages of cancer being denied treatment seem extreme compared to the everyday choices we are all having to make concerning our medical care.
You might re-evaulate your own insurance as well. For example the SF Giants fan who was beaten in LA recently was badly injured and has been under medical care ever since. His hospital bills just hit 50 MILLION. If he has your insurance he will owe 10 Million dollars (20%). I actually don't think he had any medical insurance but really what difference would it make with those numbers your declaring backruptcy anyway.
We are the only wealthy industrialized country that does not have some form of universal healthcare, most people in those countries would prefer to live under their system, not ours. We are 34th in the world for infant mortality rate (a common statistic used to measure and country's health) and 36th in life expectancy. We spend far more money than any other country on per capita medical care.
Health insurance company profits soared last year and my family's premiums just went up by $100 per month, how about yours?
Something is very wrong with this picture.

Ok this is hilarious but I'm going to source FOX news in response to the post below. We can all find scenarios where people are dissatisfied with the mediacal system in their country but the bottom line is you can't please everyone, you have to look at the population as a whole.
The US is less satisfied with their medical system than most other industrialized countries.
http://www.foxnews.com/story/0,2933,136990,00.html

Stats from wikipedia but can be found everywhere
http://thehill.com/blogs/healthwatch/corporate-news/12942...

No offense, but I think you are really, really confused as to how this is going to work.
Can you really see a time when the government (as involved as it is in healthcare) will act like that? Then why don't the healthcare companies do that now? I'll tell you why, because they can still make money on you as long as you have a breath in your body. That's not going to change.
It's not MANDATED coverage for everyone. If you have a plan through your employer--keep it! Why does everyone forget this?
This is already happening with Medicaid and VA care. Medicare administration is 10x more efficient that any private organization and the VA has some of the top medical outcome records.
This isn't some completely new, scary thing.
The people I know that have their kids covered under CHiP get excellent care. This will be much the same.

Her's an excerpt from O. article explaining in basic terms:
Barack Obama's health plan is built on choices. It will not restrict you to just national health care or private health care. Obama's plan is to make both of these options accessible to you. His plan has the same key buzz points as most plans: Health care available to everyone, same coverage as members of congress and no American will be turned down because of their pre-existing conditions. Obama also plans to make premiums, deductibles and co-pays more affordable. Obama plans to make enrollment easier and access instant to this coverage.

You can also choose to purchase private insurance. There will be new rules and practices set forth to help control the private sector, which will have the same standards as public health insurance. The Obama plan also recognizes that some states have done well in their coverage. His plan will not stop the current efforts of these states and will look to build on them. His plan will also allow for state experimentation.
Employers Held Responsible

If an employer does not help their employees out with a helpful contribution towards health coverage, they will have to contribute a percentage of their payroll towards the national plan. Some smaller business may be exempt from this part of the plan. Obama's plan will also protect you if you switch jobs. If you switch jobs you will not have to worry about jeopardizing your existing coverage.

Obama's plan will protect private insurers from catastrophic health expenditures that have been the cause of high medical expenses in recent years. The plan would help out these insurers by reimbursing them for a portion of the catastrophic costs that come about, if they promise to reduce the cost of premiums.

Obama's plan looks to eliminate wasteful spending when found. The money that is saved will be put back into the plan. The plan will also require doctors, hospitals and providers to publicly report their costs in a measure to improve quality. Obama also stresses coverage for children. All children will be required to have some sort of health coverage, and young people will be able to stay on their parents' coverage until they are 25.

First of all, people don't have to hypothesize about what would happen, because so many countries already do this. They cut medical costs and pay higher taxes, but they don't rip people off of life support. The Private insurers we have now reject treatments all the time when they know people will die because of it. They'll find any loophole to do it.

For instance, I broke my back in Germany while living there for a summer working before college. Their hospital cut costs by: six people in a room and no TV rather than private rooms. My first recommendation from my EXCELLENT doctor was to wait one week to gage spinal heeling speed before picking tests or surgeries, to keep treatment to a minimum. Not a million pricy random tests the minute you walk into the door. Wouldn't you know it, I didnt' need surgery, and made a full recovery. Here I probably would have been sliced right up to create a hefty insurance bill. Their citizens can only get out of military service for 2 years by entering a human service job for two years, so a large percentage of the orderlies are volunteers paying back their country for their higher education (free if you want it) and medical care for life (free) by working for free or very low pay for 2 years.

Yes, 50% of their salaries "go back into the system that cares for them" is how they refer to taxes, once they graduate higher education, but there you have it, people paying higher taxes and having health care and higher education for free.

Here, we don't pay THAT MUCH less in taxes, yet cannot afford health care or college for our citizens, and we are lagging internationally because of our less educated public. Their doctor's and hospitals are every bit as good as ours, just not nearly as expensive, because the government regulates the cost. The COST, not the treatments available. Doctors make good salaries there, but not insane salaries, but it works out to a wealthy life style, because they don't have huge student loans to pay back, and they get excellent benefits. No one is being taken off of life support prematurely.

No one begrudges taking care of the country that takes care of them. It's a whole different animal than here. I've also had health care in France, Canada, and Japan. They all think we're nuts here.

BUT DO NOT WORRY, this will NEVER happen here. People here are so well trained to be scared, they refer to "Obamacare" as "socialized medicine" and it doesn't even offer a public option! See how not educating your citizens pays off....you can tell them anything.

Although most people seem to be in favor of this sytem - very few did any research about how it actually works in Canada or the UK. YES - health care is rationed and it is rationed heavily. You can die while going through a petition process to get an exemption.

Recently, a baby was "allowed" to leave Canada to seek medical treatment in the U.S. He was terminal and the treatment wasn't going to save his life but it was going to allow him to go home to die in familiar surroundings with his family by his side. The parents had to do a major fight to be allowed to get him to leave the hospital. We are very fortunate in the U.S. to have so many treatment options available (no one is ever denied treatment in a public hospital emergency room) and to also have the right to refuse treatment.

People die in the UK all the time because they have exceeded the government allowance of chemotherapy or radiation. Personally, I want the right to be able to chose whether I want to pursue that sort of a treatment and the right to be able to chose to refuse it. I don't want any government interference.

Meredith - you are right, the insurance company can say no. That happened to me when I was pregnant with my second baby. However, I was able to determine that we were going to do lifesaving treatment - with the assistance of family and friends because it was worth it to us. Yes, we were blessed to be able to afford it - but it was because so many sacraficed for us. My son and I are perfectly healthy today - but if it had been up to the insurance company - we could be dead.

I agree that there is a problem with copays but the MAJOR problem most of the time is a lack of transparency. I can't make decisions about what treatment to seek using my insurance if no one tells me what it costs. I pay for my annual mammograms out of pocket because the doctor charges $100 for the mammogram and the insurance charges $250 co-pay. This may change under Obama care - but really? I wouldn't know this except the doctor is a family friend and he tells those of us with terrible insurance how to reduce our costs.

I want as little interference in my decision making as possible and that includes ALL areas of my life.

C.

The thought of the government being in charge of healthcare is terrifying! I would already be dead if that were the case.
It is very unfortunate that some people don't get the care they need and our system could be improved. However, it still is the vest available in the world.
I was just reading yesterday how in Ethiopia, until recently, there was only one oncologist for 80 million people.

You seem to be under the impression that the insurance company can't/won't say no to treatments until you hit your lifetime limit. They can and they will say no.

Reproductive assistance isn't covered by most private insurance, and I doubt it would be covered by any public option.

Plenty of people are covered by government insurance, including Medicare, Medicaid, and Tricare. They appear to have similar experiences as those on private insurance, if not better.

I do not know about Canada but I can speak for Ireland. My aunt went to the Dr. Not feeling good & has had a long history of heart disease. Her blood pressure was really bad. She needed a test. Three-Four weeks later she was able to get in for a test. Another week passed and the test results were read, she had an 80% blockage. Do you think she was rushed right in? NOPE. She was sent home to wait until the hospital had a bed available for her. We are not talking a small farm town I'm talking about Dublin, the Capital. Fast forward another couple of weeks and she gets a call that they have a spot for her, but she needs to come within 24 hours or her bed would be given away. She rushes right in only to find out that the Dr. doing the procedure did not have an opening in his schedule to do her procedure. Great, now she has a bed but no one can care for her. They allowed her to leave during the day, if she wanted, every day, but she had to be back at the hospital by a certain time at night or her bed would be given away. Sound crazy??? Yes it is!! She could have died. Here is a woman in her 70's with an 80% blockage and they are letting her come and go??? Do you think that would ever be allowed here? No, Thank God! This hospital "stay" without treatment went on for two more weeks. She then had the procedure and was sent home practically the next day with no one to care for her at home. They don't check, they don't care. We can thank God and our prior Presidents that we don't have to go through this. This is exactly the kind of thing that will happen to people who do not have their own insurance. But, let's not kid ourselves, there will be very few companies that will offer insurance, at all, to their employees if this type of "free insurance" is available here. Small companies will be the first to drop their coverage for employees. The cost of health care on a small company can be the difference between the company making ends meet and the company closing it's doors. Large companies? Maybe some will keep it to attract "elite" employees but more often then not, they will drop it as well. Look at all of the companies that are "USA" companies that have their customer service in other countries??? THOUSANDS of jobs are now outsourced. Do you really think that a company that is willing to save a few bucks by outsourcing to foreign lands won't jump at the chance to save millions by not offering health insurance to their employees? Of course they will. Don't kid yourself, this is not going to be good for anyone. No one is turned away at the hospital now, can you imagin being told to go home and they will call you when a bed is available? I can't. And I won't. One more reason why it is soooo important to get out and vote. Educate yourself and vote.

The govt. can't even manage its' already bloated programs...I don't want my health in their hands.

The govt. should focus more on letting me keep more of my household's hard earned money and just stick to protecting our borders, keeping our roads fixed and letting go of the nooses on sooo many aspects of our lives and private enterprise!

Good luck and best wishes at continuing to keep your health decisions in your hands!!

FIRST: Our government is managing healthcare for large numbers of people right now. My ex-husband gets all his medical care through the VA as he is a diabled Vietnam-era vet, with both mental and multiple physical health issues. He gets the BEST healthcare he's ever gotten since he started going through the VA. The doctors TALK to each other and coordinate his care. He gets preventative care and regular follow-up. The doctors there know him as a person and treat the whole person. This is ALL being paid for and run through our (supposedly evil and incapable) government. Does he have no say in his care because the "government" is in charge? Of course not.

SECOND: Ethical issues will always be a part of healthcare decisions. Many of these ethical decision will involve cost vs. benefit. I believe these ethical decisions should be made by a team of people - the patient, the family, and the doctors, and maybe an outside resource because doctors are so biased and see death of a patient as a personal failure. No one person should be making these difficult decisions alone.

My father recently died. In the last year of his life, he cost us (speaking of the global 'us') a HUGE amount of money in healthcare costs. His doctor continued to push expensive, painful procedures on him until the end. These procedures (heart stents, surgical lung procedures) did not add any quality time to his life, added pain and recovery time and side effects, and cost multiple thousands of dollars. He was given dialysis treatment (3x/week for three years) the same day he decided to enter hospice care. He died the next day.

My father wanted to end the painful treatments, but the decision was too big for him to make alone. He felt like that would be "giving up". Traditionally trained medical doctors in the US feel that allowing a patient to die (even of age-related health issues) is a failure. Almost none of them will talk to a patient or their family about impending death. None of my father's doctors would even use the word, or give us any idea how long they felt he had to live, or how/if these procedures would help him. He was left to struggle with this alone.

So, YES we need to talk about rationing, as a way to review cost (money, pain, and discomfort) vs. benefit (length and quality of life gained) for each patient and situation. How many thousands or even millions should we spend to keep one person alive vs. the benefits to many others that money could provide. These are challenging issues, but issues we need to discuss instead of throwing insults back and forth about who is "compassionate" or "immoral".

Private insurance does this already. Do you really think they don't think about costs. You are so naive. Talk to people who have lived with socialized medicine I have and they love it. Republicans are using scare tactics because they are in the pockets of these big insurance companies. In case you haven't noticed people are dying right now in this country because they can't afford medical care. I would much rather have a standard of care that does cut off care at some point than no
care at all. Besides I don't think health care should be a for profit system. Also
even with government health care your
doctor will have some say. So no I don't
think it's a bad thing but then again I'm
one of the people paying $500+ out of
pocket every month for shitty insurance
because we don't have an employer based
plan.

Edit.
also I have personal experience with private insurance that I am grateful for. When my son was 6 months old I severely broke my leg I had to have surgery to repair it. It cost $30000. If we had the insurance we have now we would have had to file for bankruptcy. I don't think its right that people can lose their homes and everything just because of an accident. I don't know about you but I actually care about people who might not be able to afford care at all. I guess it just boils down to what kind of person you are at the end of the day.

Edit Edit
First of all read what Peg M wrote and I totally agree. That being said I think that we do need to consider some cost benefit analysis. When my 90 year old grandmother was dying last year we had the option to give her chemotherapy. She had private and government insurance and the care would have been covered. We as a family made the decision not to give her care that would make her feel sick. Instead we took her home and made her last few months comfortable and filled with love and family. She might have had 5 months instead of 3 with the chemotherapy but she would have been sick the whole time. IMO not a very good trade off. She was comfortable and felt well all except for the last week of her life. If this is the choice that government care would give us I would take it. 3 good months versus 5 sick months.

Also as far as keeping costs down. I had my son in a wonderful birth center where the total cost was $5,000. That included postpartum care for my son until 2 weeks of age. Compare that to the average vaginal birth in a hospital at $12,000+. If that is the option given on government care I would take that cost comparison any day. Okay I have no more points I just think we need to really look at cost benefit not just "scare tactics".

I don't want government meddling in my health care at all. I think they meddle to much now. I can't see where it could benefit anyone. Look at everything else government has taken on and how it has turned out. DISASTER!

I used to think that private insurance was the only way to go--until I lost my job and I have NO options of insurance. We make too much to receive Medicare or any of the mom-children programs in our state. My unemployment gave us too much to get insurance, but not enough to buy it from anywhere else. My husband is self-employed, so he used to get his insurance through me and my job.

Right now I would take a government program over nothing. I definitely don't believe in allowing the government to take over ALL insurance--how scary! Just ask Canadians how they like their system! But an affordable option would help me out right now. I don't think it should be free, but I think it should be affordable.

I think that you are very lucky to be well off and able to afford your current insurance.

What happens if tomorrow you are no longer covered and you become homeless in a year due to not being able to pay your bills since you were not able to find any employment, your home belongs to the bank since no one else could afford to buy it, your vehicles got towed away due to non-payment. You have nothing left, even your life insurance money is gone to house payments and medical care.

What if you get sick and need medical care. You'd be glad to be able to go to any doctor you could get. Medical care would be different for you then. You can't just look at this from the wealthy person's point of view. There are millions of people who can't pay the co-pays for their insurance or they don't even get insurance through their employers.

My husband is on SSDI, the grand-kids get state medical cards, I have no insurance and every penny of our money is budgeted for food, shelter, and meeting the kids needs. I go without regular medical care, I do not have money to go to the doc for even yearly visits. If I get sick I have the ER at the local hospital.

It would be nice if everyone could see that millions of Americans are going without medical care and need some sort of government funded medical programs to fund free clinics and places to receive basic humane care.

If the Government spent the money to fund numerous programs like this and allowed the people who can provide basic care for themselves to continue to do so then everyone could be healthier and better able to participate in their communities and perhaps some of them could even be healthy enough to gain the ability to return to the work force.

I suspect you are talking about the so-called "death panels?"

Many hospitals already do this.

This has, by the way, been a law in Texas, called the Advance Directives Act, since 1999. What happens is this:
1. The family (or medical executor) of the patient in question is given 48 hours notice that the hospital's medical staff will be discussing the patient's continuing care options.
2. The family is allowed to attend the discussion, and bring their own legal and medical advisors.
3. A written copy of the findings is issued.
4. If the hospital decides to terminate continuing care, the hospital must work with the family to find another facitlity that is willing to continue care. They have ten days.
5. The family may seek an injunction allowing them more than ten days if necessary.

I don't know if this makes you feel any better, but I hope so.
http://en.wikipedia.org/wiki/Advance_Directives_Act