America passes national health care: a simple hypothetical

There is no such thing, nor is one proposed.

That bears repeating. No where did the administration propose a “death panel”. Instead, the idea was to pay for a consultation with one’s physician to prepare one’s advanced directive. I think that most people (even Republicans) think it’s a good idea to plan ahead about how one should be treated in the event of terminal illness or incapacity.

That said, the idea of rationing health care is not an unreasonable one. End of life care can be extremely expensive, while providing only limited benefit, while basic healthcare for children can be cheap while providing a big benefit. About fifteen years ago, the state of Oregon experimented with a system that expanded the availability of Medicare but also rationed care, by creating a priority ranking of treatments. Not everyone liked the idea, but I think it’s better to discuss the idea rationally than to throw around scare words like “death panel.”

I don’t understand what the issue with ‘death panel’ even is. There is a finite amount of health care dollars to go around, while at the same time a near infinite demand for them, which of course means rationing is necessary. As cold as it seems, a decision to deny treatment when the cost is too high and the benefits too low is absolutely necessary.

Actually, this still isn’t convincingly different from a hypothetical UHC arrangement. It wouldn’t surprise me if such a scheme was similarly structured: there would be one question, not two: does the UHC arrangement cover this procedure?

To answer this question you need to be more specific about your hypothetical UHC scheme. Once you do that the answer should be in your definition :slight_smile:

My wife used to work for the Workers Compensation Board here in Oregon where disputes were settled between workers compensation insurance companies and individuals who filed claims. A few of her co-workers originally worked at SAIF, the state’s largest workers comp insurance company. They said SAIF’s m.o. was to deny first, and if the client appealed, then look into the merits of the case.

It’s kind of peripheral but it’s probably worth mentioning there is zero paperwork with the NHS from a patient pov:

Name? tap, tap, tap . . .
Address? tap, tap, tap . . .

It is different if you don’t seem like you’re from the UK.

I have some experience with this. At age 100 and 4 months, my aunt fell and broke her hip. She had surgery to replace the hip and physical therapy afterward (though she was too afraid to ever walk independently again) and was deemed to be returned to a state of physical wellbeing equivalent to where she began. There was never any question of the treatment not being covered, or an attempt to limit what was available to her, she got the same treatment for a broken hip that a 40 year old would’ve received. (Well, perhaps less aggressive PT, but they pushed her pretty hard, considering.)

She lived to a month shy of 103, I should note.

HA!
That is not how private insurance works.
Here is an article about how the actual panels in the NHC work and about rationing health care.

http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?_r=1&scp=3&sq=ration&st=Search
I know it’s a lot of pages but please give it a read.

What is a British style panel, anyway? Do you mean NICE?

I would guess, but I’m in no way medically qualified, that most treatments that cost galizillions of dollars are invasive and dangerous enough that most 100 year olds wouldn’t have a good chance of surviving them and getting out with a better quality of life.

We don’t cure cancer by injecting 2 pounds of gold in your arse and shipping you home.

did she live in the US? Was she on Medicare?

Good anecdote but I’m not sure what stance it is supporting.

Yes, the article explains how the NICE program works, not only on determining care but how it keeps costs down.
It also talks about a study in Wisconsin studied people who went to the emergency room after a severe automobile accident.

Those without insurance not only received 20% less care, but they were 37% more likely to DIE from their injuries. With an average of 30 and the average cost of the extra care about $220,000 or $5,500 dollars to give them a ‘normal’ life span, that means that we will not pay $5,500 dollars for a year of life for someone.

That is the health care rationing system we have in place right now.

I always thought that whoever named NICE was a CS Lewis fan.