We already have death panels and who serves upon them, claims adjusters like the one who disapproved medication my grandfather needed.
Or a long sleeved shirt.
Serious question - would it have been better/okay if the person who denied that medication have been a Federal employee?
You need to “earn” an “active measure” because it requires “action” from “another party”.
It requires ordering someone to act in accordance with your wishes. It’s trampling over their rights to fulfill your wishes. I’ll admit the health care debate is more nuanced, but that’s the rub of it: if you declare health care a right, you declare that someone must deliver you a product, regardless of compensation or their needs or wants.
We have an active thread on the Utilitarian argument, but it doesn’t seem to be getting much play.
Serious answer? Yes. I would prefer a denial based on a putative aim to most efficiently help the most number of American people as opposed to for a profit.
I suppose to many ,if you lose your job it is your fault. With our system, you lose your medical insurance at the same time. When they get sick, they lose their homes and often declare bankruptcy. Too bad. Go away, quietly. Just do not expect help from the tax payers.
In a real-world situation, in a place that actually has UHC, the decision about what medications to give is not handled on a single patient basis by some faceless government bureaucrat. They are handled by something like a Guidelines and Protocols Advisory Committee, which is composed of members from a provincial (in this case) medical association (eg. group of doctors) and members from a ministry of health (mainly doctors). Decisions on what procedures to pay for are decided upon on the basis of:
Literature search (previous guidelines, critical literature reviews, randomized controlled trials)
Consultation with experts
Guideline drafts
External review (random sample of general practitioners, random sample of relevant specialists, experts in the field, professional organizations)
Consultation with experts
Approvals (from B.C. Medical Association, Medical Services Commission)
Three to five year planned review (may occur earlier when prompted by new information)
Guideline evaluation
(oh and to add, since this is government, the decisions of this group are public, and are open to public viewing. Can the same be said of private insurer’s decisions?
So, as you can see, it’s a pretty thorough process, deciding what procedures to provide for people and what we will not fund because it’s unproven or ineffective. And these scientific/medical decisions on what procedure to provide are for EVERYONE. It means that each person does not have to argue with a different claims adjustor or different bean counter at a multitude of insurance companies over what is covered or what is not.
So yes. I MUCH prefer the system that I currently have over arguing with a claims adjustor.
No not at all, the point is we already have rationed health care in this country. If you have money like Mr. Limbaugh you get cochlear implants if you are poor you go deaf.
I get that part just fine. My resonse is twofold:[ol][li]As Bricker and others have mentioned, defining health care as a right has the tendency to make society’s obligation to pay for, and therefore the cost of, health care pretty much open-ended. Further upward pressure on costs is the last thing we need in health care. [/li]
[li]You mentoin that Part Two is rationing. It is that much more difficult to ration rights. Therefore the urge to define health care as a right exerts a further pressure to make it as available, in all its forms, as it is now to the 85% of Americans who are covered by insurance. [/ol][/li][quote]
UHC in and of itself isn’t going to change the overall cost of things, just moves it around a bit.
[/QUOTE]
This is the part I don’t believe. Covering more people, almost by definition, has to cost more. Because, for one thing, you lose the de facto self-rationing that keeps people without insurance from going to the doctor for problems that they might otherwise figure “ehat the hell, I am paying for it anyway” or (worse still) “I might as well - it’s free”.
Take me, for instance. I have a bad back. Not much to be done about it - it runs in my family. I have had three MRIs and two CAT scans. None of this obviously has had any effect on my back. But I had no reason to decline them - “insurance pays for it”. More recently, I damaged a nerve in my biceps. I went to the doctor for it, and she referred me to a neurologist. He examined me and prescribed rest. Sure enough, it got better. Had I not had insurance, I would have - guess what - rested it. But “tincture of time” and “scientific neglect” cost a fuck of a lot of money when prescribed by a specialist.
UHC means that everybody will get the same level of care that I get. Maybe that is a good thing, maybe not, but it is hard to believe it will cost the same as health care does now.
Regards,
Shodan
Why do people keep phrasing it like that? You act is if under UHC Ruminator’s father will show up at your door and expect you to both give him your kidney and perform the operation.
You also act as if you get nothing in return. UHC would include you, unlike the list I made above that doesn’t include you (unless you’re in prison). Under your current system, you don’t get to benefit, but you are paying. Like public roads, parks, and foreign wars, you get to benefit, even if someone is freeloading.
The idea of “rights” has nothing to do with the debate.
Sir, you started off this thread in post #1 citing Bricker’s comment about “entitlements” (rights = entitlements) and then try to discredit it through examples.
IMO, you didn’t do a good job. What you did was create a list of health care arrangements that have nothing to do with Bricker’s statement. Your list answers a different question.
I think that the big divide is a basic difference in the understanding of the word ‘right’ when used in this context.
Speaking for myself, I believe that rights are (for the most part*) actions available to individuals. I believe those in favor of UHC think of rights as ‘Things that individuals should have provided’.
That is a fundamental disconnect.
To use a non-UHC example: I have heard people say ‘Everyone has a right to housing’. When I hear that statement my first thought is, no they don’t. They have the right to buy a house, sell a house if they own it, rent a house if the owner agrees or build a house but they do not have the right to housing. Why? If they someone cannot afford to build, buy or rent a house then someone else will have to be forced to provide the house for them. The person that has to provide the house has their rights violated. Their right of action is being limited by the government.
Same thing for UHC.
Slee
*Of course, it is a bit more complicated than that when you get to taxes and things like the military and fire departments.
That doesn’t matter at all. Why? Because under the current system the cost of health care is pretty much open-ended, and there is currently upward pressure on the costs of it. But you don’t have UHC, and health care is not a right. Health care costs in the US continue to rise, with or without UHC, with or without health care as a right. The point is moot, it is not an argument for or against UHC, it is a talking point that sounds good on Fox News, but falls flat in the real world. As an example, education costs will rise, both at public schools, and private schools. They are costs that as you say, make your obligation pay for it open ended. There are real and rational arguments against UHC and this isn’t one of them. It is meant as a distraction.
The “de facto” part you mention is happening with or without UHC, and you are paying for it. People without insurance cost you money. Your current system costs you money. There are ways to deal with “might as well because it’s free.” The very simple one is for a doctor to say, “no sir, your back is fine, you need diet and exercise, not an MRI.” Under your current system, there is nothing to encourage that, the doctor wants to get paid, he’ll get paid more if he orders that MRI, there is ZERO incentive for him not to. So you didn’t need one, but got one. And part of the cost of your MRI was for to pay for the person without insurance, who didn’t earn health care, but got the MRI and later declared bankruptcy. Foreclosing on his house, which brought down the value of your house.
By saying, “I don’t want to pay for other people’s health care, it’s not a right they are entitled to,” suggests that you are ignoring all of the ways in which you are CURRENTLY paying for people’s health care.
That would imply that currently, the people not getting health care, have bad backs and are eager to go through treatment. And that the people that are without treatment couldn’t be more productive with it.
So in your mind is public education a “right”? I think you are on to something. Entitlement is a better word for things like education, police, court system, etc. In my mind I have a right to a fair trial but I am entitled to a public defender. The constitution saw rights as self-evident, but I think entitlements are more open for debate.
ETA: and of course I missed the earlier discussion of this very topic
You make a good point, there is a serious disconnect, and I find within the UHC debate the opposing side is throwing around the notion of rights without any regard for context.
This idea that “people have the right to housing” does not imply tax payers are on the hook, nor does it mean tax payers aren’t currently paying for a broken system.
I remember my grandfather telling me about mining towns near where I grew up. The mining company owned everything, including the houses that employees lived in. So if you got laid-off you also lost your house, sound familiar? In a town owned by a mining company you did not have the “right to own or rent a house.”
The right to housing also sounds to me like an extension of anti-discrimination laws. Can I refuse to rent/sell to someone because of the colour of his/her skin, or are they some how entitled to it? Before the abolition of slavery, African-Americans did not have the right to own property, they now have that right, but society doesn’t have to pay for anything.
The right to health care doesn’t have to mean free MRIs for everyone, any more than the second amendment gets me a free gun. But it could mean that people aren’t denied life saving treatment because of the parents they were born to, or the company that just laid them off.
I just wanted to address some of the supposed factual statements made in the OP that have gone unchallenged. Some of my comments may be considered nitpicky, but we are in the business of fighting ignorance, after all.
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Active-duty military and their dependents do indeed get health coverage paid for by the federal government. Reservists in a reserve status do not.
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Only military veterans who either retire with a pension or are permanently disabled because of injuries received during their active duty service are entitled to medical coverage paid for by the Department of Veterans Affairs (VA). If this is the case, their dependents are also entitled to medical coverage.
Both my wife and I are military veterans. Neither of us retired or receive a military pension, and so neither of us have any VA medical coverage whatsoever.
Caveat: Military veterans with a disability due to their active-duty service are entitled to VA medical coverage in connection to that specific ailment only. Also, veterans who are indigent can sometimes receive medical care from a VA facility on a space-available basis.
- While federal employees (including civilian employees working for the military and the VA) can get medical coverage, they pay for it, just like any other employer-provided medical plan. Secondly, not all federal employees necessarily participate in these plans. My wife is a federal employee, and does not participate in the federal plan, because the health plan offered at my place of employment has better coverage for lower premiums.
If the federal government were to decide to stop providing medical plans to its workers, it would no longer be competitive with other employers who do. (Which is why, of course, any employer offers health coverage. Employers don’t offer health coverage out of the goodness of their hearts–they offer it to attract quality employees.)
I don’t think this is the case. Defining health care as a right would be an upward pressure on costs that does not exist now.
That was part of the purpose behind my examples of my back and my arm. If I had not had insurance, I could have foregone the MRIs and CAT scans and so forth. Define health care as a right and set up UHC, and I am perfectly entitled to demand these as my right.
This makes no sense. All other things being equal, why would people deny themselves health care if they had already paid for it, or if it were paid for by someone else?
I don’t see this. The doctor wants to be paid just as much under UHC as he does now. One of my issues is that if we define health care as a right, I am entitled to demand that I get just as many MRIs as I would get now. After all, I have the right to health care.
I think most people are saying “I don’t want to pay MORE for other people’s health care, since it is not a right.” One of the dangers of defining health care as a right is that people can demand that you pay MORE. Because that is what a positive right like this means - the right to compel other people to do things, not the right to do things yourself.
It may clarify to think about free speech as a right. This means currently that I cannot be prevented from speaking. Defining free speech as the sort of positive right that I think you mean would imply that other people must assist mean speaking, by paying for my platform.
Regards,
Shodan
It might have this tendency, but the experience in the rest of the world seems to be that the upward pressure is not there, since they offer health care less expensively than we do. Costs are rising everywhere, true, but this seems independent of UHC.
Second UHC may not include making it available in all forms. Rationing might make urgent care more available and non-urgent care less available, while keeping costs the same. You also assume that a UHC system will be no more efficient than ours, which does not have to be the case. In any case, if 85% of the people who are covered by insurance already overuse medical care (not at all clear) adding 15% is not going to make much of a difference.
The need to make the use of care more efficient is independent of UHC or non-UHC. There is nothing wrong with reasonable co-pays, for example. But those who claim that increased cost will be a problem while screaming about death panels and any attempt to limit unnecessary treatment are being hypocritical at best, and clearly don’t give a crap about making the system more efficient.
Did anyone tell you an MRI was going to fix your back? My wife had severe back problems before these machines were available, and if they had been she could have been treated much more quickly and efficiently. Why so many? Clearly your for-profit insurance isn’t helping the problem any.
For your bicep, your neurologist prescribed the cheapest treatment; good for her. But what if there is a 20% chance that your pain was a symptom of something serious, which, if you just rested it without going to her, would have resulted in an expensive hospital visit? Four out of five false alarms would save money for the system in the long run.
Early diagnosis is almost always a good thing. I can repeat once again my experience, of going to the doctor with a symptom even more trivial than a damaged nerve, to find I had a life-threatening problem. If I had ignored it to save money I could either have required really expensive heart surgery or be dead, both of which would be a lot more expensive than the cost of the remedy I got.
Perhaps UHC will allow more rational care to be given, while today an insurance company which limits care, even if it makes sense, might find its customers complaining to their employer, resulting in a loss of the contract.
Your points are valid except that I have known others, and have seen others on this message board, argue that the right to housing means that every one should have a house regardless of who has to pay for it. I will look to see if I can hunt up the thread. I do know for sure that I have seen arguments in the Pit where people were arguing that everyone has a right to food no matter what. I agree that the goal is that everyone should have enough food to live, but I do not believe that food is a right. Same thing with health care. But that doesn’t make it a right.
Slee