# Do you believe a person's life should be dependent on how fat their wallet is? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [July 3, 2014, 2:19pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272 "2014-07-03T14:19:17Z")\ **Posts on this page:** 17\ **Page:** 3
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [July 3, 2014, 6:50pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/41 "2014-07-03T18:50:14Z")
[quote=“Shodan, post:16, topic:692272”] No. In fact, there are circumstances in which we should deny care to those who receive taxpayer-funded health care in order to spend the money on other things. We need “death panels” and rationing, IOW. And we are going to get them whether we admit it to ourselves, or not. It won’t make any difference where they come from, either insurance companies or from government bureaucrats. /QUOTE]Actually, it does. In the sense that if we had universal care, the “death panel” is going to be rationing the care in a way that gives us (at least in their opinion) the best bang for your buck. You deny expensive care to the elderly, expensive care that isn’t expected to have a significant positive outcome, etc. You allow care that is going to have a positive impact at a reasonable cost. With insurance companies, most of the “rationing” is that the financially secure get care, and the poor don’t, regardless of the need or expected benefit. This isn’t rationing, because there’s no direction to it. What I think is funny is that this question gets treated by Americans like it’s new ground to explore, when every other industrialized nation on the planet has been dealing with it for decades. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [July 3, 2014, 6:50pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/42 "2014-07-03T18:50:48Z")
> [@Shodan](#): > > You claimed it was so his mother could continue to pay taxes, and so that he wouldn’t steal drugs from his neighbor. If his mother is poor, she isn’t paying more in taxes than she consumes. And I don’t think most people who steal opiates are doing so because they don’t have insurance. ([Cit](https://www.google.com/#q=stealing+painkillers+)e FWIW.) > > Regards, > Shodan Um, I said nothing about his mother being poor. He is poor because he doesn’t have health insurance. Just because he is poor doesn’t mean his mother is poor. But there are only a few mothers who wouldn’t drop everything to help their sick children, whether they are lazy slobs or not. If he didn’t have to lean on his mother, she could keep working and paying taxes and beng everyone’s favorite cashier/teacher/nurse/doctor/lawyer/CEO. As far as stealing opiates go, people get addicted for many reasons. Maybe this hypothetical lazy slob started taking them to treat an injury and became hooked on them. Maybe the lazy slob started doing them just get the buzz, and that’s how he get hooked on them. Maybe he started doing them to dull the effects of PTSD, and that’s how he got hooked on them. People steal not because they evil bastards. Not because they have weak characters. But because they have a disease called addiction, and diseases make you do desparate things sometimes. But just keep on moralizing and believing that poor people are hopeless no matter what you do for them, if that makes you sleep better at night. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [July 3, 2014, 6:52pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/43 "2014-07-03T18:52:52Z")
On a related note, wouldn’t death panels get sued by enraged family members all the time? ---
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [July 3, 2014, 7:02pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/44 "2014-07-03T19:02:40Z")
> [@Shodan](#): > > and this is not the reason why health care costs less in Europe([cite - pdf](https://www.ceda.com.au/media/302619/healthcarefinal1.pdf)). Can you help me with this bit? It’s like a 100 page document complaining about how unsustainable Australia’s health care spending is, despite it being about 60% of the per capita spending we have in the US, and covering everyone in the country. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [July 3, 2014, 7:19pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/45 "2014-07-03T19:19:45Z")
> [@Velocity](#): > > On a related note, wouldn’t death panels get sued by enraged family members all the time? Why do people keep acting like death panels are not already a real thing. There is no insurer who will treat every condition, no matter how efficacious or costly. And yes, they get sued all the time. They also win a lot of the time ---
**Author:** ![filmore](https://avatars.discourse-cdn.com/v4/letter/f/7993a0/32.png) [@filmore](https://boards.straightdope.com/u/filmore)\ **Post date:** [July 3, 2014, 8:07pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/46 "2014-07-03T20:07:06Z")
> [@monstro](#): > > Why do people keep acting like death panels are not already a real thing. There is no insurer who will treat every condition, no matter how efficacious or costly. And yes, they get sued all the time. They also win a lot of the time There would be a difference if the death panel was run by the government versus private insurance. People think the government insurance should cover everything, cost nothing, and have no spending limits for treatment. But with private insurance, the burden is on the individual to find a policy which provides the treatment he wants at a price he wants to pay. If he doesn’t get the insurance he’s entitled to, then he should sue. But if he’s upset because he enrolled in the cheapest plan and it won’t pay for everything he wants, then it’s his own fault. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 3, 2014, 8:23pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/47 "2014-07-03T20:23:19Z")
> [@Amateur\_Barbarian](#): > > No, it means not spending $1M+ to keep a terminally ill patient alive for a matter of weeks or days, no matter who pays for it - unless it’s cash OOP for the patient, and maybe even not then. > > Most routine medical care costs comparatively little, and chopping away at tax breaks for the top percent or so to make sure millions are vaccinated, checked up, treated for simple things that can become big things etc. sounds like a damned fine idea. Pinching a hundred mil here and there from bloated “defense” budgets, even better. > > But burning Joker-sized mountains of cash for limited time extensions for hopeless, even cruel cases - which is where a VAST amount of healthcare spending goes? Nope. I’m not sure what you are complaining about, since I said I supported rational end of life decision making. The people blocking doing this are the same people complaining about spending too much on healthcare. The average cost per stay for those over 65 was a bit over $12K. ([Cite](http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CB8QFjAA&url=http%3A%2F%2Fwww.hcup-us.ahrq.gov%2Freports%2Fstatbriefs%2Fsb146.pdf&ei=4ri1U7PSM9jgoASXooKgCQ&usg=AFQjCNFJKksTlfOhus-Eci9mvFhWQoP6cQ&bvm=bv.70138588,d.cGU&cad=rja)). Now as for million dollar stays, all I could find was from [here.](http://www.sacbee.com/2012/03/11/4328036/million-dollar-hospital-bills.html) > [@](#): > > The number of Northern California hospital stays resulting in charges of $1 million or more rose sevenfold in the past decade, from 430 in 2000 to almost 3,000 during 2010, according to a Bee review of new data from the Office of Statewide Health Planning and Development. > > Most of those bills will be lowered significantly – up to 80 percent – following negotiations between hospitals and insurers. Even then, they will usually still cost more than a typical Sacramento home. That’s a good indicator of the irrationality of our medical care pricing system, but not that these bills are driving the cost of health care. BTW the patients mentioned were not elderly, but young adults and children. Want to tell a mother that her baby is too expensive and should be let die? ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 3, 2014, 8:25pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/48 "2014-07-03T20:25:56Z")
> [@filmore](#): > > There would be a difference if the death panel was run by the government versus private insurance. People think the government insurance should cover everything, cost nothing, and have no spending limits for treatment. But with private insurance, the burden is on the individual to find a policy which provides the treatment he wants at a price he wants to pay. If he doesn’t get the insurance he’s entitled to, then he should sue. But if he’s upset because he enrolled in the cheapest plan and it won’t pay for everything he wants, then it’s his own fault. So incorrect purchasing decisions should be punishable by death. As for me, I’d prefer to trust the government which is theoretically looking out for us rather than a private insurance company which is bound by law to look out for its shareholders, not its customers. And I’d prefer doctors do it, actually. Or the patient him or herself. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 3, 2014, 8:29pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/49 "2014-07-03T20:29:31Z")
> [@Little\_Nemo](#): > > And that’s just taking the figures from this article. Which seem a little dubious. Am I really supposed to believe that Medicare is currently over half of the federal budget? > > I’m betting I could spend a few minutes looking up some more realistic figures and find out the situation is even less alarming than the only mildly upsetting scenario the article is trying to convey. Note the article is from 2011, before the recent slowing in the growth of healthcare costs. (Which may or may not be due to ACA.) ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 3, 2014, 8:33pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/50 "2014-07-03T20:33:38Z")
> [@filmore](#): > > One advantage to not having single-payer is that the government can sidestep these types of situations. In a single-payer system, if 95-year-old was denied a heart transplant and died, the family could say that the government should have done it regardless of the cost. But by using private insurance companies, the family would need to show that his specific insurance company was negligent. It’s up to the person to pick a plan which would approve that type of procedure. If no company offers it, then the family can’t legitimately complain because he didn’t get it. This would work great if when picking healthcare plans you knew exactly how you were going to use them. When exactly should this person have bought insurance to cover what happens to him at 95, and how much should he pay for it? Over the entire population you can predict who gets sick and how. Not individually. That is why the more people in the pool, the more efficient insurance is. ---
**Author:** ![JuliaSqueezer](https://avatars.discourse-cdn.com/v4/letter/j/82dd89/32.png) [@JuliaSqueezer](https://boards.straightdope.com/u/JuliaSqueezer)\ **Post date:** [July 3, 2014, 8:49pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/51 "2014-07-03T20:49:58Z")
> [@Voyager](#): > > So incorrect purchasing decisions should be punishable by death. > As for me, I’d prefer to trust the government which is theoretically looking out for us rather than a private insurance company which is bound by law to look out for its shareholders, not its customers. > And I’d prefer doctors do it, actually. Or the patient him or herself. So what do you make of my mother’s doctor, who has ordered yet another yearly mammogram and multiple other tests. Add in his hefty fee for her routine physical exam. She’s relatively healthy and she’s 93. He’s keeping the cash flow coming, knowing if Medicare wasn’t there, or denies it for some reason, she’ll pay out of her limited funds. She’s utterly convinced he’s her savior and that she will die a horrible, tortured death if she doesn’t get a mammogram, Pap smear, breathing tests, blood tests, etc. and more etc., every year. My thinking is that as long as the US has a health care system that is profit-driven, we might see some nibbling around the edges, but we will see very little substantive change. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [July 3, 2014, 8:54pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/52 "2014-07-03T20:54:07Z")
> [@filmore](#): > > There would be a difference if the death panel was run by the government versus private insurance. People think the government insurance should cover everything, cost nothing, and have no spending limits for treatment. People also think that we shouldn’t have war, that the government should stay out of our bedrooms, and that Sprite should flow freely from the water fountains. And yet for all their whining and complaining, no government has ever caved under these demands. Because reasonable people know that we can’t get everything we want. Someone has to be told no. As long as the system is fair and transparent, most people aren’t going to have a problem with their 86-year-old granny being declined open-heart surgery. And most likely all granny wants is decent palliative care so that she can die with dignity. > [@](#): > > But with private insurance, the burden is on the individual to find a policy which provides the treatment he wants at a price he wants to pay. If he doesn’t get the insurance he’s entitled to, then he should sue. But if he’s upset because he enrolled in the cheapest plan and it won’t pay for everything he wants, then it’s his own fault. What is it with this topic and moralizing? If it’s the cheapest plan he can afford, it isn’t his fault that he gets sent to the death panel squad. Just like it isn’t his fault that he can’t afford to live in the safest neighborhood or send his kids to the best schools. He may be SOL. He may need to accept that no one is entitled to live as long as they want to. But “fault” isn’t at play here. I’d much rather have the government decides who gets treatment and who doesn’t. The government isn’t out to make a profit. The government is required to be transparent. Our elected officials are held accountable every 2-4 years. People have some control over what policies and regulations are passed. And they can sue. All the way to the Supreme Court. There’s none of that in a corporate boardroom. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [July 3, 2014, 9:09pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/53 "2014-07-03T21:09:43Z")
> [@filmore](#): > > There would be a difference if the death panel was run by the government versus private insurance. Yes, there would. And the technical term for that difference is improvement. > [@filmore](#): > > People think the government insurance should cover everything, cost nothing, and have no spending limits for treatment. I’d say that nobody is that stupid. But then I read some of the things opponents of public health care say. > [@filmore](#): > > But with private insurance, the burden is on the individual to find a policy which provides the treatment he wants at a price he wants to pay. If he doesn’t get the insurance he’s entitled to, then he should sue. With private insurance you’re “entitled” to the amount of insurance you can afford. So who exactly do you imagine somebody is supposed to sue if they’re too poor to afford insurance? And, of course, the same lobbyists who are paying legislators to protect private insurers from a public health care alternative are also paying legislators to protect private insurers from lawsuits. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [July 3, 2014, 9:17pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/54 "2014-07-03T21:17:41Z")
To me, there’s one big empirical piece of evidence in favor of public health care systems. How many countries that have had private health care decided to switch to public health care? Lots. How many countries that have had public health care decided to switch to private health care? None. Apparently nobody that’s ever experienced public health care (and that’s including paying the costs of public health care) has ever regretted their decision. If public health care was as terrible as private insurers have been claiming, the people in at least a few countries would have switched back to private insurers. But nobody ever has. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 3, 2014, 11:49pm UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/55 "2014-07-03T23:49:23Z")
> [@JuliaSqueezer](#): > > So what do you make of my mother’s doctor, who has ordered yet another yearly mammogram and multiple other tests. Add in his hefty fee for her routine physical exam. She’s relatively healthy and she’s 93. > > He’s keeping the cash flow coming, knowing if Medicare wasn’t there, or denies it for some reason, she’ll pay out of her limited funds. She’s utterly convinced he’s her savior and that she will die a horrible, tortured death if she doesn’t get a mammogram, Pap smear, breathing tests, blood tests, etc. and more etc., every year. > > My thinking is that as long as the US has a health care system that is profit-driven, we might see some nibbling around the edges, but we will see very little substantive change. That’s hardly the kind of life and death decision we were talking about. But I hear you. My father in law is 98, and often has to tell his doctor that he really doesn’t need stuff that will prevent problems in ten years. I think doctors get into habits. As ACA pushes for evidence based medicine I hope such nonsense will be reduced. ---
**Author:** ![handsomeharry](https://avatars.discourse-cdn.com/v4/letter/h/e9c0ed/32.png) [@handsomeharry](https://boards.straightdope.com/u/handsomeharry)\ **Post date:** [July 5, 2014, 3:44am UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/56 "2014-07-05T03:44:23Z")
> [@Amateur\_Barbarian](#): > > Poorly worded question (IMVHO)… I don’t see where you got that from. ---
**Author:** ![Count\_Blucher](https://avatars.discourse-cdn.com/v4/letter/c/c5a1d2/32.png) [@Count\_Blucher](https://boards.straightdope.com/u/Count_Blucher)\ **Post date:** [July 5, 2014, 3:59am UTC](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272/57 "2014-07-05T03:59:14Z")
> [@Little\_Nemo](#): > > To me, there’s one big empirical piece of evidence in favor of public health care systems. > > How many countries that have had private health care decided to switch to public health care? Lots. > > How many countries that have had public health care decided to switch to private health care? None. +1 [Previous page](https://boards.straightdope.com/t/do-you-believe-a-persons-life-should-be-dependent-on-how-fat-their-wallet-is/692272.md?page=2)