No, I promise, I’m not trying to bait anyone. Let just assume that dirt poor Joe is fine in every other regard.
I think you’re ignoring a lot of real-life variables.
Should the government foot the $X bill to give Joe a Y% chance of extending his life Z years at W quality of life.
It’s the balance of the equation, not just one of the variables that need to be assessed.
If Joe is a 95-year-old with dementia, no.
If he’s a 20-year-old with a potentially productive, tax-paying, child-rearing life ahead of him, then yes. Because society has already invested a lot in getting him to where he is. If it doesn’t help him continue, then all of that intial investment will be a waste.
I think a lot of people get hung up on helping the “bad” poor people. The lazy slob who has never worked a day in his life, sitting around in his undewear drinking orange soda and eating Twinkies. What’s the benefit to society in helping him? Well, if we help him, this means his hard-working mother doesn’t have to quit her job to care for him and she can continue to be a productive tax-payer. It means that the next-door neighborhood doesn’t have to worry about lazy slob guy breaking into her apartment so he can steal her pain killers. It means that the infectious diseases lazy slob may be carrying don’t spread to others. It also means that when his long-suffering mother decides to stop working and retire, lazy slob may be able to care for her in her old age instead of putting her in a government-run facility.
Anyway you look at it, society benefits from having a well-cared for populace.
This is the crux of the issue. No operation is guaranteed to save a life - it gives a probability of extended life at some degree of quality. If an operation has a 20% probability of extending a patient’s life by 5 years but costs $1 million would you favor everyone who qualifies getting it? If so, what are you willing to de-fund in order to pay for it?
I’d like to agree, but what makes it tricky is that, with health care, unlike food or housing, there’s no upper limit to what a single person might end up needing.
You appear to be assuming that, if the taxpayer pays for his health care, he will turn his life around and start supporting himself and his poor hardworking mother so that they both rise up into the top 54% and start paying more in taxes than they have consumed in services. Do you think this is going to happen more if the taxpayer has to pay for his health care than if he had to pay his own way?
Regards,
Shodan
Without getting in to specific details, I feel that the government should be paying for some public health care. I don’t know Joe and I’m not a doctor. But I can imagine situations where, in my opinion, the government would pay for such a procedure.
monstro said what I was going to say much better than I would have. But there is one more thing. Not only should we save his life, we should try to provide care to reduce the number of $200K operations necessary to save peoples lives.
BTW I read your OP as asking if everyone deserves private suites and hot and cold running nurses. What you meant makes a lot more sense.
I might not agree with you but this is probably the most candid response I’ve seen from the right on this issue.
You have to understand that “can’t afford” means “might have to remove tax cuts for the rich.”
I’m for making rational decisions about end of life care. But remember who killed the discussion by calling paying for a discussion of what a person wants to do a death panel.
Personally, I do think this. I feel that concern over the possibility of catastrophic health care costs has a chilling effect.
The problem is health care is like a negative lottery. Anyone can suddenly lose huge amounts of money. So people living under this risk avoid taking further risks. Which means they avoid economic opportunities. A person who might be considering investing money or starting a new business might hesitate and think “But what happens if my kid gets sick next year?” and decide they have to play it safe and pass on the opportunity. That represents a loss of economic growth.
We’d be better off with a public health care system. Yes, everyone would have to pay for it. But it would be a known foreseeable cost like buying food or paying for a mortgage. People wouldn’t be wondering if next year’s medical expenses will be two hundred dollars or two hundred thousand dollars - they’d know next year’s expenses will be two thousand dollars regardless of how healthy or sick they are. So they could make plans for the future.
A public health care system would also cost less overall because it encourages people to seek preventive care rather than wait until they need much more expensive curative care.
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.
These are your assumptions, not mine. I only assume that caring for the lazy slob’s health makes it easier for his long-suffering mother and his hard-working next-door neighbor to live their lives. Do you think lazy slob exists in a vacuum? Withholding health care from him doesn’t make him disappear. It doesn’t make him a better a person. It just makes him more burdensome on everyone else.
Maybe lazy slob is that way because he hasn’t had good access to health care. Giving him health care could very well help him to be the opposite of lazy slob. You’d have to believe that people’s behaviors aren’t related to their physical health to have doubts about this.
No, it doesn’t mean that. We could rescind all the “tax cuts for the rich” you sort are always whining about and it wouldn’t cover it. The unfunded long-term liability of Medicare is over $30 trillion. Medicare is going bankrupt in about seven years. Entitlement spending is projected to double as a share of GDP.
This one-size-fits-all piece of stupid political cant is way beyond its expiration date.
If you are going to spout this knee-jerk nonsense, no you aren’t.
[QUOTE=Little Nemo]
A public health care system would also cost less overall because it encourages people to seek preventive care rather than wait until they need much more expensive curative care.
[/QUOTE]
No, it won’t, and this is not the reason why health care costs less in Europe(cite - pdf).
Regards,
Shodan
My 93 year old Grandmother developed liver cancer. She didn’t get any treatment for that liver cancer except palliative care, despite the fact that there are procedures that have been proven to save the lives of people with liver cancer.
It would have been idiotic to treat my grandmother’s liver cancer, even if she had millions of dollars of her own money to pay for it, even though there are proven treatments for liver cancer.
This is silly. Medicare isn’t funded out of a trust fund, it is funded by the yearly input of taxpayers, minus the yearly output of providing health care. The notion that before we agree to pay for someone’s Medicare we need to set up a trust fund that will provide enough money for their health care needs for the rest of their lives is silly, because our national economy can’t work that way. Actual working people have to actually deliver that health care, which means we have to pay their salaries when they’re actually working. You can invest in future output by creating durable infrastructure or training, but you can’t save labor one year and spend it in another year.
Medicare isn’t going to go bankrupt because all we have to do is agree to cut spending on medicare, or raise taxes, or both. Our medicare obligations are whatever we decide they should be, we’re not obligated to spend $X gajillion in 20dickety-seven just because some guys back in 2014 voted that people in dickety-seven had to. We can just tell them to go screw.
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.
In a fictional world the system would spend infinite dollars on every patient. But in the real world, we have to balance benefit to cost. I think the government should enable everyone to have reasonable access to reasonable care. The rich will have access to better care, and that’s fine.
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. (Cite FWIW.)
Regards,
Shodan
No, they’re not.
According to the article you cited, Medicare costs are projected to rise from “roughly 10% of GDP” to “between 16% and 17%”. And that’s in 2035 which is more than seven years away.
The same article goes on to say “To put that into context, over the past four decades the federal government has spent an average of 18.5% of GDP for everything in the federal budget except interest.”
So…if the Medicare budget goes up six percent by 2035, the federal government will be spending an average of 24.5% of GDP? Not a good thing but I’m not seeing bankruptcy there.
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.
What if he needs a $20 million procedure?