--
It upsets me that in these United States access to quality health care is a privilege afforded only to the rich and well-connected. As a matter of moral concern, this must stop.
--

That would be upsetting if it were true. But it is not true, as most anyone visiting an Emergency room knows, especially if you visit one in California. California has even more problems with the influx of illegal immigrants which has contributed to the closing down of some hospitals. So we see that one political action has a very large effect on another area, that is health care.

A demand for universal health care sounds good but putting it into practice is the problem. Having known of too many horrible episodes of health care problems with relatives who live in Canada we have to be very careful not to allow socialized medicine to become the threat to life that their system has become. Recently a relative had what appears now to have been a brain aneurism in their native Canada, after being taken by ambulance to the hospital the person was not seen by a doctor for 5 hours. True once identified as critical they go to the top of the surgical list but often it is too late by then.

Also the insurance numbers are kind of misleading because often young people being in good health intentionally go without medical insurance and when dealing with statistics we don't know who is doing that intentionally over who simply can't afford to buy the insurance. Which probably means the number of 1/3 used in the article above is not that meaningful.

Ron

With universal health care (as most of the European countries have), the young and healthy as well as older and sicker would equally be covered: IOW spreading the risk just as in life insurance.

Medicare has been one of the most successful programs operated by the government, and along with the VA, is able to negotiate volume discounts and reduce costs.

Why is "socialized medicine" such a dirty word when we have socialized education, socialized police and fire departments, socialized military, socialized food inspections, and the government intrusion into nearly every aspect of our daily lives?

Yes, a Medicare type program for everyone would be costly; but the costs of ER where everyone is guaranteed care, at 3x or more the expense of preventiion, is being paid for by our taxes every day. Diabetes is one of the most prevalent diseases affecting millions and the later care is extremely expensive. With health insurance for everyone, a once-yearly visit to a physician or nurse practitioner could improve early diagnosis of such chronic diseases and save millions on later, more expensive care and treatment.

The U.S. pays more for health care per person than many other countries but infant mortality and other health statistics are far worse. So, what are we really getting for the money?

Today, unlike a decade or so ago, most physicians are pushing for health care for everyone. Health insurance for all is the only option. Fewer employers are able to afford health insurance, and the loss of a job can mean
very expensive single-payer costs. Those of us who have health insurance are paying every day for those who do not. Why not make it more equitable for us all?

In response to Ron's comment, while Canadian health care has its problems and could be improved (like any system on earth) I cannot even imagine living under a system where you're faced with a life-threatening illness and one of your concerns is "How will I pay for this?" or even "Will my insurance cover this?" Yes, there is room for improvement but to me it's the American system that's a "threat to life."

It took a visionary Christian politician to bring universal health care to Canada, and decades later it's time for Christians in the US to pressure their government to end an incredible injustice.

Hong Kong has the most "equitable" system I have seen. It allows for both a "public health system" for all and an a "private" system for those who choose it in addition.

It also allows for a comparative system of outcomes so that the overall system improves.

With scarce resources the "public system" will always end up with some rationing and it is a pipe dream to expect otherwise.

It should be remembered here, I suggest, that we are not necessarily discussing "morality" but different economic views of health care development and delivery which ultimately must be paid for. If "health care" was a God given right it would exist in the poorest nations of Africa.

I suggested thirty years ago in print in the Ga.Dental Association Magazine that the tax preference and inequity for employer provided health care in US tax law would be the modus operandi to "national health care" coverage...it will happen as the result of that "two tier system" which through demand drove fees higher for all at the expense of others not equally covered. An entire system was developed around a tax code and third party providers.

At this point, pragmatically, a "dual system" such as Hong Kong along with equity of tax treatment is the most equitable in my view.

To appeal to EGW and "Ministry of Healing" and SDA's and relate that to "National Health Insurance" would, I suggest, be unknown to her and is irrelavent in my estimation to the conversation.

regards,
pat

Elaine the reason socilized medicine is a dirty word is because it goes against the capitalist system which is basically offering a service a person wants for which the person pays money which the person offering the service wants. That philosophy leads to competition, and even though the government is already heavily involved in medicine there is still abundant competition which leads to improved services turn around time etc.

I was curious what our Adventist medical system looks like in socialized medicine countries. According to wikipedia
http://en.wikipedia.org/wiki/List_of_Seventh-day_Adventist_hospitals

we only have on hospital in Canada, none in England or France and the one in Canada when looking at the hospital website I could not see any Adventist affiliation. The question would be what would socialized medicine do to Adventist health care with all of our many institutions. Of course Socialized medicine is not the only option but to a lot of the political liberals it is their first choice. With the logic Elaine used about Police and Fire departments, which is not really a sound comparison. But I thought the question of what would happen to our institutions should socialized medicine be accepted is an interesting idea to ponder.

Ron

One major reason why health care is so expensive is BECAUSE it is competitive: there are insurance companies that are the middlemen between the patient and the physician and hospital. Middlemen ALWAYS get the first cut.

That is the reason "straight" Medicare is far less costly than the Medicare insurance packages:
they operate usually at a 10% markup over straight Medicare. As a Medicare recipient for nearly 20 years, I have many times been offered the choice of various Medicare insurance policies, but when asked about the cost, none can compete with straight Medicare. It's a simple equation: deal directly with the government, or go through an intermediary (private insurance company) and pay quite a bit more.

Of course, the insurance lobbyists are busy padding the pockets of congressmen to keep "competition" alive (read--keep my business afloat).

For those that prefer private enterprise, how about: exclusive private education; private police and fire departments, and such? The physicians' time completing multiple different insurance claim forms are paid by all of us patients. With a single-payer system, there would be a huge savings, just as the suggested electronic records would also be a savings.

As someone who has frequented hospitals and physicians' offices, the "turn-around time" with present competition is quite lengthy: i.e., for hip and knee replacement, the waiting list is approximately half a year. Is that better than the European countries under socialized medicine?

It has not been demonstrated how a single-payer (socialized) medicine would affect SDA health systems. They have been operating for 30+ years with Medicare and Medicaid and hundreds of private insurers. Wouldn't the elimination of so many different policies save time? Has the SDA health institutions taken a position on this?
What is it?

Elaine,

Third party payers,(Insurers) reduced competition by simply increasing demand for "limited" resources. The patient saw the promise of almost unlimited "free care" when the process began if covered by one's Employer. There was no motivation to cut cost by the patient or for that matter improving ones personal "prevention/lifesytle habits."

If there was direct pay by patient to providers now what would happen? Fees would have to go down and there would be dramatic cost cuts and supply cuts across the board in the medical field until a new equilibrium was met.

That road won't be traveled because of it's painful consequences at this point and that's why I said the Hong Kong model appears best to me. It allows the most choices which is always a positive.

Following your reasoning we should just let the government set the price for everything as "it would be cheaper."
Totalitarian collectivist history shows that doesn't work.

regards,
pat

No Elaine it is not because of competition it is because of regulations and litigation.

If you find medicare to be sufficient than why not simply extend medicare to the uninsured who for whatever reason aren't covered under medicare now. Then you don't have to rework everything. You say the time for hip or knee replacement is extensive under medicare, well medicare is effectively socialized medicine. Under private insurance it is not nearly as lengthy so Yes under medicare there is often extensive waiting just like in England or Canada. But I don't see making such waits the norm is the answer.

The idea that government as the single payer would make life easier is doubtful as few areas of the government work as efficiently as the private sector. Certainly computerized records will help which is why most hospitals have moved to those systems and if every insurance company would standardize their forms that would help also as would other areas where a standardized form could be used such as college applications or loan applications etc. I doubt if the government tried to standardize such things there would be much complaint. But people seem to think that there is some grand thing the government can do that will fix everything. It never happens that way though. As we see very clearly with AIG, what the government thought was a good idea did not take into account many things involved such as the contracts of the employees. Same thing happened with the TARP monies they thought giving money was enough not thinking about accountability for the use of the money by either the company given the money or the government who gave the taxpayers money.

People act foolishly when they don't think ahead, all too often that is compounded when it is done by a government. Present some options and let them be debated, but never rush into change for the sake of change. I would much rather see some think tanks take on the issue and provide a recommendation then see a bunch of denominations get together and form some committee to work on these things.

Ron

"The idea that government as the single payer would make life easier is doubtful as few areas of the government work as efficiently as the private sector."

Agreed; however, both the government and physicians agree that Medicare for everyone (socialized medicine as you describe) is more cost-effective and efficient. Why should we, the taxpayers, pay approximately 10% more for private-insured health care than Medicare?

The pro positions taken are more conducive to a Medicare-type coverage than private. After all, it has been used now for nearly 50 years and has worked quite well. The cost increases somewhat each year, but is far less expensive than any private plans and there are no pre-existing conditions prohibiting coverage as with many private plans.

BTW, whether a patient is Medicare or private-pay, for the top orthopedic surgeons, elective surgery wait is all the same for both types of patients. Besides, most physicians, other than a few specialists (pediatricians) all take Medicare. We are the largest users of health care.

I've grown up during soviet times and I have some experience with socialism. I wonder how people now days are so quick to throw away capitalism as evil and embrace socialism as a new savior. The problem with capitalism is that when people have freedom to make money, to control businesses etc. they start abusing this freedom. To solve this problem we give more power and control to our government. However the problem is that sooner or later the government will start to abuse its power too (if its not happening already). But it will much harder to get take the given control away from it.

We are in a search for better system to sustain the life of our civilization. But the only true solution is kingdom of God. All other solution weather capitalism, socialism or communism may delay the decay of the system as a whole, but we wont be able to stop it.

Elaine wrote:

--Agreed; however, both the government and physicians agree that Medicare for everyone (socialized medicine as you describe) is more cost-effective and efficient.

--

I would like to see where you get that idea. I do remember years ago when I was ordering lab test we would choose a particular chem panel instead of ordering just a couple of tests that were on the chem panel. Because run separately they would cost the patient more. You can't do that now, it is considered fraud, the fraud being ordering tests that the doctor did not order. Doesn't matter that the cost was less that way. So no I don't buy the idea that medicare is more efficient or cost effective.

As for the time for a wait time that is related to the number of people who can do the surgery. Which means that in a capitalist system you will have more doctors available to preform a surgery.

As for the fatalism that everything stinks until the kingdom of God appears I don't think that is the kind of people God wants us to be. Make the world better, use your minds and build up the best systems you can is what I think God would have us do.

Ron

The information given is readily accessible by merely googling "single payer health care." The Physicians for a National Health Program are top supporters for single-payer.

As for lab tests, my late husband had the largest medical lab in the Central Valley of California for more than 30 years, and the mandate for including more tests has been in force for many years as most extra tests are rather insignificant in adding charges with the lab machines they are automatically performed at almost similar expense.

Information is easily obtained and when physicians, who for many years were adamantly opposed to "socialized medicine" are now proposing its efficiences they should be heard.

There are four things that need to be fixed for the USA system to begin delivering value-per-dollar on a par with other countries.

1) The legal system needs to be changed around malpractice. Anyone who thinks the current malpractice system in the USA works for anyone other than the lawyers should read the chapter in "Better: A Surgeon's Notes on Performance" by Atul Gawande. He shows it doesn't work even for most of the patients who are damaged by malpractise.

2) Money spent on medical treatment needs to be prioritized against what else can be done with the money. The hospitals and the medical supply companies will figure out a way of spending ever dollar you allocate to them on doing something for the good of the patient. That does not mean it is the best thing to do with the money.

3) The money that is spent on medical treatment needs to be spent much more carefully. I am repeatedly involved in $500 ambulance rides for people who would be adequately served with a $25 cab ride or a $0.10 aspirin.

4) The costs of medical supplies needs to be drastically cut. Lots of research money is being spent on drugs/machines/procedures that will make a profit, not ones that will make a real difference. Medicare et al need to start using their size to negotiate good deals.

Should the churches get involved? In my experience they usually make situations worse by bringing in irrational ideas that are not grounded in a proper cost-benefit analysis.

One only has to look at the disaster the "aid" programs to Africa cause, and especially such utter disaster's as the Catholic Church's anti-contraception campaign...

/Bevin
EMT-P - Nationally Registered Paramedic

What a surprise Elaine, there is a politically liberal group advocating single payer medicare for all. So that group must speak for everyone. That is not really speaking for everyone is it?

---
Liberal Groups Seek Single-Payer Health Care Bill
By Alex Wayne, CQ Staff
January 30, 2009, Washington, DC

Published by Congressional Quarterly.

A coalition of liberal advocacy groups and labor unions is trying to breathe new life into the idea of a European-style "single-payer" health system in the United States, a concept thought discredited after the collapse of President Bill Clinton's attempt at overhauling the health care system.

The groups announced Wednesday the launch of a lobbying campaign to build support for a health care overhaul that would expand Medicare, the health entitlement for the elderly, to cover everyone and act as the "single payer," putting health insurance companies out of business.

After a conference call with reporters to outline their plans, the groups held a briefing for about 45 Democratic congressional aides to discuss "Medicare-for-all" legislation and research that predicts economic benefits from a nationwide expansion.

"We cannot rely on private health insurance any longer because of its waste and its greed," said Dr. Robert Zarr, co-chairman of the Washington chapter of Physicians for a National Health Program.
--

http://pdamerica.org/articles/news/2009-01-30-10-38-35-news.php

Ron

To reiterate my main point in different terms, health care is a human right, not a commodity to be traded on the open market. Certainly there are market aspects to it, but at the most basic level health is not a commodity to be bought and sold.

The problem in our society is not the market economy but the way every aspect of our society has been commodified. If we make health care a commodity then only those who have succeeded at the capitalist game can have it, and this is MORALLY wrong.

I think Elaine said it best, "Why is "socialized medicine" such a dirty word when we have socialized education, socialized police and fire departments, socialized military, socialized food inspections."

We can see where unregulated free markets have gotten us. It's time we give people access to basic necessities of human life.

Ryan,

You are entitled to your view. I don't see health care as a "right." It is a privilege that may be received by paying for it or from the grace of others on another's behalf paying for it or by the charity of the provider. That, I suggest, is what is moral.

regards,
pat

Unfortunately, people (including churches) do not step up enough to cover "another's behalf." That's just the way life works.

The Universal Declaration of Human Rights (UDHR), which has been around for 60 years, contains 30 articles on rights for all human beings. Among these rights are (Article 4) Freedom from Slavery; (Article 7) Right to Equality before the Law; (Article 18) Freedom of Belief and Religion; and (Article 21) Right to Participate in Government and in Free Elections.

Here is Article 25: "(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."

Yes, we each have our views. The above view, however, was ratified by the countries of this world (including the U.S.--and the U.S.S.R.). This promise the U.S. has not kept.

We may argue against these rights, but for heaven's sake (literally), why would we do that? Why not work for the general welfare of good health, particularly for children, as we work for their general education? (And please don't demean Christianity with "Jesus was a capitalist" rot.)

This country can do far better. And in the far better country of the new earth, God Himself will ratify the premise behind every article.

People who advocate by saying things are a right always have the smell of taking something from someone else just like the classic grasshopper and the ant story where the grasshopper sings repeatedly, "OH, the world owes me a living...."

If heath care was a right you should be able to secure it your self. Just like you have the right to hold your breath as long as you want or the right to lie and say your sick when your not. The results are up to you.
Health care is not a right.
If it truely was a right it would have applied throughout time. Just like freedom and self determination. Can you imagine a cowboy in 1820 saying he had a right to universal health care?
It is not only nonsensical it is ridiculous.

What part of self determination dont they understand? "I have the right of self determination and I determine you will provide me with universal healthcare"?

I see that the usual scare language and anecdotal evidence has been trotted out again, by some. Socialism! Run for your lives. Canada's a disaster because someone knew someone. And that never happens in America?

I like how Ron, who doesn't live in California and is not young, explains to those of us who do and are, what the situation is.

Blame the poor illegal immigrants. Generalize about the young, some of whom lose the gamble because they can't afford (not choose to skip) good coverage as they start out in life. To some, it's so simple, really. . .

Here's one of the brightest experts on health care, Ezra Klein discussing the issue with conservative Matthew Continetti.

http://bloggingheads.tv/diavlogs/18408

Today, I listened to Paul Farmer of Mountains Beyond Mountains fame. He really knows what he's talking about and made an informed plug for universal health care.

http://www.kqed.org/epArchive/R903170900

Finally, rather than rehashing the logic involved in showing that we're all better off when we treat medical care as a human right, here's the Center for Economic and Social Rights. One doesn't have agree, but objecting to "rights" language as such makes no sense as the history of American is about the expansion of the right to freedom, including the freedom from want. Check out what Dr. Farmer says above.

Here's the CESR discussion of the right to health care.

Legal framework
http://cesr.org//article.php?id=122

What it means for America
http://cesr.org//article.php?id=118

Yes, Michael, and what would your cowboy say about the right for women to vote or some to live without being forced into slavery? Probably the same thing you're saying now about everyone's right to affordable health care.

America can afford it. A majority wants it. What will you personally lose via universal health care?

I'd be interested in universal healthcare; however, there should be reasonable limits on the "care." For instance, elderly people who are diagnosed with a terminal condition would have very limited treatment options, perhaps none at all.

They should be provided with comfort measures.
Solomon said that those ready to perish should or could be provided with strong drink. Good idea.

Futile treatment should be completely eliminated, unless people are willing to foot the bill out of pocket. There should be some private care available for those who can afford it.

People who insist on using tobacco or are alcoholics or have other lifestyle issues known to have a negative impact on health, such as obesity, should be penalized in a meaningful way. There should be lots of health promotion provided in the universal health care package to help people resolve lifestyle issues.

Type 2 diabetes, for instance. Can usually be avoided or effectively treated with lifestyle changes. If a 250 pound diabetic wants to watch tv all day, eat potato chips, and expects the public to foot the expenses for medication and care of complications, it won't happen.

This is an area where Adventist health care could really capitalize, implementing a NEWSTART type paradigm. People willing to adopt it would be preferred clients of UHC.

Alex,

"America can afford it. A majority wants it. What will you personally lose via universal health care?"

America is the biggest debtor nation in the world. That mantra simply is no longer true. America could not afford a home for everyone either as the "best and brightest" thought by creative financing and "collaterizing" all forms of debt (off the bank books) sold all over the world with guaranteed backing of credit default swaps by the likes of AIG. That AIG guarantee is now being paid by U.S.taxpayers through debt creation to prop up ill conceived ideas of the worlds largest bank/holding co's...including 20 billion to date to European banks.

To the point...I suggest no "provision of goods and services" is a guaranteed right. It is the result of someone first producing and creating wealth and then purchasing something for themselves or someone else (charity). A "public health care system" such as Hong Kong in my view should properly be seen not as a "right" but as a form of "perceived charity" by the entire population through taxation for the pupose of "base coverage" for all citizens. Do you see the difference of mentality created by recognizing the fact that we live in a world of "scarcity" where there are limitations of goods and services which can only be redistributed after being produced?

Government must first take from it's citizens through taxation or debasing of it's currency what it can promise/give to others. This law of economics can not be violated by "creative thinking" that can simply think things into existence.

I am not a libertarian but I am a "limited government" believer...because I believe it offers the most freedom of contract/choice and the most reward for excellence/effort to the most people. Sin of all types destroys "limited government." "Freedom" is not a guarantee but must be the product of personal responsibility under equal protection of just and equitable law.

Yes, I think the time has come for a system such as Hong Kong due to the "overleveraged health system" that has been created by the original tax code that created the "two tier" system we presently have.

regards,
pat

I am sure you all remember the old saw: "A country doctor drove into town in his old tin lizzy and parked in front of a group of school boys. They all started to laugh and point to the old car. The Doc said, 'Laugh it you will, but the car is paid for but you are not!". Tom

Tom,

Great comment. Those boy's right to delivery and health care were met by that "country doctor's" charity and delayed gratification.

I am sure you have much to add to this conversation related to your experience at UGA.

One thing is for sure. We can have different views but it must be paid for...and that ain't a divine right for anyone.

As a "country" farmer said when visited by his pastor after the pastor stated how the Lord had made his farm house and fields so lovely: "you should have seen it when He had it by Himself."

regards,
pat

Pat

Great Addition: MCG is still too close to home and heart to tell some of those stories.

The President that recruited me had a heart as big as all of Georgia--too big for Georgia to accept. He passed away three weeks ago at the age of 87. Not a word in the local press other than the routine notice. Tom

Ryan Bell deserves a lot of credit for pointing out that Christians of all people should put compassion above the dogmas of social darwinism. The issue of money has been brought up but money is not the issue. Every European country provides health care to its citizens. These countries are not doing it because they are richer than the US but because compassion means more to them than it does to us.

It is indeed striking to see a secularized Europe show more concern for people in need than we do who live in a nation marinated in religion and churches. Of what use, I ask, is a profession of faith, if it leaves people so hard of heart that they simply shrug at the fate of nearly 50 million of their countrymen without adequate health care.

In this country we banish Darwinism from Biology, where it belongs, only to reintroduce it in Congress as if it were a divine mandate for running a country. It's a strange world in which compassion means more to European atheists than to a lot of people of faith in this country.

Ryan, keep up the work. "Faith without works is dead." More power to James.

The culture of Christianity permeates many of those countries, atheist or not. Cultural Christianity isn't so bad, compared to, say, cultural atheism.

I suspect that people in those countries, atheist or not, can reasonably expect to be told the truth. People in countries without that culture lie about everything all the time, or so it seems.

Many of the countries of Europe would not be what they are but for the history of Christianity in those places. Compassion is just one of numerous remnants of a better age.

People don't owe me a living, or healthcare. However I was born into a society that has a concept of ownership, and I have been asked/forced to respect "Tom owns that land, Dick owns that coal, Harry owns that idea".

If I can't get what I need from this system of ownership, I will fight it - using brains, stealth, and force.

If society doesn't want me to fight it, they will make sure the system provides me with enough incentive to fight for it, not against it.

A basic level of health care is part of persuading people it is in their interests to work for the society, not against it.

As I have said above, the USA needs to adjust (a) what is paid for and (b) how it is paid.

Right now we often pay too much for the wrong things, and not enough for the right things.

/Bevin
Paramedic

ps: My daughter, home after two years in Africa with the peace corp, saw the pope's comments about condoms in the paper this morning and was horrified. Another example of well meaning christians pushing for the wrong things in the wrong ways

We already have universal health care - it is WHAT is done, HOW it is done, and how much it costs that is the problem.

Any hospital which accepts Medicare is not allowed to turn away an ill patient. A rule which results in the minor illness turning into a major illness before it is treated, and then being treated in an unnecessarily expensive manner.

Hospitals are beginning to experiment with providing outpatient care for free, to try to avoid these costs.

The need to be avoided because the government forces the hospital to bear them, and then does not recompense them for the expense - so the hospital passes it on to the insured patients, so the insurance companies hike their premiums, so we get the bill.

Currently, everyone pays for everyone else's health care. It is only the form that it is different. For those covered by health insurance, we pay premiums; for those not covered, we pay in our taxes.

Where was the outcry when billions were spent for wars in Afghanistan and Iraq? Where were the long, disputed arguments on Capitol Hill? Yet, when health care for its own citizens, the U.S. suddenly becomes very stingy.

The European countries, long ravaged by centuries of wars on their own lands, refuse to
hastily engage in wars without very good reason.
The U.S. is still more willing to spend billions to maintain military forces around the world at great expense, than to care for its own citizens.
Like Rome, no country is immune from deterioration and rot from within. The Communist countries have long pictured the homeless living in U.S. cities, focusing on the lack of care for its citizens.

The old saying: "Pay now, or pay later" is very true of health care. Those who are not protected now will eventually cost us much more later.

It is shocking to see the lack of compassion on those who call themselves Christian and feel they are NOT their brother's keeper. When and where did this attitude originate? Christians were known from their first beginnings as those who cared for the sick, built hospitals and cared for the poor and orphans. What happened?

Ryan wrote:

--
To reiterate my main point in different terms, health care is a human right, not a commodity to be traded on the open market. Certainly there are market aspects to it, but at the most basic level health is not a commodity to be bought and sold.
--

By that logic we could say food and shelter are rights and not commodities to be traded on the open market. For both food and shelter are even more basic then health care.

Alex wrote:

--
I like how Ron, who doesn't live in California and is not young, explains to those of us who do and are, what the situation is.

--

For your information (not that you know how to use information) I used to live in California and I used to be young and I used to be without insurance. Also relating personal information about the problems in Canada's health care is far more meaningful then the opposing position which was that as someone said ""How will I pay for this?" or even "Will my insurance cover this?"

But as Alex demonstrates the political liberal does not engage with ideas other then their own very well. And frankly their own ideas appear to be poorly reasoned and often based upon false assumptions.

Ron

How many good folk here have contributed "liberally" to SDA medical work in foreign countries over the many years? Where the natives are poor and have no medical care at all?

Why are overseas "missions" or needy folk in foreign countries more worthy than our next door neighbors? Have we forgotten the Golden Rule:
"Do unto others..." or "Love your neighbor as yourself?"

How many here are benefiting from their employers' health insurance plans? What happens to you, or millions like you, when you no longer have a job? Who will pay for your medical care?
We, the taxpayers will. We can give them the dignity of their own coverage, or grumble that we are paying through our taxes. Either way, we ALL pay for the uninsured. The only difference is how it is structured. Who is willing to say:
"Let them eat cake"?

So the question is what is the best way to help those who can't afford insurance and what is the best way to reduce high costs of medical care. It is not about who has the most compassion. If socialism was the most compassion oriented system then the communist system would have been the model of compassion. But it is not, if totalitarian government was the best approach because government knows best, again communism would be our compassionate model. The reality is far different. The reality is that issues are more complex then taking the money from everybody and letting the government decides how to spend it.

Compassion is what the individual does or group of people do, it is the sacrifice of the missionary giving up his/her opportunity costs and personal inconveniences for someone else. It is not compassion for the government to take your money pay for a bureaucracy and funnel a portion to the needy to be used as the government allows them to use it.

But that is the common argument that Elaine and others use. Compassion is doing things their way, any other method cannot be tolerated because theirs and only their method is compassion, other ideas are simply the ideas of the cruel and the money grubbing capitalists.

Elaine wrote:

--
How many here are benefiting from their employers' health insurance plans? What happens to you, or millions like you, when you no longer have a job? Who will pay for your medical care?
--

That gets back to my observation to Ryan. What happens when you lose your job. food and housing need to be provided for you, who will pay for you food. Well the fact is that if the economy collapse and millions lose their jobs there will be starvation, the farmer won't be able to buy or fix or fuel his equipment and even if he did farm, people would steal the harvest. Because there is nothing more basic to human need then food.

Now we benefit from employers health insurance because we pay for it out of our wages. The difference is that food comes not from a cooperative effort of employees getting together to get the best price for food but because we take our wages and buy food. When we lose our jobs we will lose the ability to get food. So Elaine who will pay for your food then, the government? and where are they going to get their money from? the people who can't buy their own food?

Ron

America can afford it. A majority wants it. What will you personally lose via universal health care?

Posted by: Alexander Carpenter | 18 March 2009 at 5:53

I have rarely read 2 more absurd staements.

America can NOT afford it. Why do people who bash Reagan and republicans for deficits think that NOW of all times in history, is the time to bring up this rats nest? Deficit isnt high enough yet?

The majority wants it? Of course they do. So what? There are alot more grasshoppers than ants in America.

What will I loose? I will be the one paying for it.

Where is the majority's responsibility? Or do they have a right to whatever distructive behaviours they feel like even if it drives up the cost for those of us who will be footing the bill? Can they have their cake and eat it too?
Perhaps we should set limits for Body mass index, drinking smoking and other high risk behaviours and say if you are so worried about your medical status then we will cover you if you refrain from these activities.

Why not honestly say: "We are not our brother's keeper. Let him starve, die from disease, or criminal action. It's not my problem."

What will I loose? I will be the one paying for it.

If you are insured and paying taxes, you are already the one paying for it.

If you are uninsured or not paying lots of taxes, then you are already getting your coverage from those who do.

Where is the majority's responsibility? Or do they have a right to whatever distructive behaviours they feel like even if it drives up the cost for those of us who will be footing the bill? Can they have their cake and eat it too?
Perhaps we should set limits for Body mass index, drinking smoking and other high risk behaviours and say if you are so worried about your medical status then we will cover you if you refrain from these activities.

We already place limits on the kinds of activities people are allowed to engage in. They can't drive a car that doesn't meet various tests. They can't own a home that doesn't meet various tests.

As I said above, it is imperative that we STOP covering various things THAT WE COVER TODAY.

Do you know what happens if an uninsured over-weight smoker not wearing a seat belt has a car accident while over the legal limit of alcohol in their blood, and requires $1M of medical care to keep them alive and ongoing bills of $0.1M/year for care?

THEY GET IT TODAY AT THE TAX PAYERS AND INSUREDS EXPENSE and the lawyers, the health care companies, and various others ALSO get a large cut.

Do you know what happens if some unemployed woman with 6 kids decides to give birth to octuplets?

THEY GET THEIR COSTS COVERED TODAY AT THE TAX PAYERS AND INSUREDS EXPENSE and the lawyers, the health care companies, and various others ALSO get a large cut.

/Bevin
Paramedic - who spends hours filling in forms because of the unnecessary complexity of the current system.

Elaine, When you are up to your elbows in the fecal matter of a combative patient who doesn't know what planet he/she is on, day after day, week after week, month after month, you might get a different idea about keeping your brother/sister.

Active, involuntary euthanasia would have to be included in any realistic UHC package.

Family members who have problems with that can step up and provide the care themselves.

Hansen

I would be interested in your view on elective abortion. Abortion certainly limits health care costs a lot more than euthanasia of the incompletent. It seems there are no shades of gray in your palette. Tom

Michael
Reagan and Bush ended up with huge deficits because they wanted services and programs without paying for them. In other parts of the world they pay for health care without the incessant whining with which the conservatives of this country approach funding.

So what if it will cost you a bit more in taxes to provide health care for everybody? It doesn't strike as particularly Christ-like to argue that millions of people should suffer because I'm too selfish to want to contribute towards a solution. Can you seriously imagine Jesus arguing against helping your neighbor because it would go against Republican ideas on taxation?

Tom, Of course I approve of elective abortion. Non elective as well. Some people would be better off having never being born.

Aage,

I don't accept the way you construct your argument. "Can you seriously imagine Jesus arguing against helping your neighbor because it would go against Republican ideas on taxation."

I don’t believe Christ has a Democratic or Republican agenda. Both parties are full of half truths and compromise.

What I do think of Jesus is this. He is a God of justice and mercy. He is a God who requires accountability and not an "open checkbook" without consequences regardless of choices. He is a God who respects and created the right of "private property" in the command of thou shalt not covet.

You place all the responsibility for another’s care in your framing outside of one's family unit and act as if all needs are the same. You also act as if all choose the same "personal economic value" in life's choices. I’m sorry but the philosophy of being able to do what one emotionally perceives to be “just doing the right thing” in economic activity often leads to bankruptcy. Scarcity exists in real life choices requiring careful decisions and priorities.

So, I do not believe Elaine or Aage that I am my "neighbors keeper" in all circumstances where my neighbor with discipline and effort could be the keeper of himself.

For the "truly needy" help should be made available especially at the state level where such an evaluation is much easier than simply being a "national number" with no real accountability.

I do believe that health insurance needs to be made available at the same average cost for equal coverage to private individuals through a collective pool as made available to employees of Corporations and they should be tax deductible expenses in the same way for all if they are for any. I see no equity of law otherwise.

regards,
pat

Glen Hansen,
I think you're speaking tongue in cheek or maybe sarcastically regarding non-elective abortion and non-elective euthanasia. Am I correct?

I've been a nurse in nursing homes and hospitals all my life and I would never want to see the USA start down that slippery slope of euthanasia. Abortion is already murdering millions of innocent human beings every year. This is just as bad a sin as the human sacrifice of innocent babies to the god Molech in the old testament except of course that instead of placing the baby alive onto a red hot pan at the feet of Molech we simply take forceps and crush its brain or else suck the brain out with a vacuum pump. And some call this "health care"?

Hansen

The morality or immorality, the ethical or unethical taking of life be it abortion or euthanasia is based not so much on the death of the victim as on the debasing of the perpetrator--the Nazi effect!

Pat:

Those that abuse themselves with riotous living are less costly to the health care system than the veggies, if you factor in the 20 years of health care the long livers live.

The heavy smokers, drinkers et al die in their late fifties and early sixties, while the veggies live well into their eighties and ninties. The 20-30 years of additional health care and custodial care adds up to more than the final health care costs of the prodigal.

Never-the-less, I believe in a very heavy tax on tobacco, alcohal,junk foods, and high performance sports cars. Tom

Wow, this is remarkable. What's amazing about my work in PICO is that we have Republicans and Democrats and Independents, liberals and conservatives all working side-by-side to solve the problems we ALL face in our communities.

When you're working on the ground with actual people and listening to stories and sharing your own stories you realize this is not about ideology. It's about people. It's so easy to create all these straw man arguments at the level of ideology - all from the comfort of our well appointed homes with our health care safely in hand. I live and work with people who don't have either. They are my concern.

Tom, Does capital punishment "debase" the perpetrator? On the contrary, the non implementation of capital punishment is debasing.

The OT admonishment to execute recalcitrant children as well as abort undesirable fetuses certainly provides guidelines worth consulting in modern society. Scripture acknowledges the proper use of the sword relative to law and order.

Talk of UHC coupled with an unwillingness to make the difficult decisions required for an effective system is just that, talk. Without checks and balances, it would be worse than the present system. Every malingerer and psych case would be lined up for "care."

"Tom, Does capital punishment "debase" the perpetrator? On the contrary, the non implementation of capital punishment is debasing.

The OT admonishment to execute recalcitrant children as well as abort undesirable fetuses certainly provides guidelines worth consulting in modern society. Scripture acknowledges the proper use of the sword relative to law and order."

---

I'm just going to pretend I didn't read that. This thread is bordering on fascism. I'm out.

When the going gets tough, start labelling and run away. Great leadership skills? All you noble ones who want to provide UHC, try providing just basic care, day in day out for a few months or years. Do the work yourself. Wrench your back, experience burn out, get stuck with a dirty needle, see how you like it.

These ideologues are not the ones who are going to actually involve themselves in the work of caring for the sick under UHC, nor are they going to have to deal with the medically unsophisticcated types who are going to begin screaming when futile treatment is denied them or their families.If UHC is going to work, there must be boundaries. Those who think we can afford it haven't looked at a bill for ventilator assisted ICU treatment recently.

I once spoke to a "doctor" who was opposed to the use of abx to treat pneumonia. "No need for them," he said. "Just do hydrotherapy around the clock." "So who is going to be up all night giving the treatments, I asked. Oh, we'll let the nurses do that." Right. Doctor sleeps comfortably in his bed while an underling carries out his ideology.

That's about where this UHC is headed.

Tom,

I am not against "sin taxes" but more often than not the funds go into a "general fund" that is spent on politicians favorite new project...then where is that "earmarked money?"

Kinda like SS payrole taxes going into the general fund and a paper IOU being made. Oops...where's the money? The printing press.

Hey...leave those sport cars alone but make insurance rates higher for bad drivers. :~)

regards,
pat

Ryan

Yes, There is no evidence that the death penalty deters crime. Compare Illinois with Michigan. There is evidence that the death penalty is far more costly that life without the possibility of parole. Even Supreme Court Justice Stevens who has voted consistently for the death penalty now believes it should be abolished because of the cost to the state and federal government. The only way that the cost of the death penalty could be reduced would be to abolish Habius Corpus--The Religious Liberty Department would have a tizzy.

I suggest you read Fox Book of Martyers again. Even Calvin and Luther have blood on their hands. Or just read Great Controversy on the Peasant's Revolt.

Pat: A one percent tax of soft drinks built the original academic health center for the state of West Virginia.

The sports car issue is two fold--the car does not adequately protect the driver and passenger and the temptation is to drive at the edge. Insurance for personally liability may be the better answer as well as high (six figure coverage) personal injury coverage for driver, passengers, and victims. The health care cost for burn victims can run into seven figures. Tom

True that in the USA, the death penalty may not be much of a deterrent. That's not because the death penalty in itself is not a deterrent. It's because the American legal system makes a mockery of justice. The American legal system thwarts justice in capital offenses. It does not serve justice.

If people were promptly executed for their crimes, by firing squad, for instance, there would not be the kind of situation there is in America.

The right to bear arms in modern American society is also a farce. The intent of that right was not to provide every sociopath with a weapon, which is what has happened.

Hansen

Did you ever serve in the Armed Forces? If so in what capacity? Were you ever in active combat? Are you willing to be a member of a firing squad? Have you ever served on a jury of a capital case? Tom

Hansen,

Bill asked you...
"I think you're speaking tongue in cheek or maybe sarcastically regarding non-elective abortion and non-elective euthanasia. Am I correct?"

I also wonder where that foolishness is coming from as others have.

I definately do believe a Living will should be "required" and I have one that voluntarily "disconnects me" under certain circumstances and believe all should have a health care surrogate.

pat

Tom, I served as a witness for the prosecution in an attempted murder trial of two prison inmates who each had a previous conviction related to the taking of human life. They were tried together. After my testimony against the first, the second defendant's attorney chose to not question me.

The fact that they were bumblers did not mitigate their intent. They conspired together to murder another inmate. Had they been properly executed the first time around, they wouldn't have had an opportunity to attempt murder again.

There are lots of guys who would jump at a chance to be on a firing squad, especially those in law enforcement with military backgrounds. Originally, the prison system was the domain of the military. Now it has fallen into the hands of social scientists who want to "treat" inmates. Great boon for the manufacturers of psychotropic medication. Sociopaths don't respond well to treatment because they are suffering from a personality disorder rather than mental illness

The medicalization of the death penalty led to its non use in California. The IV injection of lethal drugs, on its face, is stupid. Many criminals have IV drug abuse histories, making venous access, in some cases, nearly impossible. A bullet would work just fine. It's a lot easier to miss a vein than a heart pinned to a shirt.

If UHC is bungled the way criminal justice has been, it will be just another fiasco.

Pat, There's nothing foolish about being realistic in the face of chatter about universal health care. Most people have no idea the money wasted on futile medical treatment in the last weeks or months of a patient's life. They know even less about what is involved in the care of such patients.

Jewish medical ethics used to hold that, because the breath itself is sacred, no reference to quality of life issues are required, as long as the breath is preserved. Those kind of ethics played well during the days of fee for service. Nowadays, keeping people breathing, simply because it can be done, when there is less financial incentive for so doing, well, the ethics might require another look.

A lot of this nonsense is based on the so called "sanctity of life" doctrine which is as shamelessly peddled by Rome as were indulgences in the past. There is nothing sacred or sanctified about human life, unless it is connected by faith to Jesus Christ. People are born sinners, enemies of righteousness and of God.

"There is nothing sacred or sanctified about human life, unless it is connected by faith to Jesus Christ."

I beg to disagree. Because one is not "saved" does not remove their "sanctity of life." God in His goodness causes the rain to fall on the just and unjust. I am not prepared to "double guess" Him. Some might have killed me in the past!

I suggest to avoid the shock treatment and thouroughly point out your observation and "solution."

pat

Hansen

The glee in which you express your vindictive retribution is appalling. Scripture is plain. "Vengence is mine: saith the Lord, I will repay!" We now live in a civil society, not a theocracy--it is a proven fact that the death penalty is more costly and less effective solution to capital crimes than life without the possibility of parole.

I agree with you on the right to bear arms. It was allowed in the days of the minutemen. Now, to purchase a gun, the purchaser should be required to take proper military training and be a part of the national guard on call under strict military discipline.

I suggest you compare Chicago with Detroit. Chicago has the death penalty and Detroit does not. Factored for population the murder and other capital crimes are as high or higher in Chicago than Detroit per thousand residents.

Frankly, I don't sleep better knowing one with your vengence is loose.
Tom

It is interesting to see the twists and turns in the conversation regarding universal health care. The fact is that aside from the death penalty conversation most of the other issues are critical to universal health care. The cost of caring for a premature infant, say two months premature is going to be several hundred thousands of dollars. that is a lot of well baby visits for a lot of other people. where does one draw the line? The same is true of end of life issues, we do much better with hospice care now but keeping an elderly person alive for another year can be very costly also. What about the treatment of cancers, when other methods fail many try methods involving bone marrow transplants which can again cost hundreds of thousands of dollars.

What happens on these issues, are you content to let the clowns in Washington DC decide them for you, the same people who presided of the financial collapse of Freddie mac and fanny mae the people who give money to bail out companies like AIG without taking the time to address the other issues involved.

It sounds oh so good to say my concern is the people on the streets the poor without insurance. Acting as if only people like you care about them. When in fact caring involves far more factors then these people think about. But then isn't that always the problem with short sighted people. When they can't defend their positions without simply using emotion or calling names they simply ignore the questions.

I think with the current administration we will very likely get universal health care. You will however find that it cures very little and that the quality will decrease, the availability will decrease and the poor will still be poor and still die at about the same rate as the previous system. But the liberals will be happy because spreading the misery is what they normally try to do rather then increase efficiency and make systems work better. The funny thing is that is how America has built itself up through the years yet it seems most have forgotten our own history in favor of using some other less successful models. But you really can't have the discussion with those who say do it our way or else. It would seem the most obvious compromise would be to expand medicare but that is not what the liberals push they want to create a single payer system for everyone even the 250 million people already covered. It makes no sense.

Ron

Also just because some envision a national heath care system it doesnt mean they are allowing for everything, even the salient issues Ron raises.
Part of the cost of healthcare is medical malpractice insurance.
If you cracked that nut alone one could make health care more affordable and we wouldnt even be considering the bloated and in effecient government becomming involved.

Just because someone might have national healthcare does not mean giant lawsuits go away.

Michael

The annual cost of malpractice insurnace in Wisconsin in 1950 was 21 dollars a year for a general dentist. When I was in practice in Milwaukee the highest settlement for a dental malpractice suit was $2,000. Just imagine what the costs are in plastic surgury etc. The thing that really kills is the tail. The number of years one must continue to carry coverage even in retirement. Liability continues for a minor until at least two years after they reach their majority which is at least until 18 and in some cases 21.

With the recent shambles on Wall Street I know several who will have to postpone retirement.

A much better approach would be to offer major tax incentives to small businesses to provide coverage for their employees and to expand Medicaid for at or below proverty levels.

Tom

Of what benefit to taxpayers is the guarantee given to small businesses to offer health insurance to employees? Why is it better to subsidize the small businessman than to pay directly through the government? There also are many people who are self-employed, with private pay insurance at exorbitant rates.

Admittedly, we, the taxpayers are the last wallet, and must "cough up" for single payer insurance. But isn't it better to have single-pay, just as Medicare for everyone with all in the group together: the poor risks and the healthy young people to spread the costs? Cherry picking is practiced now by all the insurance companies. I recall some twenty years ago, my husband was covered under my Medigap insurance as no insurance company in business would have offered him a policy at any price. Medicare is the exception.

If Medicare can do it at between 10-15% LESS than private insurers, why shouldn't everyone be given the same opportunity? Why should health care providers have to deal with hundreds of different insurance companies? I would much rather my taxes go to health insurance for everyone than to fight useless and unending wars in Afghanistan, Iraq and God knows where else. We taxpayers had no voice in those decisions. I don't recall voting on that, do you?

Elaine wrote:
--
Afghanistan, Iraq and God knows where else. We taxpayers had no voice in those decisions. I don't recall voting on that, do you?
--

I would wager if we do get universal health care they won't be a vote that you will vote on for that either. That is simply not how Representative Democracies work.

Ron

Elaine

Very good points. The problem is the government sublets Medicare through big fish insurance companies that take a mighty big bite out of the pie before it gets to the provider. These fat cats and hospital CEO's are getting rich off of taxpayers money and at the expense of the provider. I would rather seem the flux go directly to small business owners than to the fat cats that are now getting morbidly obese.

A recent invoice from BlueCross reads as follows:

Amount Charged 91.00 Amount Allowed 63.93 Medicare 45.92

BlueCross 11.26.

Fortunately the physcian is a good friend--I still get 100% of his care. But he is out of the baby boomer generation--what about those guys and gals who come out now deeply in debt and see their work discounted by 30%!

I don't have the solution, but we sure are facing a big problem, no matter which way we turn. Tom

Pat
You seem to ressurect the Victorian distinction between the "worthy" and the "unworthy" poor, not that I understand what it has to do with providing health care for all. Tom is probably right when he suggests that it would be more expensive to extend universal health care to you than to the bum on the street since he won't be around as long as you.

I came from Europe ten years ago. All my life I had had access to health care without having to lift a finger. I can tell you that it's a wonderful feeling going to be at night never having to worry about going bankrupt because of medical bills, never having to lie awake at night because of lack of adequate health care. Never worring about losing your health care because your job is in jeopardy. Never having to worry about providing health for employees or yourself if you started up a new business.

You don't think Jesus would have thought that was a good thing, even if the greedy and the rich would whine and complain about this costing them a few percentage points more in taxes?

My 30 year old daughter lives in Norway. She's having her first baby in a month and a half, and for the next half or full year (I forget which) she will home on paid maternity leave. She was born in this country but would not dream of moving her, even though she and her husband would save a bundle in taxes. Money is not everything. There are values that go beyond material goods. Family values, for instance. But then again, I'm not a Republican.

Pat
I'm sure you and I would get along fine, and I'm sure you're the model of Christian charity. I'm only addressing your political philosophy.

Aage,

I have not necessarily given a lot of money but I have given my time as a dentist over the years to the less fortunate.

"Never having to worry about providing health for employees or yourself if you started up a new business.You don't think Jesus would have thought that was a good thing,"

Not necessarily...I have found that "worries/troubles" in life helped me grow and become more responsible and grow in personal faith.

Most definately money is not everything. Have you heard of delayed gratification? Perhaps some purchase their insurance and not many things they would rather have with what "money can buy."

My mom use to quip, " I don't like money, I just like what it can buy."

That's what I mean by "relative economic value." Every family set's their priorities for what they want with their "scarcity" of funds. All are different. In HK I used to see middle class families save for what they considered to be the best medical care which they deemed not to be part of the public system. They felt that was an honor and priority.

Others may have chosen to eat out more or vacation etc. Some might choose to save to take a year off from work after having a child...others might not. I don't want to decide for them.

regards,
pat

PS. Aage, perhaps you didn't notice that I am "understanding" of a model of "public and private" health care at this point in history, like in HK, since the "tax code" corrupted our system.

Others may have chosen to eat out more or vacation etc. Some might choose to save to take a year off from work after having a child...others might not. I don't want to decide for them

until the people that have spent their money on vacations and fancy cars etc. rather than insurance get extremely sick and go into hospital and get their bills paid by tax payers and the suckers who bought insurance.

The USA has the WORST of all possible payment systems:

(a) You get treated even if you can't pay

(b) The payment system has many layers of middle men who are motivated to increase costs because they get a percentage of the total cost

(c) The malpractise system amounts to gambling with huge payouts also being percentaged out to middle men

We need to do one of two things

I: Don't treat people who can't pay or

II: Implement a cheap way of providing a basic level of health care to all

The first is unacceptable because it will lead to social uphevel. We got the way we are because people would not tolerate hospitals turning away mothers in labor who can't pay their bills. THAT WAS THE CASE that forced hospitals to start treating everyone - an ambulance going from hospital to hospital with a mother in labor in the back and the hospitals refusing her because they could not be sure they would be paid.

The second is really easy to do. Take the money that we are collecting today via taxes and insurance and spend it more effectively. It won't increase costs. It will change where the money goes - and the insurance companies in the middle won't like it. Guess what - insurance companies don't qualify for government welfare (or at least, they shouldn't).

/Bevin

Bevin,

Investigate the "public/private" system in HK.

Is it OK with you that after "basic" but good care with most types of surgery done etc. but perhaps a longer waiting period for certain procedures be offerred to all and then...if some choose what might be faster and in their minds "better" care in the private system and wish to pay for it with either insurance or personally "without any tax exemptions"...which I view as essential... no corporate perk tax exemption OR personal tax exemption...ok with you OR must we all be made to be in one system?

Just wondering? Not that my view has a chance in hades!

regards,
pat

PS. When I was in HK there was a 15% personal income flat tax for all. A wonderful way not to have disallocation of capital for "pet project advantage."

regards,
pat

If someone wants better care than the base line the govt provides everyone, then they should be able to buy it for themselves on the open market.

If companies want to offer insurance that provides benefits beyond the base line to a 'cherry picked' group, then that should be allowed also.

After all, nothing is stopping such people flying to another country - be it Mexico or India or a boat in the middle of the Atlantic - and buying such treatment.

Nor should the 'base line' be independent of age.

The cost-effective treatment for testicular cancer in a 45 year old male is not necessarily the same as the cost-effective treatment for the same in a 95 year old male.

Another example of something we should be avoiding is $0.5M medical bills for extremely premature babies. It is not cost effective. If they want child, a couple can easily produce another a lot less than that, one that will not have the health problems this child will face!

Unfortunately emotional irrational Christians will fight tooth and nail if favor of wasting the money on this kid rather than using it to save dozens of lives somewhere else.

/Bevin

You wrote - "It upsets me that in these United States access to quality health care is a privilege afforded only to the rich and well-connected. As a matter of moral concern, this must stop."

As a Pastor, do you consider yourself "rich and well-connected?" I'm guessing not. Do you receive quality healthcare? I'm guessing yes.

This is the state of many people (in fact, most that I know). They aren't "rich and well-connected" yet they are receiving quality healthcare. Before I went to college, while I was working in an entry-level job at BlueShield of California, I had great health insurance. Such is the case with many people I know who aren't college educated or wealthy. They are employed by a variety of employers and have access to healthcare.

When I was unemployed and broke my collar bone while playing football, I received quality healthcare and afterward applied for Medi-Cal (Medicaid in most states) and all the bills were paid...in fact, I never even received any bills at my home.

Such is the case with most people I know who aren't employed, or are employed at places that do not pay much or offer healthcare. They receive Medi-Cal/Medicaid (or wait until they need it to apply), they receive the low-cost Blue Cross Healthy Families program...whatever. There are a variety of options out there for those who aren't "rich or well-connected" yet receive healthcare at little or no expense.

For a few years I worked as a registration clerk in the Emergency Room at a local hospital, and the VAST majority of those who we saw had Medi-Cal and Medicare. Those who didn't, and made too much money to qualify, were given huge discounts (up to 55%) and offered the option to pay whatever monthly payment they could afford.

Yes people should have access to healthcare, and they do. There are laws that now prohibit ER staff from asking about insurance prior to receiving treatment. So everyone receives treatment...the nurses and doctors have no idea what kind of insurance their patients have, or if they have any at all. Occasionally a doctor would ask me what kind of insurance the patient had so they'd know which type of medication to prescribe so that it would be covered.

A final thought is this:

Is it a Christian concept to force others to do good deeds? Does God advocate the Robin Hood method of stealing from the rich to give to the poor? Should Christians support the government forcefully taking money from people to pay for the healthcare of the less fortunate? Shouldn't those who believe in the concept be the ones who give their money, voluntarily, to help the less fortunate?

Just the thoughts of one traditional Adventist.

In Christ's love,
Todd G. (oursword.blogspot.com)

Todd, I do consider myself rich and well-connected. And yes, I have health insurance. The fact that I have health insurance and a good job and a place to live means I'm more wealthy that a lot of people in my community. That was my point.

Thanks for clarifying.

And what you're saying just isn't true. There are millions of people who cannot see a doctor until their condition is severe enough to warrant a trip to the ER. And, as many have pointed out here, do we want our tax dollars spent on ER visits when a simple antibiotic, for example, would have cost a fraction of the cost?

Finally, yes, I think you can find many example of just economic distribution in the Bible. One of the best examples I know is at the heart of the Sabbath. Read Exodus 16. Read this article - "God Speed the Year of Jubilee," by Ched Myers. It's time for Adventists to understand that Sabbath is about more than the right day of the week.

Oh, those poor guys whose work is going to be discounted 30%. Must be really tough geting along on $120,000 a year instead of $180,000. That's the first year out of medical school, 180,000K.

Not difficult to get $1,000/ day if you have the right specialty. Think they can manage on just $600/ daily? Won't have to. Guarantee is $1000

Give em some more cake, Tom.

"There are millions of people who cannot see a doctor until their condition is severe enough to warrant a trip to the ER."

I have to laugh a little at this...when working at the ER you would be shocked at how many of our visits (nearly all) were for boils, stubbed toes, nausea, etc. The people I see never "waited" until anything was severe before coming to the ER.

But I see your point about saving money on an ER trip vs. office visit.

Then again, on the other hand, while I'm finishing my last semester at college now, I have Medi-Cal. And when I ever need to go to the doctor for anything, or have my son or wife go to the doctor for anything, we go to our family doctor's office. And Medi-Cal pays for everything, we never have to pay. Most doctor's offices take Medi-cal or it's equivalent.

Anyway, like I said, most people who have commercial health insurance aren't rich or well-connected. My mom works at a Wal-Mart distribution center for health insurance since my dad is self-employed and purchasing private insurance would be too expensive. They have good Blue Cross insurance from her mediocre job. Such is the case with most people I know...mediocre jobs that give them health insurance.

I've had two mediocre jobs where I certainly wasn't making that much, (25k-30k/yr) and had great insurance both times. And that was before I went to college. I wasn't rich and well-connected in any sense of the words.

I'll check out that article and get back to you.

Todd

Ryan,

You mention Jubilee and Ched Myers. What many forget, along with B.Bissell that I spoke on this subject with was that it specifically related to the theocracy of Israel in laws that were made in advance before entering the promise land.

They were specific on the return of the land every 50 yrs. to the original owner and the 7 yr. release of debt to fellow Israelites but not the foreigner by law. There is no evidence this was followed and was part of the reason for Israel's and Judah's captivity.

You simply can not make an arbitrary "application" to today. As the saying goes the proof of the pudding is in the details...which most "social theologians" want to overlook.

It isn't justice or a sabbatical law but "mercy" in our "gentile" system. Many of these folks don't even believe in the inspiration of scripture unless it is convienient for their agenda.

The consummated sabbath rest/jubilee occurs at Christ's appearing. "Our inheritance is laid up above" according to Peter.

regards,
pat

I dunno, the article seems kind of shaky so far.

"In God’s economy there is such a thing as “too much” and “too little.” (This contrasts radically with modern capitalism’s infinite tolerance for wealth and poverty.) "

Sounds a lot like inferring that there's something morally wrong with being wealthy? Solomon was perhaps the richest man ever known, yet it wasn't accounted to him as wickedness. Jesus didn't tell every rich person to sell all they have and give to the poor...only (as far as we know) the rich young ruler who loved wealth more than God. But little Zacchaeus He didn't command to give away all he had, even though Zacchaeus tried to repay his ill-gotten gains.

"It is no accident that Israel’s forced labor consisted of building “store cities” (Exodus 1:11), into which the empire’s plunder and the tribute of subject peoples was gathered. (This too prefigures capitalism, whose dictum, according to Marx, was: “Accumulate, accumulate, accumulate—this is the Law and the Prophets!”). "

Now comparing capitalism to wicked Egypt. Really?

"Because the earth belongs to God and its fruits are a gift, the people should justly distribute those fruits, instead of seeking to own and hoard them."

Now it's wrong to own and hoard "fruit?" Come on, Ryan...are you consistently emptying your bank account to give to the poor? Who gets to draw the line as to what amount will determine whether one is "hoarding?"

"The Sabbath year restores equilibrium by restraining the activity of “productive” members of the economy and freeing constraints upon those the economy has marginalized, both the disenfranchised (the poor) and the undomesticated (wild animals)!"

The Sabbath year is to "restrain the activity of the productive"? I thought resting the land was a sound agricultural practice. Also the year was to "free constraints" of those the "economy has marginalized"? What does that even mean? I thought it was a blessing for them to be able to go through and fields that they didn't even own and glean? They did that all the time, not just during the Sabbath year. Sounds like a lot of political jargon to me.

"He saw it as a betrayal of Israel’s vocation to be “God’s pleasant planting; God expected justice, but saw bloodshed” (Isaiah 5:7)."

Isn't it up to the individual to decide whether he's going to keep God's commands of love and compassion for the poor and needy? Again I ask, should we force anyone to follow God's plan?

Ryan, do you really, REALLY, believe that the Sabbath is mainly a socioeconomic example? Or, is it about time to cease from the cares of this world and turn our focus toward our Creator?

Hansen, are you really putting down doctors because they make a lot of money? "In 2005, the median debt was more than $120,000." (for docs fresh out of medschool), probably significantly higher now, some 4 years later. God had many wealthy followers in the Bible.

Don't get me wrong...I think it's right to give most of your money in helping God's work. It doesn't seem quite right to drive around in a BMW or an Escalade while so much of that money can be used to proclaim the Gospel and help the poor. But it's still a choice we each have to make on our own, and not be forced into. God loves a cheerful giver.

When the church decides it has the prerogative to reach into someone's pocket and take their money to help those less fortunate...well...we all know where church/state leads us, and is going to lead us in the future.

If we believe in the health message, we as a church should have a program to help those who need it. Our hospitals should have programs to help those who need it. But should we join forces with and put more power into the hands of a government that we know is on its way to persecuting God's people?

Todd, It was not my intent to "put down" doctors. I was just pointing out that Tom is living in a fantasy land if he thinks physicians have it so tough because of insurance discounts. He knows that.

Like his reference to the Peasant Revolt in the Great Controversy, If it's there, I'm not seeing it.

6 ¶ But godliness actually is a means of great gain when accompanied by contentment.
7 For we have brought nothing into the world, so we cannot take anything out of it either.
8 If we have food and covering, with these we shall be content.
9 But those who want to get rich fall into temptation and a snare and many foolish and harmful desires which plunge men into ruin and destruction.
10 For the love of money is a root of all sorts of evil, and some by longing for it have wandered away from the faith and pierced themselves with many griefs.
11 But flee from these things, you man of God, and pursue righteousness, godliness, faith, love, perseverance and gentleness.

The Adventist medical missionary vision, construed by Mrs. Ellen G. White, was a great one. Ministers and physicians working together to heal the body and soul of the lost, a tremendous power in the world.

Of course, Mrs. Ellen G White, from the shaded porch of her lovely home in St Helena, saw physicians making the kind of money ministers did. LOL

Ahhh I see. I'd have to agree wholeheartedly with you...doctors are pretty comfortable regardless of any insurance discounts. Sorry for commenting out of context.

Todd and Hansen,

When you take 22+ years training to be a Physician or 20+ to be a Dentist with much delayed gratification and then accumulate a large debt for school and large debt to start a practice, you don't need 50% discounts from insurance Co.'s

If you haven't walked the walk then don't complain. Yes, they have a good prospective future ahead but it isn't all roses and it is a long time before one "breaks even."

This dentist had a bank call a business loan in my second year of practice in the last "real estate depression" of 1973 which forced me into bankruptcy at age 30 married with 3 kids under 7. No one offerred me the "right" to stay in practice.

I grew and learned much of the world and people's attitude and worked in an indigent clinic doing extractions and constructing dentures in downtown Atlanta for $125 a day until I later was able to start a private practice again.I am sure there are some physicians with similar stories...so get over it and be grateful for the priviledge not "absolute right" for health care.

regards,
pat

That's you, Pat. I doubt that the hardships which you suffered are typical. I'm not interested in depriving health care professionals of their due. I figure that anyone who is able to get through preprofessional and professional training is intelligent enough to figure out how to make ends meet.

I'm not buying Tom's lament about how tough healthcare professionals have it. That ~180K was the actual reimbursement after the insurance discounts, which would put the full salary at ~$270,000.

Sure, the work getting there was grueling. Again, I'm just looking at things from the perspective of God's plan according to the SOP. If you think Loma Linda was simply an opportunity for a medical education without an obligation to labor in the Lord's vineyard, and I'm not suggesting that you or Tom do, then I would disagree.

Loma Linda was not developed so Adventist physicians could do "boob jobs" on Southern California girls.

I spent some time with an Adventist physician in a developing country. The guy was a millionaire several times over. He chose to live in a crummy mobile home and operate a clinic in a developing nation. He did this not for a six week period, or a "mission trip" but over a period of several years, deprived of privacy, good company, decent food, and all the trimmings usually associated with being a physician. He once hitchiked across an entire country, due to circumstances which escape me. He certainly could have bought a plane ticket.

The people which he served killed his dog, stole from him, and only God knows what else.

I'd be interested in hearing what someone like him has to say about universal healthcare. Ideologues who simply jump on the band wagon as activists have no idea what they are doing, except buffing up their resumes on the way to a desk job. It's not them going to be cleaning fecal matter out of the vagina of a comatose stroke patient, day after day after day after day after day.....

Hansen

Your math matches your logic. The actual reinbursement was $56.28 of the 91.00 charged. Of course, the man had to employ an additional full-time person just to do that paper work for billing, plus his nurse, the lease, the utilities, the malpractice insurance and his Toyota Camry. His wife drove the BMW. During that same time frame, the CEO who was rejected as a medical school applicant took home over $4,000. out of a salary and bonuses of over 2.3 milllion.

My point was, the work ethic and the incentive carrot are fast disappearing--thus the system is in the slough of despond. I might add that that surgeon I referenced is one of the most cheerful, out-going, considerate, well liked in the entire medical complex. He did lose a lot in the secruities market and will have to work well past 65 if things don't turn around within 3-4 years.

The issue of health care delivery cannot be resolved equitably without a healthy application of Raul's Distributive Justive model of ethics. Unfortunately government seldom works that way. It would seem neither do you. You write as if you insist on being the sole decider. Even God invites us to reason together. Tom

"Fortunately the physcian is a good friend--I still get 100% of his care. But he is out of the baby boomer generation--what about those guys and gals who come out now deeply in debt and see their work discounted by 30%!"

Last time I checked, even without a calculator, 180 was ~60% of 270.

It supposedly is a fact that when women enter a previous man’s field the salaries go down. When men enter a previously woman’s field the salaries go up. Check out Social Work, Teaching and Nursing career salaries over the past 100 years and look at the salary levels. I know when men started to become social workers – the salary levels increased as also the case when men entered nursing in larger numbers.

Having said that, it is also a fact that prestige, honor and societal recognition follow salary levels. Doctors and Lawyers are considered the pillars of the community, in part because of their ability to financially influence decision making.

If the income level of Doctors decrease and more women enter the field, doctoring (and even lawyering) may eventually be on the level of social work and teaching. Would this be a bad thing?

All of this reminds me of the tightrope walker over Niagra falls. Everyone was absolutely sure he could do it but no one wanted to be pushed across in the wheelbarrow by him.

How sure and final statistics can make things look and become a given without the least understanding of what goes into making things happen... you can almost make a "squirrel into a dog" by skewed statistical information.

pat
-------
When I practiced dentistry most dentist had between a 48-60% overhead before they received a before tax profit. As production increases the overhead % decreases and you do well to get it in the 48% level before taxes.

How much 50% insurance deduction does that allow. None for me as I refused at that time to join those plans. Was that insensitive and cruel and un-Christlike?

Hansen

Where did you get the 180, is may question the charge was $91. plus change and the reimbursement was about 60% of the charge.

The problem is and will continue to be that the government works on the basis of checks and balances. The checks go to the fat cats and the balance goes to those in need. Be it the poor among us, our roads, our bridges, and the inner city.
Tom

The Augusta National Golf Club got free city water for over twenty years because the main ran through their land and they just tapped in! There are only three members of the club that live in Augusta. The rest are fly ins--Lear jets and up! Oh yes, one local is an attorney who was engaged to write-up the by-laws of the club--he was rewarded with membership. The only Augustians that get to play are those who volunteer to be parking attendants, score board attendees, and crossing guards: then only the day before they close the course for the summer season. Rank always has its priviledges. If we go to socialized medicine do you think Donald Trump will have to wait in line? Tom

For the posts that state individuals can receive care through an ER at a hospital here's my response. Individuals needing healthcare cannot always access services through an ER. The ER is only required to provide the services if the individual is in an situation that would place the individual in serious jeopardy. See emtala.com Emergency Medical Treatment and Active Labor Act know as the anti-dumping law.

For a person with a significant laceration on their body - the ER would treat. If a woman shows up and is in labor - the ER will admit her to their OB Unit.

For a person that shows up with a large lump on their neck and there is no visible signs or symptoms of the person being in immediate serious jeopardy they will be told to see their primary care physician. If they did provide services they could start the diagnosis process but then they would have to find a variety of resources --a hospital, an oncologist, a surgeon, and an anesthesiologist who would take it from there - with very little payment or no payment. They take on this patient they don't know what they are getting into so further services are responsibility of the patient to find.

This happens every day . . . Yes, just go to your ER and everything will be ok. Say that to the Mom with a large lump on her neck carrying a baby in her arms, one by her side, and worried looking husband when she is told to go see her doctor - she doesn't have one. This was a true situation btw.

Universal healthcare is a difficult nut to crack but when you take into account that the feds already provide to Medicare, Medicaid, and the entire military --that's probably 40-50% of our population. We already have socialized medicine and it's costly - yes.

I have a good friend who works 30 hours a week for a church. No health insurance. Her husband is a carpet layer who does not have steady employment. No health insurance. They have a daughter. In order to qualify for Medicaid their family income cannot be above 12,000.

The husband had a growth on his neck that grew so large it looked like a goiter. He was pretty sure it was thyroid cancer but wouldn't go see anyone because he knew the treatment would be expensive. Finally his mother broke down in tears and begged him to go. He did, got the surgery and is now undergoing radiation treatments. He will be ok but they are having to file for bankruptcy because they cannot pay the bills. My friend looks shell-shocked whenever she talks about it.

I can't imagine having to decide between your health and your family's financial future. Yes he was treated but at what cost? Those without insurance are usually billed at a higher rate than those who have it. He has had to go through the humiliation of seeking treatment knowing he couldn't pay and then the humiliation of bankruptcy.

There are working poor (of which my friend is certainly a member) who think it is their moral obligation to not mooch off others and to have to seek treatment that they can't afford is devastating.
l
Access to decent health insurance is very much a state by state thing and there are many states where things are much worse than California. I live in one and it simply isn't true that if you work, you can be covered. And this is not ok.

I don't know what the answer is. But I do know that any answer that does not provide affordable health care to all is not the right answer.

Tom
You ask:"If we go to socialized medicine do you think Donald Trump will have to wait in line?"

Universal health care means that health services still have to be rationed because of the high cost, but on basis of seriousness. What people of means do, when told they have to wait for cataract surgery, is to go to a private clinic and have it done the next day at their own expense. All over Europe there are private clinics and hospitals for those who opt out of the publically provided health care system. Being rich confers privileges but in this case it benefits all that the rich pay their own way.

And in general: I don't see much of an attempt on this thread to explain how your Christian faith leads you to arrive at your conclusions on this topic. I'm not a believer anymore, but I wish that you who are, would focus a bit more on it. Politics and religion can not easily be separated, and in my opinion should not, but many of you do, and it seems to me that many of you do it in favor of politics. When I visit this website, it's for a broader perspective than what I get when I go to my favorite political sites.

At times I get the impression that Jesus plays a very secondary role in the life of Christians when it comes to how they live and think.

Aage

The opportunity to be misunderstood in blogging seems greater than the opportunity to contribute.

I don't believe in a billfold scan prior to provided needed health care. I believe serving a need takes priority over ability to pay. Bonnie and Beth gave good illustrations of the problem. You gave good examples of solutions.

I could tell almost endless horror ER stories. I could also tell almost endless merciful trauma center stories.

Our system is a mixed bag. It probably will always be so as long a humans are in charge.

Just one story to illustrate my personal experience with the California Welfare Systsem. I agreed to treat a cleft palate young boy on the reduced fee of the California Welfare System.

The California system gave the monthly check to the mother- rather than sending it to me directly. The idea was to perserve her dignity. She was to submit a receipt of payment prior to getting the next check.

What she did was buy a pad of receipts and sumbitted in her handwriting bogus receipts to the California system. My accountant didn't inform me until the balance due was over $400.00.

I called the California welfare office and was told that they had receipts of payment from the mother. They faxed me one as proof. I explained it was bogus. They responded in that case we will refuse any more payments and you will have to sue the mother not us for payment due. I asked, how many other orthodontists are accepting patients referred by your office?
She replied: "None". I said, "How soon do you expect me to accept another?" From then on I chose my own charities. Tom

Aage,
"At times I get the impression that Jesus plays a very secondary role in the life of Christians when it comes to how they live and think."

I sometimes feel that people see Jesus as a doting grandfather or a celestial Santa Clause. Tremendous guilt is placed on "believers" if they don't buy into that "love" model.

I see Christ as a God of justice and mercy. He expects us to use our brains. He allows confrontation to cause us to grow. He also expects us to come to the reality that all of our "physical" blessings and desires in the present age will not take place or we most likely would not care if He ever returned to set things in their proper order.

Try as we might properly do, this world can not be made straight because it has a "crooked" foundation and the components are faulty and all are part of it. I find it the same the world over.

regards Aage,
pat

" But should we join forces with and put more power into the hands of a government that we know is on its way to persecuting God's people."

This unwarranted paranoia has affected, as well as infected too many of our societal problems today. While we all enjoy the benefits the U.S.government provides in numerous ways, there are too many SDAs who, from their mother's milk,
became thoroughly indoctrinated that the government would someday (that day is always just around the corner) turn on the poor, persecuted Adventists and attempt to enforce religious laws upon them.

Ignoring the irrationality of such fears, why then, if that is the expected future, would anyone be so fearful of the government, yet so unwilling to emigrate to another country? If the U.S. is expected to order genocide on all SDAs some day, why would such believers stay and enjoy its benefits rather than fleeing to far away places?

Everyone I know who has lived under a system that provides universal health care has nothing but good to say about it. This includes (some very conservative) people who have lived in the UK, Denmark. Doubtless there are horror stories to be had about UHC but they are, I suspect, nothing compared to those we hear all the time in our "system".

It would seem that resources (people, medicines, know-how) needed to deliver care do exist. I have heard that as much as 30% of the expenditures of healthcare insurers is wasted on the bureaucracy required to 1) select customers for profitability and 2) get some other entity to pay the claim. In a rational system, those people would have to find other (useful) work to do.

The people who take the brunt of our present system for doing this are the poor. And didn't Jesus say we should take care of the poor?

There are certain things that are done best by everyone in the society working together, rather than individually. When the society decides to do this through their elected representatives, it is called government. Paying for health care would seem to be one of those things that is best done together.

If this be socialism, let us make the most of it.

Don

I believe there are two contrasting views of the role of Adventist Christians in society, God and religion proposed by Ryan's original post and the subsequent comments in this thread.

The first view proposes a reality where health care is simply one of many goods and services subject to God-ordained free-market forces. In this view, health care is no different than any other commodity such as nuts, bolts, automobiles, appliances, aluminum tubes, industrial lubricants or widgets. God gives each individual talents, skills, discipline and health to participate in the accumulation of scarce resources called "private property". In this economy of scarcity, everyhing I give or donate out of what I have accumulated to those less fortunate is solely my prerogative; and should not be forced out of me by my church, my government or an appeal to an alternate economic morality.

Whether I choose to consume, give away or enlarge my storehouse/barn to accumulate even more should be off-limits to a pastor's challenge for a different moral imagination, or even worse, government intervention or regulation. There should be a high and thick wall separating earthly pursuits like economics, politics and government from spiritual concerns like religion, scriptural and prophetic interpretation/application, and personal morality. The governing impulse in this world view is individual free will, personal responsibility, hard work and resourcefulness. What I do with my hard-earned gain is protected and blessed by my inalienable, God-given right to life, liberty and the pursuit of happiness. Individual property rights are constitutionally-guaranteed, God-ordained and trump anyone else' claim on what I have legally and fairly earned and accumulated. In this economic world view, resources are scarce, but my individual ability to consume or accumulate is/should be unlimited.

A second view (proposed by Ryan) is that, perhaps occuring concurrently with, and parallel to, the first world view above, is another alternate narrative. In God's economy, he is the owner of everything, and we are merely stewards. He owns the cattle on a thousand hills, and there is abundance, enough for everyone--when a community willingly and open-handedly shares with those who are less fortunate. It is an economy of "enough". There is enough such that we can afford to stop accumulating one day out of seven, and yet be none the poorer (Sabbath economics). There is enough such that we can afford to return a tithe and throw in free-will offerings, and yet remain adequately fed, housed and clothed. There is enough such that we can render unto Caesar that which is Caesar's, and return to God that which is his, yet have enough to take care of ourselves and others.

Yes, this economic perspective of abundance (rather than scarcity) and limits (rather than unlimited consumption of resources and accumulation of wealth), may challenge our closely-held American free-market capitalist principles; but sometimes it takes someone like Ryan to take on the prophetic role (similar to Nathan confrontmg David), and appeal to our sense of justice when we insist on justifying previously-unchallenged societal structures and norms, and are not satisfied with "enough".

This second view also proposes a view of God and religion which integrates with, and informs, ones economics, politics and participation in democratic self-governance. It argues that, perhaps Adventist Christians (individually, and maybe even corporately as a denomination) guided by, and expanding upon their theology and tradition of a "prophetic health message", can exercise their civic duty and participate in advocacy for or against, and prioritize, certain government programs and services. Acting in our stewardship role, this view suggests one can make moral distinctions between, and assign priorities to public expenditures and allocation of resources toward, nuclear submarines, stealth bombers, cruise missiles, fire engines, farm subsidies, affordable housing, public education and universal health care. It further implies, in the context of a given time, place and socio-cultural setting, not all goods, services and widgets are value-neutral, subject only to market-driven forces.

Challenging, uncomfortable, inconvenient, up-side-down, counter-cultural (at least to "wild west", ruggedly-individualistic, American culture)? Perhaps.

For a seeker, wanting to believe in God, and deciding whether to follow Jesus or join a community of faith, I wonder which view would be more compelling?

Marijuana is a drug. Drugs are bad. Marijuana is a stepping stone to heroin.

Lighting candles in church is a Catholic practice. Anything Catholic is bad. Lighting candles are an image to the beast.

Universal health care is socialized medicine. Socialized medicine is bad. It is a stepping stone to communism.

You have to be taught to hate. Before you're six, seven or eight. Drugs are bad. Catholics are bad. Socialism is bad.

Don't let anyone tell you differently!

I've yet to meet an agnostic or atheist that has the hate-filled attitude of staunch religionists:
whether Christian, Muslim. The most fiercely devout one is to a particular belief system, the tighter his circle is drawn excluding all others not just like himself.

From such attitudes, atheism flourishes.

Elaine

Amen, if that is not too religious an endorsement. Tom

Neville,

Could I ask a couple of questions?

1) Is there a difference between church members well being and society for Christian responsibility in your mind?

2) What might Acts 5:4 mean? " Didn’t it belong to you before it was sold? And after it was sold, wasn’t the money at your disposal?"

3) Must I share all with society to be part of this new vision?

4) With such wisdom shouldn't the church take the place of government? How does that play for unity of church and state?

regards,
pat

Elaine,
"This unwarranted paranoia has affected, as well as infected too many of our societal problems today. While we all enjoy the benefits the U.S.government provides in numerous ways, there are too many SDAs who, from their mother's milk,
became thoroughly indoctrinated that the government would someday (that day is always just around the corner) turn on the poor, persecuted Adventists and attempt to enforce religious laws upon them."

Firstly I'd say that Bible prophecy is hardly "unwarranted paranoia."

Secondly, I've only been an Adventist for 4 years, so I was not "thoroughly indoctrinated from my mother's milk". From what I've seen it's the ones that were born into Adventist families that are breaking away from traditional Adventist beliefs and values. It seems the most theologically conservative Adventists are the ones who have come from the world and discovered these precious truths. Look at our leading evangelists like Doug Batchelor, Shawn Boonstra, Leo Schreven, Steve Wohlberg, Jim Hohnberger, etc. All came into the church instead of being born into it. Like they say, familiarity breeds contempt. It seems (and EGW agreed) that the vast majority of Adventists have never had a true conversion experience.

In Christ's love

Hear, hear, Neville.

It is being argued by some that taking care of people's basic needs is just another good to be traded in the marketplace--to be traded only if one can make a profit on it. They might cite, for example, the provision of food through the marketplace, at a profit, which works fairly well.

There are several reasons why providing healthcare in a similar way does not work well. Food is available at a fairly predictable price, and how much you spend on it is largely under your own control. The same is not true with healthcare.

One cannot know with certainty if or when one will require a very expensive medical procedure. Yes, there are some personal choices that make such more likely, but for most of us, a big medical expense is something over which we have little control.

Saving money is not a realistic hedge against an unexpected large medical expense. It might make sense to save 15% of one's income for medical expense, but for most of us, that won't do much good if we hit a really big expense. But if everyone puts 15% of income into a pool, the resulting pot of money will be sufficient to pay for what's required for the whole population.

Finally, the "free market" is largely an illusion in healthcare. For one thing, those who are least able to pay for it are charged the most for it--insurance companies routinely pay much less than what is billed. And we tend to need health care most urgently when we are least able to bargain for its price.

Assuming that we have values (religious or otherwise) that prevent us from letting people die in the streets, we cannot be satisfied with an "everybody for himself" approach to paying for healthcare. Is the worth of a person's life really measured by the size of his bank account?

I followers of Jesus will say "no". Working together is a much better way.

Don

Will marijuana be available with UHC?

Pat, to respond to your questions:

1. If your question is, "Should a Christian's responsibility differentiate between looking after the well-being of a church member vs. a non-member?", I believe Jesus answered that when asked the question, "Who is my neighbor?", in the parable of the Good Samaritan. If you had a different question in mind, please re-phrase the question.

2. Here, I'm not sure I understand the intent of your question. Taken at face value, it is a story of incomplete disclosure, and implies a partial witholding of what a couple had previously pledged in full. Beyond that, I'm not sure where your question is going.

3. That's not for me to say. I cannot presume to know what God's plan is for you in the context of your time, place, ministry and witness to his Kingdom.

4. Why would I presume my church has a monopoly on wisdom? In the American political arena where one speaks out and listens in proportional measure, should I not benefit from the collective wisdom of other faith traditions (Jewish,Muslim,Budhist, etc. --and perhaps even agnostics and atheists? There is a tension between being a foretaste and bearing a present, tangible witness of "the Kingdom of God is at hand", and the future "My Kingdom is not of this world."

Dear Friends, After spending the last hour reading this thread it is hard to know where to begin or if I should begin! A few observations: 1) this is an extremely complex subject with no really good answers in the world in which we currently reside. 2) any system we develop must incentivise good behavior not bad behavior re: health issues specifically and life in general 3) most idealogues are great with theory and very short on the practicalities and knowledge of modern medicine. 4) if medicare/Va system is so good why is it that your legislators opt out of that for themselves and their families? 5) if you could reform the legal system in this country current estimates are you could have enough money saved to buy everyone an insurance policy of their choice. This is largely why costs are less overseas. Legal system here is another form of legalized gambling. 6) if UK system is so good why are they contracting with Johns Hopkins U. to redo their failing system? My sister in law (anesthesiologist at JHU) has spent many weeks overseas working on this project.The theorists might enjoy some real insight to this issue. 7)the business aspect of this is if I can't make enough to cover my ever increasing overhead and ever decreasing reimbersements I can't care for anyone! 8) lest you think I don't care about the poor you might walk a few days in my shoes these past 26 yrs. caring for all patients regardless of insurance status but dealing with all manner of self destructive behavior largely from lack of individual responsibilty. I could literally give you thousands of examples. 9) I will be glad to call you the next time I am called out of bed to care for a drunk rollover or spit on by the 9 time DUI driver who just ran head on into the motorcyclist who he killed "for the hell of it". By the way, no jail time for the 1st 9 offenses. These are but a few examples!!! 10) why a local general surgeon gets paid $170.00 for a carotid endarterectomy from Medical and that won't even cover his malpractice ins. to do the case!! I could go on for hours but maybe you get the point. 11) God's return is the only longterm answer to these problems and I believe that is close at hand!! Until then I will continue to answer the late night phone call from the ER!! If you are naive enough to think the politicians have the answers please stay tuned these next few years!! Sincerely, Fred

Fred
If we're already paying for irresponsible people inflicting damage on themselves and others, I don't see what extra problem would arise if their bills would continue to be paid for (with less outlay of money) under a universal health care system.

Malpractice insurance is obviously a serious problem. In a universal health care system the Government--at least that's how it's done in Europe--would provide such insurance. Physicians might make less money outright but without these crippling insurance costs, the take-home pay would be no worse. You seem to imply that malpractice insurance and frivolous law suits is an argument against universal health care. In reality, these are problems unique to our existing system.

You also raise the issue of quality of care with respect to systems such as that run by Medicare and the VA. While some privileged individuals opt out of these programs, you and I both know that the nearly 50 million uninsured in this country would be delighted to have access to their services.

But in concluding, I would urge you to make your arguments against helping your neighbor on Gospel grounds. I already know the GOP arguments; I'm still waiting for somebody to explain to me, in the words of Jesus, why it's wrong to help our neighbour in need, when it's within our power to do so.

I don't read Fred's reply as being against UHC.

He is pointing out that changing only the "who-pays" aspect of the situation is not the answer.

We need to fix

- the legal issues (malpractice, who must do what and when)

- the motivational issues (waiting until things are completely broken down is not cost effective)

- the business side issues, not only billing but also records keeping and communication

Almost all the experts agree we are spending enough money, but we are not spending it effectively

/Bevin

Well said, Aage.

A recent study in Hawaii, where there has been a push to "reform" malpractice, indicates that malpractice is not so big a problem as is often suggested by the medical profession. Physicians like Fred, who pay the malpractice premiums, cannot be blamed if they see this as a bigger problem for themselves than it is globally.

One suspects that the insurance companies know well that they are "onto a good thing"--the medical profession. They are there to make money, as much of it as possible.

Don

Good comment bevin.

There seems to be a lot of (GOP) fear that with UHC malingerers will game the system endlessly. Yes, there are people who indulge habits that make themselves sick. But they are already gaming the present system, by waiting until they think they're at death's door and then visiting the ER. With UHC they would have more opportunity to head off such episodes.

There is a built-in motivation for avoiding getting sick and needing medical care: being sick is not fun.

Don

An inside view of the "wonderful world" of competitive medical care:

March 21, 2009 NYTimes
Op-Ed Contributor
A Tumor at the Heart of Medicare
By MARK LANGE
San Francisco

GENERATING efficiency in the health-care market will be one of President Obama’s greatest challenges. To do this, he will have to create meaningful competition between drug companies, and between public and private plans. Congress’s attempt at market-driven health care offers good instruction in what not to do.

Medicare Part D, the prescription benefit that went into effect three years ago, was supposed to let the elderly get their medicines more cheaply by creating competition between private insurers. Yes, the program has undeniably improved access to prescriptions. But the cost to taxpayers has been 3.5 times the market value of those prescriptions, according to a study in the journal Health Affairs.

Part of the problem was that insurance analysts saw a chance to double the size of the managed care industry. Drug companies stood to collect $30 billion in windfalls over the coming decade. So legislation was pushed, paid for and effectively drafted by thousands of lobbyists.
Proposals requiring the government to use the buying power of 40 million Medicare patients to negotiate prescription prices were defeated. Pharmaceutical lobbyists fought for direct federal subsidy of drug benefits, knowing plans would be reimbursed no matter how much prices were inflated. Lobbyists also prevented identical but less expensive drugs from Canada and other countries from coming here. After arm-twisting that reduced at least one member of the House of Representatives to tears, the bill to expand Medicare passed at 5:53 a.m. on a November morning in 2003.

When the program went live in 2006, a fragmented market of 80 insurers — with 1,400 prescription drug plans — lacked the purchasing power to negotiate drug prices. Nor did those insurers have much reason to bargain, since Part D subsidized the most costly patients at 80 percent. So prices under Medicare private insurance plans for the top 10 medications shot up, and in 2006 the five largest drug firms notched a 45 percent spike in profits over the previous year. After insurers rushed to sign as many retirees as possible at attractive rates, they raised premiums 13 percent. Medicare patients in private plans cost taxpayers about 15 percent more than those covered under traditional government programs.

Then the story started to resemble a Dickens novel. State insurance commissioners complained about a nationwide pattern of aggressive, abusive and deceptive marketing practices by sales agents. Free of basic oversight and enforcement, other insurance agents and brokers manipulated the elderly by falsely claiming that they worked for Medicare, selling unrelated and inappropriate policies, bullying the elderly and even forging signatures.

It doesn’t have to be this way. There are a few relatively simple steps Congress could take quickly to redeem Part D, and build momentum for effective, market-driven health care reform.
Congress should begin by requiring private insurers accepting public money to offer a plan option equivalent to what the Department of Veterans Affairs offers, at the same price.

Another important step would be mandating that the Department of Health and Human Services negotiate drug prices on behalf of Part D plans. Rather than reimburse private insurers for pharmaceuticals through unlimited direct subsidy, Washington could compare prices paid by Part D plans to Medicaid’s best prices (today both price lists are confidential), and pay at either market or Medicaid rates, whichever is cheaper. Deceptive marketing could be combated by passing a bill to allow states to regulate and police marketing. To further ease confusion, Medicare should clearly outline plans with simple side-by-side comparisons of costs and benefits.

The public can also play an important role. While the larger health-care reform debate unfolds in Washington, the rest of us can keep an eye on the members of Congress who may be the most conflicted about bringing real competition to bear. At sites like www.maplight.org you can see whose campaigns have gotten the plushest contributions from pharmaceutical manufacturing and managed care companies.

This year, total Medicare and Medicaid spending will probably account for nearly a quarter of all federal spending, and by 2016 it could rise to almost a third. Enlisting real competition will be crucial to containing costs. So before offering a new universal benefit for the millions of Americans who lack health insurance, Congress should put an end to manipulative profiteering in Medicare. As challenging as the program’s problems may be, they do not prove that a market-based approach can’t work.

Mark Lange, a technology industry consultant, was a presidential speechwriter from 1989 to 1991.

Aage,I am not making an argument against helping my neighbor which I have been actually doing daily for many yrs. and my father did for his lifetime and many family members continue to do both in this country and for many yrs. overseas. I am saying that any solution that doesn't address liability reform (not just malpractice ins.) which is woven into the costs of every aspect of this issue unseen and not acknowledged by the politicians will make any current solution being discussed not sustainable!! What chance do you have with >95% lawyers in congress to reign in the real issues regarding sustainability? The system currently doesn't cover anywhere near the costs of irresponsible people doing damage to themselves or others that is why so many hospitals and ER's are closing their doors. The MD's and hospitals for many yrs. have been asked to "deal with it" but now with dollars getting tighter that is making it even harder to do. The idea that these costs are just passed on to the insured is passe because the insurance companies follow medicare reimbersement trends to stay solvent and control costs and the MD's and hospital's have very little bargaining power because of government rules and mandates. The government just says this is all you get period and then the system has to decide how to ration care resources. The politicians stay out of the firing zone by saying we are the bad guys!! Most folks who can pay for services that are in short supply in Canada,UK,Europe, (most high risk services) either go outside the public system or come to the USA. The others get the rationed care the best they can.Also the VA has extremely limited ER care or exposure. Most Medicare folks don't abuse the ER system but again because the legal system is so screwed up we are left with end of life care expectations and related issues that are very difficult for the system to deal with. Hospice care helps but is not funded by Medicare by an large. The arguments you refer to as the "GOP" position unfortunately are facts that are largely ignored by the idealogues who try to deny what is really going on out here for agenda reasons or naivete'.The reason no one is saying we should not help our neighbor because Jesus tells me to is because we are currently helping our neighbor daily on a practical basis inspite of the obsticles placed in our path by our politicians. UHC sounds great but the practicality is what is being questioned. Jesus clearly mandates we love & care for our neighbor that is why I continue to answer my phone 24/7!! Jesus is the answer, what was the question?

Dear Friends, The real problem with this whole discussion and many others like it is the focus. Many of you are trying to treat the symptoms of the problem rather than understanding the true causes. It is like me treating the patients fever instead of the cancer that is the origin of the fever! Example: Why are drug prices less in Canada or overseas? Is it that we just need a better negotiating team or process? No!!! The reason largely revolves around liability exposure in the USA. In Zambia it costs ~ $35. to treat malaria with drugs from China as opposed to $100.s for drugs from the USA. Why? please refer to the above answer!!! Until we all demand that the real causes be discussed and answers postulated the UHC issue will not be solved although politicians may try to mandate a "solution" for political reasons. The main reason MD's take this abuse is because they want to help patients! Why would my daughter want to go into medicine for 10+ yrs. of training beyond college and $250K+ debt before she even starts to make a living knowing what she knows? It is coming from her heart to take care of the patients she has seen in my practice and my other family members practices!!! By the way my sister lives in Haiwaii on the "Big Island" has sufficient money to obtain care but calls me regularly to ask me questions about care issues because orthopedic care is in short supply!!

Fred, you will have to give me more data to convince me that the root of the problem is liability.

Seems to me there must be a connection between high drug prices in the US and the fact that pharma companies are among the biggest contributors to congressional campaigns. Doesn't Medicare part D specifically prohibit the government from negotiating prices with the drug companies?

Don

Fred
The problems you focus on are problems with OUR system. They are at best arguments FOR universal health care. We spend twice as much per capita (even though we don't cover 47 million)as in Europe and our outcomes are worse.

You speak in favor of what you yourself practice: charity. I'm glad you do, but you can't help nearly 50 million people. Only a government sponsered system can. And it's not a fantasy; it's reality in most industrialized nations.

When I bring up Jesus, it's not to impugn anybody's personal ethics. It's to question their politics. To ask why they think Gospel compassion should be banished from politics in favor of social darwinism.

Don, I am not discounting the many abuses the system encourages but I am pointing out a major problem that is not being acknowledged or discussed. Why do you think many drugs are developed and marketed by USA drug companies outside the US? Lack of excessive regulation and the fact that the overseas legal system doesn't encourage legal redress of every perceived bad result. We encourage our legal system to sue!! I suggest you look at the dollars the trial lawyers pour into the congressional war chests and compare that with the medical profession numbers!! No contest. Again I would encourage everyone to ask some more questions about why our legislators won't seriously discuss these issues. The root cause for these problems is a much broader discussion than UHC and UHC will fail as our current system is failing unless these causes are addressed.

Fred,

I managed to find that the Trial Lawyers spent 7.2 million in 2005 on lobbying (Congress and federal agencies, if I recall correctly) while (according to the NE J of Medicine) the Medical profession as a whole spent 351 million in 2006 but I don't know if that's comparing apples and oranges, since the numbers are not from the same source. Even if it isn't, you have to overcome quite a disparity to sustain your point about contributions.

It appears that the aggregate totals for medical malpractice awards aren't very easily obtainable. There was a report by the Consumer Federation of America, published around 2002, that said that as of 1999 the total malpractice premiums for the whole country was about 0.56% of total medical expenditures, with perhaps 2.5 to 4 billion in total malpractice awards. The medical profession will take issue, of course. What is not disputed is that the profitability of malpractice insurance companies is excellent--10 to 12%.

From your point of view, a premium payer, there's a pretty bad situation, but there's an argument to be had about the overall picture.

I'm not convinced any of this is really critical to the UHC issue. I have heard presentations (by physicians) saying that there is already plenty of money in the "system" but about 30% is wasted in overhead in healthcare insurance companies, on bureaucracy whose twin functions are 1) passing the buck for claims and 2) selecting customers who are healthy, hence profitable. Seems to me like the biggest vested interest to overcome is the insurance companies.

Wouldn't you enjoy practicing medicine more if you didn't have to constantly deal with a whole bunch of different companies about their policies and payments? I should think that single payer would be lots easier for doctors.

Don

To all in this conversation.

I think it is important to realize how we got here regardless of where you think we should go in the future.

In the US, FDR always wanted a National Health Plan. It was not politically or publicly feasible for acceptance 60+ years ago.

Plan B.- Create Business tax perks for businesses that would provide health care benefits for employees. Results…support of Big Business and Labor unions for the pre-tax coverage of employees with the obvious glee of employees of these firms.

Problem 1…those not so covered were penalized by paying for there own healthcare cost in “after tax dollars.” (unequal protection of law through tax code)

Problem 2…increased demand of insured caused health cost to go up further penalizing those who paid for their own care.

Problem 3….The covered lost interest in cost since they were “covered” and the normal legitimate worry of maintaining their health with proper “health principles.”…creates further demand and cost increases on system.

Problem 4. A “two tier system was created ” with myriads of third party payers and cost that can not be met by the “uninsured."

Problem 5. In reality "legacy health cost" helped make business non-competitive internationally.

All of the above consequences were warned about by "narrow,extreme conservative" economists.

Today…

The very one’s who pushed the merits of this present paradigm system say we must now past the cost on to the taxpayers and create a “Universal System” so we can be competitive with other nations.

What’s lost in both? The original Physician-Patient relationship and payment contract.

Don...How do you disagree with that single payer?

For what it’s worth,
http://eh.net/encyclopedia/article/thomasson.insurance.health.us

pat

"Seems to me like the biggest vested interest to overcome is the insurance companies."

Here's hoping the chicken littles will remain in their coop.

Much of this could be easily resolved by realism. The reality being that people die, no matter how much money, treatment, or technology they or their family claw unto themselves.

A huge % of health care dollars are spent during the last months of a person's life. A lot of this is because of family members who are unwilling to let go. Of course, there are many patients themselves who will not accept the inevitable.

They opt for futile, costly, time and resource consuming treatment because they can. Uncle Sam is always there to "cover" costs. Pancreatic cancer? Sorry. We are not going to do everything we can. There is really nothing that can be done. You or your loved one will be made comfortable. No aggressive treatment, no Chemo, no radiation.

Want to spend $100,000 to maybe add a couple of weeks to your life. Fine. You spend it. It comes out of your estate. No estate? Sorry.

This single issue, responsibly handled, could save plenty each year.

Not only acute care. Nursing homes have literally millions of people in them that linger on the edge of life, receiving costly medications through feeding tubes or ground up in apple sauce. Their minds are gone, their families rarely, if ever, visit them. They are like herds of cattle on the range, each head worth so much to the SNF owner.

This issue is a black hole through which the money of any system is going to disappear, unless the right decisions are made.

Pat,

Please explain to me how having a single entity paying for medical expenses would change the physician-patient relationship.

Don

Hansen,

I quite agree with your observations. Most of the push for heroic measures at the end of life comes from relatives who feel guilty. Maybe, as you say, some people who are dying want to prolong the process, but a lot of them don't--many of them don't know enough to care. Everybody should have a living will and medical directive. As a reasonably healthy, for now, 71 year old, it's not an entirely theoretical issue.

Yes, a universal health care system should provide palliative care for the terminally ill, hospice and that sort of thing. I think that's the way the UK does it--my predecessor (in the Math chair at Andrews) Ken Thomas died a few years ago, in Scotland. His wife said that National Health Care was very helpful. They have a more realistic view of such things in Europe, it seems.

Don

So Don,

You guarantee that my choice of Physician will be honored on a lasting basis in the "new system?" On what basis?

But that was not my main question...how do you disagree with a "single payer" of the "government type?"

regards,
pat

"The one in 20 Medicare patients who die each year use up almost one-third of expenditures by Medicare, the government health insurance program for the elderly and disabled.

One third of expenses in the last year of life are spent in the final month, according to the report, with aggressive treatments in the final month accounting for 80 percent of those costs.

WASTE OF MONEY

"This is a waste of money ... The real cost differences could be substantial," said Holly Prigerson of Dana-Farber Cancer Institute at Harvard, who helped perform the study."

http://www.reuters.com/article/healthNews/idUSTRE5286EK20090309

Adventism is positioned to lead out in this area, with its integration of theology and medicine. The key word here is LEAD. That would be opposed to wait until political correctness says the step can be taken without difficulty.

Friends, After checking with several lawyer friends and using the Am. Ac. Ortho. Surg. national physician #'s the per capita spent for lobbying is about $5. lawyers/ $1. physician. Even if I am wrong with that the point is that the entire cost of liability to the patient for medical care dwarfs the end of life costs(which is very costly) and is hidden because it is so splintered and woven into every supply/medicine/instrument/surgical drape/machine etc. Europe/Canada etc.have much less indirect costs because of their legal system. Also the numbers quoted by others re: infant mortality are very deceptive because how other countries calculate these rates doesn't account for the age at which we deem an infant to be viable. Many times you are comparing apples to oranges. This makes the US system appear worse when in fact if these values were calculated the same we would be much better! There is a reason that the overseas elite come to this country for any serious health procedures!! UHC sounds good with less paperwork etc. but when you get down to the details it has huge problems!! If anyone of you has tried to deal with the federal office of workman's comp. or tried to get information from the VA re: a given patient you will know what I mean. Do you really trust the government to handle confidential personal information re:patient records???? The devil is in the details!!

Don and Hansen,

The demands "supposedly ethical and religious demands" placed on the "private system" quickly disappear under a "one payer system." "Sudden pragmatism" is allowed. Likewise...who sues the government... they don't but they can still sue the recipient of the "single payer."

regards,
pat

Pat,

I do not disagree with a single-payer system, whether a private corporation or run by the government. I think Obama's original proposal was to leave the insurance companies to sell insurance but offer a government run plan that would compete with them. Then let people choose which they want to go with. If they all migrate to the government plan, then the insurance companies disappear.

The insurance companies are opposed to this, of course. They say it's unfair for them to compete with a government run entity. I'm trying to square this view with the widely held idea that government is inherently less efficient at everything, than the private sector. If the latter is true, the insurance companies have nothing to fear. . .

I am not in a position to guarantee anything, Pat, but I have never heard any proposition that a single-payer plan would in any way dictate who you have as a doctor, any more than your present insurance company does. In fact, my health care payer (Anthem) does have a list of "in network" providers, which does restrict my choices somewhat. If there were a single payer, than any provider in the area served would have to belong to their system to function, I should think.

HMO's--health maintenance organizations do get between the patient and the doctor--you get whomever happens to be on duty the day you go in. The most famous of these is Kaiser Permanente. At one time some people thought HMOs would be the answer to rising health care costs, but I think that has faded.

All the best, Don

Let me assure you the government has very little ethical concerns when it comes to the practical money concerns!! I agree that the end of life costs are extreme but they are fueled by extreme expectations from the public and backed up by the threat to "get justice" for their loved one!!

Don, Who decides which physicians CAN participate and under what rules??

Don,

"If there were a single payer, than any provider in the area served would have to belong to their system to function, I should think."

What is the "morality" of that as to the "rights of the provider?"

Just thinking aloud.

regards,
pat

The same answer that bank robbers give for robbing banks: "Because that's where the money is," is the identical reason insurance companies are in the health care business: it's where the money is."

With a single-payer system: the government, it would decrease the costs that are being paid today by 10-12%. Note which congressmen received the largest contributions from the health insurance as seen on Maplight.org.

Are there some out there who are so insistent on "private-pay" (insurance companies) do you enjoy paying such a large percentage to private companies above and beyond what the government charges?

As to the largest expenditures being during the last six months' of life, who here would be willing to forego all care for the last six months of his life if he knew the date? Chronic diseases: diabetes and obesity are now one of the largest costs and they are not at all limited to Medicare ages but younger patients all the time.

Elaine,

The government can "set" a price for all and any sevices or products that is "cheaper" than the private sector...SO? What is the final outcome?

regards,
pat

THe government sets the prices currently. All pricing is local: depending on the local physicians and their specialties. In some areas the charges may nearly double those in other geographic areas.

I'm unsure your meaning of "private" sector. There are presently "boutique" practices where wealthy patients pay a yearly fee for all medical care.

It is not easy to imagine physicians not willing to take Medicare, as it is the largest group of patients for many specialists, and such physicians agree on charges. I'm very aware that they do not adequately cover all costs. But the costs of completing dozens of different insurance forms and dealing with them on a daily basis would be changed to one single payer--the government with allotted charges which they physicians must agree to accept.

What other suggestions are offered?

A qualified entity could choose to be a provider or not to be a provider; providers could choose to take or not take patients, just as now; all qualified providers would get paid by that single payer.

I don't understand the concern about who pays the bills, as long as they get paid.

Don

Elaine,

Great...I have the choice between AIDS and STD's...what a blessed assurance.

regards,
pat

Don,

Don't you get it? The "tax preference" or the power of the federal government destroys the system and choice ultimately!

pat

How about, 1) government providing catastrophic ins. umbrella coverage 2) people choose to buy insurance/not by insurance or individual health savings acct. to cover routine costs which they can use how they deem best!

"Power corrupts and absolute power corrupts absolutely" comes to mind!! Do any of you want the government to be in a position to make all the choices for you and under what rules??

All this talk about single payer, reimbusement, insurance. If the tough decisions to discontinue futile treatment are made, you wouldn't need to worry about who is paying. No one is paying because the patient died, like they will inevitably do anyway.

They die before money is wasted on treatment that doesn't prolong life or ad any quality to it.

Hansen,

"you wouldn't need to worry about who is paying"

Yes you do...the legitimate things you say are just the icing on the cake because fees have been distorted related to the private payer... the system has been corrupted by the tax code.

Did you read the history I posted?
http://eh.net/encyclopedia/article/thomasson.insurance.health.us

regards,
pat

Hansen, I hear you but the legal system can inhibit that option depending on the individual case. Physicians can only try to guide the decision process ie: hospice etc. No one seems to get the absolute need for legal reform BEFORE any realistic reordering of the medical system can really work to bring down costs!!

Hansen,

To clarify the point. If there was no third party insurance payment and threat of suit how long would these people be kept hooked up to "artificial living devices?"

Where would all the idealogues be found if they were personally paying for it?

regards,
pat

Pat,

You say "The 'tax preference' or the power of the federal government destroys the system and choice ultimately!" Perhaps you could clarify what you mean by that assertion, and what the ground for it is.

Let me say this again: There are certain things that are done best by everyone in the society working together, rather than individually. When the society decides to do this through their elected representatives, it is called government. Why so much fear of our elected representatives? And by inference, why should we have so much trust of corporations not answerable to us in any way?

Fred, your suggestion for a government provided catastrophic health care system, with individuals paying for routine costs, might be workable. The disadvantage I see is that there are people (poor people, mainly) who need to be encouraged to see a physician on a regular basis for preventive care; having to pay first-dollar cost out of pocket might be a discouragement to that.

Major medical coverage is what my wife and I have now. At age 73 she's still working full time for Indiana University, and we have a health care plan administered by Anthem with $900 annual deductible for each of us. It covers emergency care and pharmaceuticals outside the deductible. Cost to us is $1.00 per paycheck. Such a scheme makes it possible to plan one's finances.

Don

Don,

Read the development of our health care "third payer" system that I posted so that I can know we have a frame of reference.
What is the "morality" of the tax deduction for employer/employee preference vs. the individual payer? Who established this system? Now that it is not working who is offering an alternate idea...perhaps the same one that made the first system? ;~)

regards,
pat

Don, There are many clinics available to the working poor that provide preventive care for a very low cost. How do I know that you ask? Because several MD's (me included) went out and borrowed the money to start one up in our town many yrs.ago and it continues to thrive today. The biggest threat to it's existence is government over regulation and oversite by agents of the government who know very little about healthcare and care less. UHC would have the same regulators!! Again let me reiterate that a redo of the legal liability system HAS to occur as a major part of this discussion or it will not work. Bureaucrats don't know much about healthcare!!!

I'm with Don and Aage on this one. Why such fear of "the government". "Them is us"--"We the people..." Government is ideally suited for many services--especially "essential services". Many red herring scare phrases like "choice of provider" and "socialized medicine", etc. seemt irrelevant when applied to other government-run/provided essential services. When I call the Police or Fire Department--do I really worry about my choice of provider? I've lived in countries where the income tax rate was 7%, but if you called the police they might show up two days later (the nearest police station was 5 Kilometers away). I also observed a situation where the Fire Department was called to a burning neighborhood, but the fire hoses were directed only on those houses whose owners could afford to ante up the (average worker's 6-month's wage) "water fee". Now there's a two-tier system for you!

I hae only been a practicing physician for 54 years. I have close relatives in Canada who require or required health care. I practiced in Canada for a short time and then for everal years in the Far East. I have been involved in Health Care politics for more than a dozen years, having served as the president of our local medical society and for ten years as a reviwer for hospital accreditation with our local state medical society. I have worked for the VA system for 23 years but in all this time I have not yet attained perfection. I am still practicing.
As recently as yesterday, I had a long conversation with a colleague who graduated from a medical school in Canada, practiced ther for half a doxen years or so and now has been in the USA, in paractice for an equal amount of time.
After reading the above comments for the last hour or more, the most accurate reflection in my judgment is that of Fred Eastman. Many of the other commenters have not given an accurate or balanced view of either facts or written from experience. If it were possible, I would love to have them accompany me as we see cancer patients. I have students and residents on rounds for years so would love to show and tell.I would love to hear them experience denials of care by Medicaid, by Medicare and by the VA as is done in Canada. For those deeply convinced that the federal governement is the answer to providing health care equitably, promptly, please read the novel by Ayn Rand, "Atlas Shrugged" and substitute 'health care' for 'railroad'. Ann Rynd emmigrated from Russia to the USA. I know that we as Adventists have been cautioned against reading novels except those sold by Adventist Book store.

Universal health care is not free health care. I live in Nova Scotia (Canada) where I would be able to walk into the ER and have all my medical evaluations and procedures covered by the government, but FREE it isn't. We pay 13% tax on EVERYTHING from gas to infant formula. On top of that, we purchase Blue Cross to cover what the government system does NOT cover - dental, eye care, and stuff I'm not familiar with.

I also know of people who have had to wait in ER waiting rooms 24+ hours for service. Obviously, they were not critical cases, but when ambulance drivers have to line up at the ER entrance it can get interesting.

Another aspect of government sponsored health care is what happens to those working in the system. There is a critical shortage of nurses here because they go SOUTH to get better pay. The same goes for doctors. The nurses in the ER are supplemented by the ambulance crew, giving nursing services.

Because of the shortage of doctors (having left for greener fields), waiting time for a specialist could be years (2 years for a cardiologist if you're looking for an evaluation). The role of the GP is to be a clearing house for medical problems. The goal seems to be to get as many people through the office in one day as is possible. If a specialist is needed, they go on a waiting list; and depending on what field, that list can be very long. No one is able to access a specialist directly with an appointment. This why the ERs are packed because at least the doctors are somewhat more available.

Anyone moving into the area will have quite a time finding a doctor. The only way is to find a new doctor, just opening up an office. There is no shopping around. You get what is available.

It is nice to be able to have all those runny noses your kid gets taken care of with no out-of-pocket expenses, but you pay for it every day as you do your grocery shopping, go to the restaurant, get gas, and pay for every other little thing.

Absolute power corrupts absolutely

If you think this motto reveals a serious problem for UHC - this is the same government that has UMC and ULC - universal military care (they control the one and only armed forces) and universal legal care (they control the one and only legal system). They also have a monopoly on roads and on regulating the use of radio waves.

The government does not have absolute power, and would not have it in a UHC system any more than they have it in those other systems. The people get to see and to vote and to go elsewhere.

The biggest threat to it's existence is government over regulation and oversite (sic) by agents of the government who know very little about healthcare and care less (sic)

There is more than enough blame to go round

1. doctors who don't discuss end-of-life options with their patients
2. lawyers who chase ambulances
3. insurance companies who care about profits not patients
4. schools that don't teach a realistic understanding of life
5. churches who claim to believe in life after death but which fight tooth and nail to stop someone being taken of life support and which oppose contraception
6. Scientists who are looking for grant money to cure baldness, not malaria
7. etc.

There is NOBODY in this equation who don't have a vested interest either in (a) keeping the costs down because they are a payer, or (b) pushing the costs up because they are either getting paid or getting services.

It is time the (a) group banded together against the (b) group.

/Bevin

Pat, Yes, a tax exemption is given to healthcare costs paid by employers for their employees, but it is not given to a person paying his/her own healthcare. That is unfair: it should be given to both or neither. But as we have seen from the history you have cited, this situation developed as a result of the system not having been "designed", but have just "growed like Topsy". There is, I should say, a provision to deduct medical expenses off Schedule A, but only to the extent that these expenses exceed 7.5% of ones AGI. That is not so good, and a lot of people can't benefit from it.

Fred, Yes, I know about these clinics. We have one recently established here in Bloomington, IN, called Volunteers in Medicine. We give a fairly substantial amount to this enterprise each year. Many good hearted physicians and others volunteer their services there. One of them is a fine diagnostician, now retired, who served our family for 30 years as our family doctor.

Such local ad hoc arrangements fill a great need and I applaud them, but they do not take the place of a comprehensive health-care system available to everyone everywhere. A poor person living where there is no such clinic "falls through the cracks". That poor person living a thousand miles from me is my neighbor, as Jesus taught, and I should care about him.

We deliver mail to everybody; we charge taxes to everyone; all public water supplies are monitored for safety; the armed forces protect all of us; police and fire protection are available pretty much everywhere there are people, and delivered on demand, no matter who is asking for their services, etc, etc. The resources exist to provide a reasonable level of health care to everyone. It is just the arrangements, mainly the financial ones, that are lacking.

You can raise all the straw men you want about the federal government meddling and being overbearing, but that has not been my experience. I ran a small business for 14 years and while I chafed at the complexity of taxation, I did not object to the amount taken. The system of taxation is basically fair, and the burdens fall mainly on those who can bear them. I suspect a lot of the people who have "horror stories" about the feds were trying to get away with something.

I was audited various times by both federal and state entities, and I must say that the federal bureaucrats were of a high quality, very reasonable, and not at all difficult. The Indiana state bureaucracy was more difficult.

I also know personally some people who have worked in the federal government. They are intelligent, well-intentioned people just like the rest of us, intent on doing jobs that need doing, and by and large, doing a good job. My wife and I draw Social Security, and we're on Medicare Part A, and those programs seem to be run efficiently.

I think generally the federal bureaucracy gets a bad rap, while other far less efficient systems get a pass, because they are "private sector". Bevin, you are pretty much right on with your last comment.

Thanks, folks, for the conversation. This will be my last post on this thread.

The grace and peace of Christ be with you all.

Don

Sirje
Your problems in a remote outpost of Canada is similar to what you would find in south-west Virginia or any other rural area of the US. I can guarantee you that the problems you face are totally different from what somebody living in Toronto deals with. But even in populated areas of the US waiting time for a specialist is common.

And, Neville, you're so right. Americans are schizofrenic when it comes to patriotism. Nobody is more patriotic, many to the point of jingoism, but nobody is more anti-patriotic. The very people who pledge allegiance to the flag with such pride often hate nobody more than its own Government. Black helicopters with huge American flags. As Neville says, the Government is "we the people." Certainly not perfect but still capable of much good, if given a chance.

And again, not many of you process your thoughts about this subject in terms of your Christian faith. And few of you seem to express any concern, Christian or otherwise, for the millions of people who do not have what you take for granted: good health care. An estimated 30,000 people die uncessarily every year because of it. If the Christian faith has nothing to say to this reality, then of what use is it?

The United States is the only developed nation on the globe that does not have a comprehensive health care system. Nowhere else does any country deliberately deny access to a major segment of its population purely to protect the profit-making capacity of some health care organizations. That is a moral problem.

Ellen White and the Adventist heritage clearly is on the side of extending health care to all. That is precisely why generations of Adventist health professionals went as missionaries and established "sanitariums and city missions." No Adventist with can support the status quo on moral grounds or any measure of effectiveness nor efficiency.

Yes, the emergency rooms of most hospitls are (by law) open to anyone who needs care, even if they cannot pay. But, if you talk to any of the hospital administrators or ER doctors involved, you will be told that this is not the best way to care for most of the cases that come in due to lack of health insurance. People do not get early care and prevention; they wait until it is more painful and costly to care for their needs. They do not have a physician or group that follows them for the long term. The hospitals are losing money on this approach. It is an ad hoc type of universal care that is not cost-efficient nor effective.

People in the Canadian system sometimes have to wait for care. People here in the U.S. sometimes have to wait for care. There is zero evidence that there is significant difference in the length of waits or the incidence of occurance. There is no evidence that the U.S. system is significantly better than the system in Canada or the system in the U.K. or the systems in most European countries. And their systems do not leave out a third of the population.

Employer health benefits are no longer a viable method of providing health care for most Americans. The business sector is ready for some version of universal health care so that it can shed what has become an impossible burden in global competition in business.

To label universal health care as "socialized medicine" is name-calling, not reasoned argument. Anyone who believes that universal health care is wrong needs to explain why they do not also feel that universal education is wrong. No system is perfect, but we need to get beyond old arguments and focus on finding the system that will best provide universal health care with the least investment in administrative overhead. (Currently half the total expenditure on health care in the U.S. goes to administrative overhead--insurance companies, etc.--and only half to actual health care providers. The Canadian system is considerably less costly, pro rata.)

This is a moral issue because of those who insist on maintaing a privileged class that has good health insurance and an underprivileged class that has poor health insurance or none at all. That is simply inhumane! WWJD?

Pat,

"Where would all the idealogues be found if they were personally paying for it?"

Exactly my point.

Even within the system, there are people who fight patients and family members because of the personal needs or the agenda of the health care provider.

Personally, I experienced having a nurse lie to me about treatment which was being given to a patient, treatment which I thought I had clearly proscribed. She knew that I had DPAHC for the patient. On the other hand, the physician was quite understanding and cooperative once he clearly understood my position.

I totally agree with Fred regarding the need for legal reform. No physician should have to practice defensive medicine.

Aage,
Halifax, Nova Scotia is not in a remote corner of wild Canada, where igloos dot the vast tundra and moose roam in every back yard. The hospital I referred to is in the middle of Halifax and is affiliated with Dalhousie University, one of the top medical schools in Canada outside Toronto. To compare Halifax to Appalachia is really funny. But don't let me confuse you with facts.

FYI
www.halifaxinfo.com/explore-halifax.php

www.medicine.dal.ca/

Sirje

more FYI -

www.jpands.org/hacienda/gratzer.html

An excerpt - The early success of medicare- back when the population was young and costs were low - became hard-wired in the Canadian psyche as a source of national pride. Now that the system is failing, no political leader wants to be first to tell the truth. As with "The Emperor's New Clothes," denial reigns supreme.

Sirje
Ok, you got me there. I apologize to all to everybody in the Great Banks. Still, you would grant, wouldn't you, that adopting the US system would solve your problems? And I assume that your weather has something to do with your recruitment problems?

Monte
Exactly!

Sirje
Of course, I meant to say that adopting the US system obviously would NOT solve your problems. Or would it?

Bevin,
More on your point about end of life care. I think it's interesting that the stronger the religious belief, the more intensive the treatment. One would think that would be counterintuitive.

http://www.harvardscience.harvard.edu/culture-society/articles/link-foun...

Aage,
The Grand Banks accepts your apology.:)

I'm not a Canadian; and I don't have the solutions to, either the Canadian problems, nor the US ones. I just get frustrated when people bring up the Canadian health care system as something that should be emulated when really sick people here try to find a way to access US health care.

P.S. You're not the first to show ignorance about anything Canadian. Believe it or not, cars show up at the border with skis on the roof trying to find snow in July. That really happened. This year they may even find some, global warming aside.

Monte, one has to wonder why those who always cry socialism when it comes to medical care, don't do the same with our highway system or the postal system.

It seems to be overlooked when comparing Medicare with Universal health care, that we recipients of Medicare do not pay. Nothing could be more erroneous.

As a nearly 20-year-recipient of Medicare, for coverage with additional "Medigap" is an annual cost of $3600/yr. Each year both premiums are regularly increased.

How does that compare with both private Medicare and with private non-Medicare insurance for one individual? Also, that all working years we were paying for the benefits of such coverage, just as Social Security is "pay ahead." Is anyone out there complaining about receiving SS?

Monte,

"Nowhere else does any country deliberately deny access to a major segment of its population purely to protect the profit-making capacity of some health care organizations. That is a moral problem.

Ellen White and the Adventist heritage clearly is on the side of extending health care to all. That is precisely why generations of Adventist health professionals went as missionaries and established "sanitariums and city missions." No Adventist with can support the status quo on moral grounds or any measure of effectiveness nor efficiency."

Do away with the Employer/employee tax provision deductions and the inequity you mention will go away.Your asking us to accept AIDS in place of STD's. Both are bad.

Or create an "entire system to offer basic care to all by the Fed's being the provider and payer" and let private hospitals/and physicians exist without "individual employer/employee tax writeoffs." Private fees would go down. Now that sounds fair and equitable to me and offers the most choices to all and takes care of the needy or those who don't care to spend more for health care... and not force as Don Rhodes properly observed..."well I guess physicians will have to join the "new" system to survive."

EGW might have wanted more access to care but I dare suggest it would not have been "national care" but charity based for the needy...but I'm not sure either of us knows or the fact really matters.

Nevel, Dick, Monte and others...The police, fire, highway, and post office are deemed good for the "public welfare." However at least the first three also penalize for inappropriate behavior and also there are laws agains "mail fraud." Are you going to enforce punitive laws against "health violators?"...who decides what those laws will be? (Stated only because you are comparing apples and oranges as a strawman argument)...but as I stated above anyway, start an "independent fed system" for all.

regards,
pat

PS. Monte, WWJD? He would perform a miracle to heal the sick and turn loaves into fishes without Rome's help. That is WJDid.

Pat
You're more concerned, it seems to me, to preserve the ideological purity of Conservativism than addressing the fact that thousands of our fellow citizens die for lack of adequate health care. To deny others the health care we have, when we have the means to help them, is indeed a moral issue.

A single payer universal health care system has a proven track record and seems to be the most practical and cost efficient way of taking care of everybody. I'm open to other ways of doing it, one that would not offend the principles of the GOP, for instance, but at the end of the day I'd like to know how 47 million people "neighbors" are going to have their needs met, the way our needs are met.

No system is perfect--certainly not our own--and any universal health care system will have its problems, but that is not the issue. Perfection can often be the enemy of good.

The Darwininian approach is to say that those who lack health care are loosers, that it's their own fault that need care, and that by helping them survive, we're upending the principle of the survival of the fittest. I would have thought that Christians thought differently. I know that you do on a one to one basis. Why not let your Christian charity assume society-wide proportions?

The hardness of heart that some Christians display in the face of suffering which is not their own is nothing less than appalling. To some the only suffering worth our attention is the one we might incur at the end of days, should we fall into the hands of an angry God. That is nothing but CYA religion, sanctified selfishness.

To all
I'm not a believer so you can disregard my words, but go back and reread Monte Sahlin's post, which is very much to the point.

Aage,

Here is my point. I resent anyone telling me WWJD or EGW would do in order to be a Christian and AS SUCH I , "should be in favor of a universal health system in the US because every other nation has it"....Soooo?

I am not a libertarian who opposes most all functions of government but I am opposed to churches assuming they know WWJD and applying it to fiscal public policy.

If anyone wants to do vote for that it's fine with me. I am a Christian who feels it is not the best policy for the nation but doing away with the employer/employee tax exemption or applying it "equally" across the board is. I feel there needs to be Tort reform and end of life issues dealt with that limit cost to the terminally ill while always keeping them comfortable.(Unless the family chooses to pay the bill personally)I am not by the way a Republican or Democrat and don't support all or none of either's agenda.

I am "old enough" to know that not everyone who doesn't have insurance does not simply because they can not afford it. The truly poor should be helped by the state public health systems at a minimum if they have slipped through the cracks.

So keep your political agenda and "socio-economic-religious" view to yourself without attempting to make others feel guilty about "your" understanding of WWJD when in reality you don't have the SLIGHTEST idea in this multifaceted complex problem that deals with the ever ending complexity of the "rights of the one and many."

regards,
pat

"The truly poor should be helped by the state public health systems at a minimum if they have slipped through the cracks."

That is precisely what is being done currently. There is no "free" medical care; just a difference of opinion on how and who should pay for it. In counties and states it is the tax payer; and as is well known, the uninsured are charged much more than the insured.

It is getting a little tiresome to read of employer-paid plans when we are now experiencing the highest unemployment since the Great Depression. California now has double-digit unemployment and in the central valley it is pushing 20%! It's no different than Marie Antoinette telling the starving "let them eat cake."

With such forms of Christianity as has been expressed here, secular humanism is far more attractive for hearing and answering human problems. Remember, when one's religious beliefs are threatened, the ACLU (that awful liberal organization) will take your defense pro bono, if needed.

One's concept of "love" is not the issue in civil affairs.

"Do not pervert justice; do not show partiality to the poor or favoritism to the great, but judge your neighbor fairly."
Lev.19:15.

Politicians do an excess of both today(usually feigning help for the poor for their own purposes)...thus the plastered high wall that I suggest is in danger of breaking the world over.

regards,
pat

One aspect that this discussion has failed to address is that as society has moved more and more towards a welfare state with more and more "rights" being discovered everyday, the family unit has continued to break down.
What ever happened to family assisting when emergencies occur?

I had embryonal cell carcinoma when I was about 25 with a wife and 2 kids less than 4. Family helped ALOT.

Everyone seems to describe the poor as if they are orphans too which is practically criminal. Especially when we should be doing all we can to make families as strong as possible.

I hear so much about "thousands of our fellow citizens (dieing) for lack of adequate health care."

Why even discuss it? If one is being so magnanimous start with the homeless. Who worries about a toothache when they dont have a bed?

Also it is disingenuous to say we, "deny others the health care we have, when we have the means to help them...."

We dont DENY anything, in fact services are offered and advertised every day. Just because I dont pay for everyone else is not saying they are not allowed have it.

It is sad that poor perspective and personal philosophies are interjected into what is really a nuts and bolts problem.

If it is such a problem I would like to see the statistics of people emigrating to Europe or Canada since it is made to be such a critical issue.
Kind of makes one wonder how the human race survived till now dont it?

I have lived in the US for 15 years, and am now back in my home country, Australia. My constant fear while living in California, Michigan and Massachusetts was what would happen if I were to get very ill--how would my husband and I afford to pay for the costs over and above insurance reimbursements (yes, we did have health insurance). Even with health insurance we lacked access to regular affordable health care. For example, I was unable to have regular mammograms (available to me free here in Australia now that I am over 50). Attending an emergency room in the US with my son on a couple of occasions for a broken limb (or two), it was distressing to me to see large numbers of people who were there simply to see a doctor about the flu, as they were unable to access care in the usual way. I am thankful that I now live in a country where it is every persons right to have access to excellent health care through the Government funded medicare system (not just those over 65)--no one needs worry here in Australia about the financial consequences of a long-term illness. My mother-in-law who lives in the US does not seem to avail herself of regular medical care (she has various needs, including diabetes, which we suspect is not being adequately managed due to the residual costs to her). I also have friends in the US who are supporting their elderly parents with the high cost of their monthly drug bill, due to the lack of insurance coverage. I can't imagine that scenario here in Australia. My 92 year old father is on various heart medications, and cost has never been a concern, thanks to medicare. Perhaps it would be worthwhile to listen to the recent NPR Health special on health insurance, as they analysed what countries such as France, England, Canada, etc were providing their citizens in the way of health care. Definitely worth a listen. I believe most US citizens don't have a clue as to how disadvantaged they are. It is unthinkable that 47 million are without access to health care. Unthinkable!!

A lot of problems could be resolved with neighborhood walk in clinics. From there, people could be triaged to ERs or sent home with OTC meds. Legal issues probably make a simple solution like this unworkable. Its unfortunate that a lot of these poor patients are looking for a payday of any kind, including legal action against health care providers.

Peter Druker had an interesting observation over 30 years ago. It seems that it was costing New York City over $300.00 for each out-patient visit to the ER. He suggested that if the city paid out $300.00 to each patient entering most would immediately turn around and go home and buy sone OTC remedy
and spend the rest on self-indulgence or credit card debt.

Triage is certainly the operative word. It should be something better that hours of waiting or direct payout.

Years ago, the President of the Medical College had a minor medical problem. He thought this would be a good time to check out the ER. So he reported to the ER and gave his Chief Complaint and vital information with no title. He was directed to a seat in the waiting room. He had arrived at 8:15 A.M. He sat and read year old mag. until 11:45 when the chief of service happened to walk through the waiting room.
The chief said: "Harry what in the world are you doing here--Harry replied, just trying to get seen by a physician about this nagging pain in the butt over health care delivery. The Chief said, why didn't you tell them who you were. Harry said, would that have helped? I thought the patient not the person came first.

People being people, I don't think any system will get any better. Just more costly with the major benefit going to third party payers. Etna comes to mind. Tom

Years ago, the President of the Medical College had a minor medical problem ... He had arrived at 8:15 A.M. He sat and read year old mag. until 11:45 when ...

Good. The ER was doing its job properly.

The ONLY real weapon an ER has against abuse by people who don't need to be there is to correctly prioritize the group of people waiting and handle them in priority order.

These long waits are the only things that stop some people from going there even more often.

The outpatient clinics are a good idea.

The $300 handout is a terrible idea - lots of people would walk into the ER just to collect their $300 - even if they had to wait all day for it.

/Bevin

Angela wrote:
"I believe most US citizens don't have a clue as to how disadvantaged they are. It is unthinkable that 47 million are without access to health care. Unthinkable!!"

So true, but when you've been brought up to believe that you live in the best of all possible worlds, it's hard to conceive that life can be better elsewhere.

Aage,
I have seen European "public" dentistry while in HK for 7 yrs. and it is pathetic when compared to US standards. So at least in that realm people truly got what they payed for.

In 1988 I was at the SDA Dental Clinic in Dhaka, Bangladesh for 6 mos.and besides locals I saw individuals from the former USSR embassy which were "more blessed" than the average populace of Russia. Their mouths were truly a sad commentary of dental care.It was then I realized first hand that the Soviets were simply a 2nd or 3rd level nation with a strong military.

Freedom of choice in health care has been truly a blessing to be enjoyed/appreciated in a previously prosperous nation...perhaps it's days are numbered.

I have said enough on this strand and I am finished "most likely."

regards,
pat