So Woody's thread can get back on course.....
PAUL

For the sake of context, let me first state something for the record: It is just not the place of the federal government to provide each and every individual with health care. Employer-provided health insurance was first introduced broadly after World War II. Employers used it to attract workers. Americans got used to health coverage, as a matter of course, such that we now think of it as a right. Today, few people even know what is spent on their health care because they don’t have to be aware of it. We, and our employers, pay our insurance premium; we pay our deductible. And the insurance company pays for our treatment. That’s a scenario that all but forces doctors and hospitals to charge more. Sadly, most people don’t even think in terms of a fix. If it’s too expensive… well then the government should pay for it.

Paul: You asked about cancer, heart disease, catastrophic health issues. There’s a difference between treating these maladies and writing prescriptions for less serious conditions. All of us have health concerns, most of which are not immediately life threatening. Perhaps part of any solution should include separating routine medical issues from coverage of serious accidents and catastrophic illness. When health care is less affordable it is also less accessible to more people. Clearly steps must be taken to reduce the cost of health care, which, of course, drives up the cost of insurance and out-of-pocket expenses.

When we buy automobile insurance we don’t expect that Geico will pay for oil changes or tune-ups. That’s not what automobile insurance is for. Also, why is it wrong to charge young people, who need only hedge their risk against accident and major illness, less? Why is it wrong to charge people who are smokers or hugely overweight, more. What ever happened to personal responsibility?

A short opinion piece in today’s Wall Street Journal makes this point nicely. It says in part…

“… These views are difficult to reconcile with the consensus that unhealthy behavior contributes significantly to obesity, diabetes, heart disease and cancer, and thus accounts for a substantial proportion of health-care costs.”

“Regulation that seeks to divorce insurance rates and coverage terms from health status would deter potential innovation that might provide meaningful financial incentives for healthy behavior and lower costs.”

http://online.wsj.com/article/SB124623169143066199.html

It is essential to reform civil legal procedures that allow lawyers to cash in, in a big way, on the suffering of victims of medical malpractice. How can it be, for example, that a drug company, which spends years jumping through government-mandated trials be sued when, after years of use, a statistical link is drawn to a given drug supposed to have some unfortunate side effect. No doctor can prescribe a medication that has not first been approved by the Food and Drug Administration. If anything, it is the government that should be sued since it is responsible for approving the drug, but that’s not allowed by law. Adding to this expense is the thoroughly documented fact that doctors order far too many tests, just to cover their backs.

As things are now, insurers are forced to deal with pages and pages of regulations, state by state. Obviously that’s going to increase their costs. If we’re going to nationalize anything, let’s have one set of regulations that apply to every state. Let’s allow consumers to purchase insurance from companies that compete for our business across state lines, the way we do with auto insurance. Isn’t that a common sense measure upon which we can all agree? The reason that it won’t happen is because of lawyers who, as a group, are one of the largest contributors to politicians.

Bringing free market practices into medicine would do much to reduce the expense of health care. One of the best ideas I’ve heard is medical savings accounts. This system would allow you to put money into an account, with tax advantages, from which you could pay for your more routine medical bills. Putting consumers back in charge of spending on their own doctor visits and prescriptions would introduce competition back into the system. Consumers would shop for the best deals. Health care providers would compete for “customers” like any other business. Cash is king. When doctors and hospitals aren’t forced to deal with insurance and government red tape, costs will come down for everyone. At the end of the year you could pocket any savings, and end up ahead of the game. I for one, and I’m sure I’m not alone, would come out ahead if I could put the money my employer and I pay for medical insurance into one of these accounts. Such a system would also foster increased personal responsibility.

Bear in mind, please, that Mr Obama and his friends in Congress are unwilling to consider common sense reforms, but perfectly willing to parcel out treatment to cut costs. Consider this; the main argument for improving education is to pay teachers better. Yet the President has promised to “put the squeeze on doctors.” Won’t that have an impact on the quality of health care? Did you see last week’s ABC/Obama infomercial? Remember the lady who raised the issue of the human spirit and a pacemaker for her 100-year-old mother? Mr Obama is fine with rationing health care. The answer he gave that lady was absolutely creepy.

Implementing even some of the measures discussed here would be an improvement. At the very least they’re a good place to start. Tending to the physical needs of the unfortunate or the unwilling is the province of charitable institutions and those who support them, and not the role of government and federal bureaucrats. There are a lot of good ideas out there, but the bottom line is there is no way to provide comprehensive health care. There is no magical, sustainable solution. I don’t have one… and neither does anyone else.

Ken

Great post. I am a big proponent of the personal responsibility thing too. Yes, what is wrong with charging more for obese and "unhealthy lifestyle" people? I mean, Should a life insurance policy premium be the same for an obese person that drinks heavily and smokes heavily versus one that doesn't? I am quite offended to have to pay for an extra bag at the airport when a person 80 lbs overweight gets a free pass. I feel discriminated against. It defies logic.

I must confess that I agree with much of what is noted in the previous post - the car insurance analogy is a good one, as are the points about personl responsibility, and some common sense ways to try to keep costs down for all (I like the savings plan as well - but I won't go back to my "make better choices" rant). While I believe that doctors must take responsibility for their mistakes I also think that the litgiousness of our society is a huge issue - and just as many folks feel that doctors should not be so concerned about the money making aspect of their profession, I feel that some thought should be given to the money that lawyers are making from medical lawsuits - is that any better? Our government is lined with lawyers - not a bad thing, but I think we would do well to mix it up a bit - with a few more doctors and farmers, teachers, etc. participating in the decison making that affects us all. I do not feel that the "middle Americans" are being represented in Washington (not on either side of the fence) - haven't been for a long time. Unfortunately, there are many, many grey areas and I don't know what the best solution is either. We will bail out the big corporations but we'll "put the squeeze on doctors" - it almost seems a little backwards to me. Sure, I'd rather spend my money on a fancy car or nice clothes, but if my kids get sick my money goes to pay the doctors, if they work hard to make my kids better they deserve to be compensated - and having healthy kids means more to me than owning a fancy car or strutting around in Coach (or Prada?) shoes - it's about choices. Sorry - I have not thought this through, just spewing - not looking for a debate - just thinking out loud - I really am trying to make sense of this whole issue - not that I have any control in the matter. I actually sent a healthcare related email to my state Senator (I've never done that before) - I received a reply - a "form letter" that did not address any of my issues directly. I know that these folks are busy, but I would like to know that I was heard. I suspect that my letter was dumped into a pile of a million others, never to be seen again. I'll let you all know If I hear anything more. I'm probably on the official "crazy lady" watch list now! ; )

Another thing to note is that mortality rates are alarmingly higher in countries with goverment run healthcare. Lack of resources.

Here are some of my grey areas:

While I personally think that insurance companies should be able to make some determinations with regard to smoking, use of seatbelts, helmets, etc., I then wonder where we draw the line - should they (ins. companies, government, whoever) also have the right to argue that we must eat only organic foods, filter our water, exercise, get 8 hours of sleep? We can all do more to be healthier, where do we draw the line? This is where I think that personal responsibility comes in - perhaps if insurance companies want to make specific rules - and be up front about it them (ie: if you smoke, or are not wearing a seatbelt when you crash your car, or you never exercise or get regular check ups) then your premium will be higher or the "payout" will be lower if you choose to do otherwise. That way, they have a choice in who they cover and we have more of a choice in who we do, or do not, want to employ as our insurer and where we are willing to draw the lines.

I also feel that children are caught in the middle of this, often innocent victims of ignorance, red tape, etc. - if their parents make poor choices, they pay the price. I would like to see a system that encourages regular care for and the development of healthy habits early on - that would probably save us all money in the long run - and make for healthier kids and adults. But the grey area - do "we" have the right to tell parents how to care for their children? Where are those lines drawn?

A few random thoughts: I know several folks in the medical and dental fields who often forgive payments or offer extended payment plans to people who fall on hard times or are having to deal with catastrophic illness, most do not hear of it because it is done quietly, so as not to cause embarrassment to the families. Also, over the years when various members of my family have been hospitalized I have learned that a portion of what we have been billed for is for indigent care - so we are already contributing to the care of those who can not afford it.

Still no anwsers from me, just more ruminations....

You raised some very good points, golfwidow. In general, I think insurance companies and government should hold individuals responsible for the consequences of their actions. But no entity—government least of all—should dictate how we live our lives.

The beauty and burden of being free to make choices is that we all have differing ideas/opinions of what is responsible, healthy, respectful, reasonable, and there a just SO many of us......as has been discussed previously, where is the baseline? I personally like the "do unto others" philosophy, but even that leaves a lot of room for interpretation....

I found this rather interesting since I haven't heard many details.

http://www.nydailynews.com/opinions/2009...r_coverage.html

I also heard that "your plan" will tax you on the coverages the goverment plan kicks in. For example, you have a $1000 procedure done. Your portion is $200 and the goverment plan covers the other $800. You will be taxed (as income) on the $800. Nice....

From The Heritage Foundation 7/02/2009:

[Yesterday, President Obama held a town hall event in order to “sell his health care message to the public” during Congress’ July 4th recess. However, worried that the President cannot answer tough questions about his plan for health care reform, White House officials carefully screened each member of the audience in attendance and each question asked.
This time, the mainstream media took note, even grilling White House spokesperson Robert Gibbs on the choreographed spectacle. In fact, veteran White House correspondent Helen Thomas, not known as a conservative sympathizer, even lamented: “I’m not saying there has never been managed news before, but this is carried to fare-thee-well–for the town halls, for the press conferences. It’s blatant. They don’t give a d–n if you know it or not. They ought to be hanging their heads in shame.” She added: “What the h-ll do they think we are, puppets?”

The AP reported: “Some of Obama’s questioners Wednesday were from friendly sources, including a member of the Service Employees International Union and a member of Health Care for America Now, which organized a Capitol Hill rally last week calling for an overhaul. White House aides selected other questions submitted by people on YouTube, Facebook and Twitter.”

With the elaborate choreography President Obama managed to talk a good talk, despite his rhetoric not matching his plans. For example he said: “We need a permanent solution that when you lose your job, or change jobs, you can still keep your health insurance.” Absolutely. Do you lose your car or life insurance when you change your job? Of course not. The same should be true for your most important coverage: health insurance.

Heritage’s Bob Moffit, at a recent Congressional hearing, testified that “Americans need portability. If we had portability in health insurance that was tied to the person and not where they worked, the numbers of the uninsured would drop dramatically.“ Unfortunately, the President’s plan doesn’t offer this portability. Obama went on to deliver another one of his prized pieces of health care rhetoric: “If [private insurance] is such a great deal, why are [insurers] so concerned about government competing with private plans?”

The President has been searching for the logic on this one, and luckily it’s easy to explain. There’s no real competition when the Referee making the rules is also playing the game; it’s a fixed competition. Congress’ ability to pay doctors and other providers less will hide the true cost of the public plan. Undercutting private insurance will drive enrollment to the public plan. That’s not competition on a level playing field.

While bemoaning that Congress moves slowly on legislation, he offered this analysis of our Constitutional government three days before the 4th of July, saying: “Part of that is the way the Constitution is designed. We don’t have coups [de’tat] or governments collapsing. The disadvantage is it’s hard for us to make great, big, bold steps.”

At Heritage, we tend to think that one of the more important aspects of the Constitution is the very fact that it is so difficult to take “great, big, bold steps.” Perhaps, on America’s upcoming 233rd birthday, this is a quaint idea. Some still tend to agree with us, however. The point is health care reform doesn’t need to be so radical that the Constitution holds it back. There are other ways to fix health care that won’t intrude into our daily lives or our personal choices.

Nevertheless, the President is going to ask you to hold his hand and jump off the cliff with him, saying: “We’re in one of those rare moments where everybody is ready to move into the future. We just can’t be scared.” Frankly, when a plan is so big, so intrusive and so expensive to every American’s life that the President feels the Constitution might hinder its approval, you should be scared.]