Worthiness, Socialized Medicine, In Addition To Private Responsibility
My final post service examined the questions: Who is worthy of having adequate wellness insurance too high-value (safe, cost-effective) care; what makes them deserving? And who, on the other hand, is unworthy; what makes them undeserving? I linked to this post service on some other forum, which led to an interesting conversation nearly personal responsibility. Following are excerpts from that conversation. I welcome your comments.
One somebody commented:
Everyone deserves unobstructed medical attending for illness too injury; curable, chronic, and/or terminal. In that I encounter an absolute fulfillment of the constitutional mandate to encounter to the 'general welfare'. One measuring beyond that is preventive care, to a greater extent than opinionated too intellectually based; but I none the less would consider that the 'general welfare'. Every other service for everyone associated every bit medical service should stay privately financed too marketed (like kid bearing too voluntary procedures).
One critical number inside that seat is how to bargain alongside self induced wellness impairments. This wellness course of study should possess got a name, definition, too social remedy. Let's telephone telephone it IHIs. It's tough because it's smoking, miserable diet, drug addiction, STDs, miserable dental care, high gamble sports, etc. I'm thinking IHI classification puts an private into a particular insurance category requiring add-on premium or mandatory savings both during too for some fourth dimension subsequently such circumstances.
I replied:
Yes, dealing alongside the form of self induced wellness impairments (IHIs) is a thorny issue.
H5N1 logical instance tin live made for having those alongside the fiscal way pay out of steal for at to the lowest degree a share of treating wellness problems clearly determined to live voluntarily induced. That is, delivering tending to people alongside adequate maturity, knowledge, intelligence too rationality, but who brand a witting determination to engage inward high-risk behaviors too endure the consequences, would toll them more, so they are held accountable for their actions.
Unfortunately, many (most?) of these people are either (a) young (e.g., teenagers enticed past times tobacco too alcohol marketing, every bit good every bit peer pressure, too so larn hooked); (b) ignorant, confused or unintelligent (they don't fully realize or sympathise the risks of eating every bit good many greasy french fries too failing to practise regularly, or they possess got problem self-managing a chronic status requiring a complex medication regimen too lifestyle changes); (c) irrational (e.g., they deceive themselves into believing they tin halt taking drugs, or they are self-destructive due to a psychological problem); or (d) they lack the funds too back upwardly needed to alive a to a greater extent than salubrious lifestyle (all their fourth dimension is taken working 24-hour interval too nighttime at minimal-wage jobs, or they lack affordable transportation, to watch the dentist every vi months, or they can't afford fresh fruits, vegetables too lean meats when pasta is a fraction of the cost). Or, they exactly mightiness live unlucky (e.g., the got an STD because the security broke).
In other words, this is a complex number too a smashing bargain of idea should become into defining the atmospheric condition for the form of punitive costs y'all propose.
Also consistent alongside your proffer would live a policy of taking punitive activity against the manufacturers, distributors, retailers too marketers of unhealthy foods too ineffective medications too supplements. And what nearly tobacco companies too alcoholic potable producers who promote their products to college students, too fifty-fifty the promoters of unsafe sports?
It seems to me, therefore, that establishing a reasonable ii tier system--one for folks who self-manage their wellness effectively too some other for those who don't--is a daunting task, but 1 worth examining.
On altitude of this is the query of whether contraception, abortion, too kid bearing should live paid privately.
Nevertheless, the bigger number inward my hear (and discussed inward my blog) isn’t nearly penalizing sure people for miserable behavior; instead, it’s nearly enabling too rewarding the delivery of high-value wellness too healthcare services. I fence that minimizing waste, inefficiency, too ineffectiveness--while maximizing transparency of character too cost, along alongside wellness instruction too services, too rewarding positive results--would genuinely relieve so much coin that in that location would live no demand of the form of two-tier organisation proposed.
Another somebody commented:
Providing the form of full general welfare y'all suggest is way beyond what our founding virile somebody nurture meant past times this or far beyond whatever logical interpretation. Providing for the full general welfare way our legal citizens powerfulness to pursue their lives too piece of work safely, securely, too costless of regime inference too detailed mandating. It inward no way way the regime should taxation everyone to pay for things that everyone has the liberty to choose. This includes medical care.
Per the Census Bureau's 2005 / 2006 census report:
I am unwilling, every bit good as, unable (I am retired too on a rather fixed income) to pay for the healthcare of illegal aliens too those citizens who desire me to pay their way!
And last, but non least, delight render valid, relevant, accurate, too consummate statistical information which clearly shows those countries who possess got socialized healthcare render healthcare of equal or improve than is currently provided inward the US.
This does non hateful major improvements are desperately needed inward our acquaint healthcare systems! But these are improvements non a replacement! I volition non grip my breath waiting on the healthcare manufacture to brand these needed improvement, because of regime regulations too interferences! The politicians are a major component of our healthcare problems, non a solution amid them! :-)
I replied
You said: Our regime [should not] taxation everyone to pay for things that everyone has the liberty to choose. This includes medical care.
While I concord alongside your premise, I don’t believe it’s nearly “freedom of choice.” There are many reasons for people non having coverage, including:
You said: 17,742,000 uninsured Household earned $50,000 too to a greater extent than inward 2006. … These People sure could afford to larn their ain wellness insurance.
It seems to me that the number of folks who tin afford insurance too exactly chose non to larn it is real small. Take your illustration of a household unit of measurement earning $50K/yr. In NY, an HMO household unit of measurement excogitation alongside steep copays too deductibles too no dental, offered through a minor business, toll a household unit of measurement over $11K/year inward premiums alone, which increases every year. That’s a sizable expense fifty-fifty for a household unit of measurement earning $50K, on altitude of out of steal dental costs, every bit good every bit copays too deductibles. I don’t encounter that many neglect to purchase insurance because they’re looking for a “free ride.” I say this inward lite of the fact that the uninsured tend to possess got worse wellness and, when they larn sick, they possess got to hold back for hours inward a emergency room or become to a community hospital security cyberspace facility. This is non a glamorous option.
Another group, btw, are the “underinsured” who purchase coverage too so are shocked to realize that what they possess got doesn’t come upwardly unopen to paying their medical bills. According to a recent consumer reports study, 24% of Americans possess got wellness insurance that barely covers their healthcare needs, non to mentions the 16% alongside no insurance at all. This leaves a huge number of people unprepared for major medical expenses.
You said: Please render valid, relevant, accurate, too consummate statistical information which clearly shows those countries who possess got socialized healthcare render healthcare of equal or improve than is currently provided inward the US.
I don’t believe such clear-cut information has e'er been collected to brand the instance 1 way or the other. But in that location is convincing information that the the States lags behind many industrialized countries inward delivering primary care, access too character … spell at the same fourth dimension costing much to a greater extent than than other countries. See, for example, The Commonwealth Fund (Sep 20, 2006). New National Scorecard: U.S. Health Care System Gets Poor Scores on Quality, Access, Efficiency, too Equity. Available at this link.
You may also desire to watch this link to a page on our WellnessWiki for to a greater extent than facts too figures nearly the healthcare crisis.
As far every bit non belongings your breath waiting on the healthcare manufacture to brand needed improvement due to regime regulations too interferences, I don't blame you! It volition possess got rigid leadership, novel mind-sets, innovative policies, too consumer pressure level to modify the organisation inward the form of profound ways I propose.
And what nearly dealing alongside undocumented workers (illegal immigrants) who are hired past times American employers to do back-breaking piece of work at below minimum wage? I sympathise when our citizens complain nearly the toll of giving them costless healthcare. But consider the alternatives: We tin allow them choke inward the streets without whatever assist too pray they don’t top contagious affliction due to lack of treatment, waste materials huge sums of coin edifice walls around our dry soil inward the naïve promise that nosotros tin move along them from crossing our borders, etc. And nosotros could punish employers who hire them to do back-breaking menial labor few of our citizens would do, but that wouldn’t assist much since nosotros demand them too they demand us for piece of work to feed their families.
Alternately--and I realize this is controversial--we tin adopt a national policy that makes the U.S.A. the world pump for promoting wellness !
Why? Well, if nosotros could afford to do so, non only is it the moral affair to do, but it would also live 1 of the most powerful things nosotros tin do to create do terrorism. Imagine what would probable hap if nosotros showed the basis that a primary business office of our nation is to improve the wellness of all peoples at abode too abroad. This would live a major measuring toward winning the hearts too minds of all peoples, including those who aren’t real fond of us correct now; and, at the same time, it would larn inward much to a greater extent than hard for terrorists to demean us too recruit individuals who desire to destroy us.
So, assuming what I exactly said is valid, so how tin nosotros afford to live the leaders inward promoting greater wellness too improve healthcare for everyone around the inward our ain dry soil too around the world?
There are many things nosotros tin do to larn the coin needed; some of which require a shift inward our national priorities, policies too processes. Three of the to a greater extent than obvious strategies would live to:
One somebody commented:
Everyone deserves unobstructed medical attending for illness too injury; curable, chronic, and/or terminal. In that I encounter an absolute fulfillment of the constitutional mandate to encounter to the 'general welfare'. One measuring beyond that is preventive care, to a greater extent than opinionated too intellectually based; but I none the less would consider that the 'general welfare'. Every other service for everyone associated every bit medical service should stay privately financed too marketed (like kid bearing too voluntary procedures).
One critical number inside that seat is how to bargain alongside self induced wellness impairments. This wellness course of study should possess got a name, definition, too social remedy. Let's telephone telephone it IHIs. It's tough because it's smoking, miserable diet, drug addiction, STDs, miserable dental care, high gamble sports, etc. I'm thinking IHI classification puts an private into a particular insurance category requiring add-on premium or mandatory savings both during too for some fourth dimension subsequently such circumstances.
I replied:
Yes, dealing alongside the form of self induced wellness impairments (IHIs) is a thorny issue.
H5N1 logical instance tin live made for having those alongside the fiscal way pay out of steal for at to the lowest degree a share of treating wellness problems clearly determined to live voluntarily induced. That is, delivering tending to people alongside adequate maturity, knowledge, intelligence too rationality, but who brand a witting determination to engage inward high-risk behaviors too endure the consequences, would toll them more, so they are held accountable for their actions.
Unfortunately, many (most?) of these people are either (a) young (e.g., teenagers enticed past times tobacco too alcohol marketing, every bit good every bit peer pressure, too so larn hooked); (b) ignorant, confused or unintelligent (they don't fully realize or sympathise the risks of eating every bit good many greasy french fries too failing to practise regularly, or they possess got problem self-managing a chronic status requiring a complex medication regimen too lifestyle changes); (c) irrational (e.g., they deceive themselves into believing they tin halt taking drugs, or they are self-destructive due to a psychological problem); or (d) they lack the funds too back upwardly needed to alive a to a greater extent than salubrious lifestyle (all their fourth dimension is taken working 24-hour interval too nighttime at minimal-wage jobs, or they lack affordable transportation, to watch the dentist every vi months, or they can't afford fresh fruits, vegetables too lean meats when pasta is a fraction of the cost). Or, they exactly mightiness live unlucky (e.g., the got an STD because the security broke).
In other words, this is a complex number too a smashing bargain of idea should become into defining the atmospheric condition for the form of punitive costs y'all propose.
Also consistent alongside your proffer would live a policy of taking punitive activity against the manufacturers, distributors, retailers too marketers of unhealthy foods too ineffective medications too supplements. And what nearly tobacco companies too alcoholic potable producers who promote their products to college students, too fifty-fifty the promoters of unsafe sports?
It seems to me, therefore, that establishing a reasonable ii tier system--one for folks who self-manage their wellness effectively too some other for those who don't--is a daunting task, but 1 worth examining.
On altitude of this is the query of whether contraception, abortion, too kid bearing should live paid privately.
Nevertheless, the bigger number inward my hear (and discussed inward my blog) isn’t nearly penalizing sure people for miserable behavior; instead, it’s nearly enabling too rewarding the delivery of high-value wellness too healthcare services. I fence that minimizing waste, inefficiency, too ineffectiveness--while maximizing transparency of character too cost, along alongside wellness instruction too services, too rewarding positive results--would genuinely relieve so much coin that in that location would live no demand of the form of two-tier organisation proposed.
Another somebody commented:
Providing the form of full general welfare y'all suggest is way beyond what our founding virile somebody nurture meant past times this or far beyond whatever logical interpretation. Providing for the full general welfare way our legal citizens powerfulness to pursue their lives too piece of work safely, securely, too costless of regime inference too detailed mandating. It inward no way way the regime should taxation everyone to pay for things that everyone has the liberty to choose. This includes medical care.
Per the Census Bureau's 2005 / 2006 census report:
- 10,231,000 non-citizens are uninsured (See page 21 of the census report) - the increment from 2005 to 2006 inward this expanse represents 38.3% of the .5% increment inward uninsured PEOPLE
- 17,742,000 uninsured Household earned $50,000 too to a greater extent than inward 2006. (See page 21 of the 2006 census report) These People sure could afford to larn their ain wellness insurance.
I am unwilling, every bit good as, unable (I am retired too on a rather fixed income) to pay for the healthcare of illegal aliens too those citizens who desire me to pay their way!
And last, but non least, delight render valid, relevant, accurate, too consummate statistical information which clearly shows those countries who possess got socialized healthcare render healthcare of equal or improve than is currently provided inward the US.
This does non hateful major improvements are desperately needed inward our acquaint healthcare systems! But these are improvements non a replacement! I volition non grip my breath waiting on the healthcare manufacture to brand these needed improvement, because of regime regulations too interferences! The politicians are a major component of our healthcare problems, non a solution amid them! :-)
I replied
You said: Our regime [should not] taxation everyone to pay for things that everyone has the liberty to choose. This includes medical care.
While I concord alongside your premise, I don’t believe it’s nearly “freedom of choice.” There are many reasons for people non having coverage, including:
- Health insurance is unaffordable to many, including individuals who are unable to larn affordable private coverage due to toll or pre-existing medical conditions.
- Many employers do non offering wellness insurance coverage.
- People who lose their jobs ofttimes lose their wellness insurance.
- Some workers are non eligible for wellness insurance offered past times their employer.
- Workers too individuals do non take-up coverage that is available.
- People may live miserable but non eligible for world coverage, for example, childless adults are to a greater extent than ofttimes than non ineligible regardless of income.
- Individuals are eligible for world programs, but are non enrolled.
You said: 17,742,000 uninsured Household earned $50,000 too to a greater extent than inward 2006. … These People sure could afford to larn their ain wellness insurance.
It seems to me that the number of folks who tin afford insurance too exactly chose non to larn it is real small. Take your illustration of a household unit of measurement earning $50K/yr. In NY, an HMO household unit of measurement excogitation alongside steep copays too deductibles too no dental, offered through a minor business, toll a household unit of measurement over $11K/year inward premiums alone, which increases every year. That’s a sizable expense fifty-fifty for a household unit of measurement earning $50K, on altitude of out of steal dental costs, every bit good every bit copays too deductibles. I don’t encounter that many neglect to purchase insurance because they’re looking for a “free ride.” I say this inward lite of the fact that the uninsured tend to possess got worse wellness and, when they larn sick, they possess got to hold back for hours inward a emergency room or become to a community hospital security cyberspace facility. This is non a glamorous option.
Another group, btw, are the “underinsured” who purchase coverage too so are shocked to realize that what they possess got doesn’t come upwardly unopen to paying their medical bills. According to a recent consumer reports study, 24% of Americans possess got wellness insurance that barely covers their healthcare needs, non to mentions the 16% alongside no insurance at all. This leaves a huge number of people unprepared for major medical expenses.
You said: Please render valid, relevant, accurate, too consummate statistical information which clearly shows those countries who possess got socialized healthcare render healthcare of equal or improve than is currently provided inward the US.
I don’t believe such clear-cut information has e'er been collected to brand the instance 1 way or the other. But in that location is convincing information that the the States lags behind many industrialized countries inward delivering primary care, access too character … spell at the same fourth dimension costing much to a greater extent than than other countries. See, for example, The Commonwealth Fund (Sep 20, 2006). New National Scorecard: U.S. Health Care System Gets Poor Scores on Quality, Access, Efficiency, too Equity. Available at this link.
You may also desire to watch this link to a page on our WellnessWiki for to a greater extent than facts too figures nearly the healthcare crisis.
As far every bit non belongings your breath waiting on the healthcare manufacture to brand needed improvement due to regime regulations too interferences, I don't blame you! It volition possess got rigid leadership, novel mind-sets, innovative policies, too consumer pressure level to modify the organisation inward the form of profound ways I propose.
And what nearly dealing alongside undocumented workers (illegal immigrants) who are hired past times American employers to do back-breaking piece of work at below minimum wage? I sympathise when our citizens complain nearly the toll of giving them costless healthcare. But consider the alternatives: We tin allow them choke inward the streets without whatever assist too pray they don’t top contagious affliction due to lack of treatment, waste materials huge sums of coin edifice walls around our dry soil inward the naïve promise that nosotros tin move along them from crossing our borders, etc. And nosotros could punish employers who hire them to do back-breaking menial labor few of our citizens would do, but that wouldn’t assist much since nosotros demand them too they demand us for piece of work to feed their families.
Alternately--and I realize this is controversial--we tin adopt a national policy that makes the U.S.A. the world pump for promoting wellness !
Why? Well, if nosotros could afford to do so, non only is it the moral affair to do, but it would also live 1 of the most powerful things nosotros tin do to create do terrorism. Imagine what would probable hap if nosotros showed the basis that a primary business office of our nation is to improve the wellness of all peoples at abode too abroad. This would live a major measuring toward winning the hearts too minds of all peoples, including those who aren’t real fond of us correct now; and, at the same time, it would larn inward much to a greater extent than hard for terrorists to demean us too recruit individuals who desire to destroy us.
So, assuming what I exactly said is valid, so how tin nosotros afford to live the leaders inward promoting greater wellness too improve healthcare for everyone around the inward our ain dry soil too around the world?
There are many things nosotros tin do to larn the coin needed; some of which require a shift inward our national priorities, policies too processes. Three of the to a greater extent than obvious strategies would live to:
- Take some of the coin currently beingness spent on weapons too the military machine to create do the “war on terrorism” through devastation too death, too operate these funds constructively to improve wellness inward the world.
- Remove waste materials from our electrical current healthcare organisation past times fostering wellness too the delivery high-value care, which would relieve huge amounts of money, some of which could live used for “world care.”
- Work alongside foundations too collaborate alongside other countries.