I have no problem with letting these guys have a separate system just for them. In practice this is exactly what happens; they go on “medical tourism” whenever they need non-immediate health care.

If our friend Eric wants to shoot himself with a gun as a pain or cancer remedy, I certainly wouldn’t try to stop him. Just don’t make me pay for the cleanup or burial costs!

Maybe you’d like to live in a country without taxes? Without government?

Well good for you… and I am sure that among Madoff’s clients there were many that shared the same goal.

Me? My goal is always to be healthy and not have to spend one dime on my health but, since my goal is sort of ambitious just in case I spend some money on health insurance. In doing so I am perfectly aware that I run a counterparty risk since, the day I might need my insurance company to step up to the plate, it might not be there, having lost it all pursuing some super-safe AAA investments. If that would happen, let us hope it does not, I would have to use whatever resources of my own I have available or rely on the government.

Should we all carry a tattoo that puts us all in two camps, those who do not mind some government help in health issues and are willing to spend some taxes on it, and those who truly want to fight out come rain come shine? I say it because I have often seen how many of the “I do it on my own” machos are the first furious about the State not being there when needed.

This sort of presumes we have some collective goals — “our” goals. I agree with some of your goals, but not with others.

One of my goals is to keep my money and spend it on the health care I choose. Right or wrong, the resources belong to me, and I should not be forced to buy an insurance policy that does not fit MY goals. The statist solution will limit my access to holistic care, which is what I prefer. I think people should be free to spend their own money on ineffective care or effective care, or care that makes them happy, but is ineffective. I do not believe that two parties should get together and decide how to spend a third party’s money.

To the statist, this is incomprehensible. I don’t even know why I bother to bring it up. It appears that most have swallowed the collectivist, statist argument, and anyone raising a finger in protest will have it bitten off.

This is all based on the notion that “health care is a right.” I agree, it is a right. Like free speech. Does that mean the government is obliged to give everyone a megaphone and a printing press?

So asks the voice in the wilderness.

Sorry James, I agree with 93.7% of what you say, but not this time.

Private Heath Insurance has failed. Private hospitals have failed. the AMA that creates scarcity by keeping the number of medical schools very low, and the graduation standards high, has failed-the US has some of the lowest MD levels per capita in the industrialized world. The US single handedly subsidizing the worldwide profits of the Pharma companies, and not negotiating prices has failed.The whole system has failed. It doesn’t work. 60% of all personal bankruptcies can be tied directly to healthcare expenses-the vast majority of these folks are insured.

The United States is the ONLY industrialized, or even “civilized” country that does not have a single payer system that covers everyone. Why does the US continue to engage in yoga-esque gyrations and other un-natural acts in a continuing insane attempt to try to make a horribly inefficient, expensive, and terrible system, that doesn’t even provide quality care, work?

Translated, why are we so fixated on making sure Big Pharma, Big Health Insurance, Big AMA, and the Big Hospital and Health Care industrial complex stays profitable? They all have failed. Miserably. Costs have exploded. Care is not better, and maybe in all probability, worse. They all had their chance. They all have proven unworthy of leading the way forward.

The smartest thing to do is accept this, and move on. Single payer. Does the US really think that it knows something the rest of the industrialized world doesn’t? France’s system is half as expensive as the US’s, and provides the #1 ranked healthcare in the world. Denmark. The Netherlands. Britain. Canada. Australia. Panama. All single payer. All much less expensive than the US system.

I know a fair bit about this topic as my wife is Canadian, and my kids are duel citizens. And, I roomed with a Dutch resident when I lived in Holland. Having used the Dutch, Canadian, and Panamanian healthcare system personally, I’d take any of these any day over the US system.

“In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.
Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

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What is the Liverpool Care Pathway?
But this approach can also mask the signs that their condition is improving, the experts warn.
As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.
“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.
“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”
The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.
The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.
Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.
It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.
It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.
Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.
They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.
However, doctors warn that these signs can point to other medical problems.
Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.
When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.
If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.
Dr Hargreaves said that this depended, however, on constant assessment of a patient’s condition.
He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.
He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.
“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.
“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”
He added: “What they are trying to do is stop people being overtreated as they are dying.
“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”
He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.
Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.
In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.
“If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.
Katherine Murphy, director of the Patients Association, said: “Even the tiniest things that happen towards the end of a patient’s life can have a huge and lasting affect on patients and their families feelings about their care.”

There is one issue in this health care debate that has gotten almost no press. When the issue of the HIGH COST of health insurance and the high cost of health care and drugs are discussed there is never any mention of the employer tax deduction for employee health insurance. My understanding of the effects of this tax deduction is that this is the primary cause of the high cost of insurance and care. The fundamental reason is that the individual citizen (i.e. the employee) is separated from his health care dollars. Each employee is not allowed to “vote” with his dollars for the most cost-effective health insurance, and indirectly health care, that meets his/her needs. Because of this there is no market place for health insurance. Instead the health insurance companies have complete control of the health insurance market through employer paid health insurance, which is subsidized by taxpayers through this tax deduction. Health insurance companies, and American Big Business in general, do not want an active, critical, citizen/employee-based, market place. When someone else (i.e. taxpayers) is paying part of the bill there is no reason for the purchaser (i.e. the employer) to strike the very best bargain.

Without this tax deduction there would be no reason for employers to provide health insurance. Without this tax deduction we would have a true health insurance market place at the citizen level. As long as this tax deduction is in place there will be no significant improvement in the cost of insurance and care. I do wonder why economists do not focus on this tax deduction in their many analyses of the economics and cost of health care. My speculation is that conservative economists don’t mention it because they believe eliminating this tax deduction would be bad for health insurance companies, and American Big Business in general, while liberal or progressive economists don’t mention it because they believe that eliminating this tax deduction would work against the individual employee/citizen because they believe the employer would not increase wages by their current cost of health insurance. So what I suggest we have here is a case of a very unhealthy co-dependency on a tax deduction that has driven health insurance and care costs to their highest possible levels. A co-dependency not unlike a drug-centered co-dependency. And of course there is the co-dependency between members of Congress and the health insurance industry.

I’m well aware this is not a trivial issue. The employer tax deduction for employee health insurance is the single largest tax deduction, significantly larger than the tax deduction for home mortgages. A solution would be for Congress to eliminate this tax deduction by reducing the deduction by an equal amount over five years. This would allow employers, health insurance companies, and employees/citizens to develop a new cost-benefit equilibrium over the next five years. Of course members of Congress currently receive considerable sums from the health insurance industry. Eliminating this tax deduction would serve to reduce those campaign contributions and lobbying efforts considerably since the health insurance industry would no longer have to “protect’ this tax deduction. In summary, we currently have high cost health insurance and care and drugs because Congress has given away, and continues to give away, tax-payer dollars via a tax deduction. This would constitute REAL CHANGE in our political and corporate cultures.

I am in support of a single-payer non-profit health insurance company. If that is not politically possible, then I am in support of a public non-profit health insurance company to compete with for-profit health insurance companies. Under NO circumstances should there be a law REQUIRING every citizen to purchase health insurance, which I think would be UNCONSTITUTIONAL.

Yes, that is exactly what I was taking issue with. Thank you for your post. And I agree entirely with what you have said in this reply.