If 1.7million is the average, and not the median, it is not exactly half. I imagine it is skewed heavily on the high end.

Why bother with the 10th amendment at all, if welfare were defined in such an expansive way? It would be like saying “The Federal Government can do anything. The Federal Government cannot do anything that the previous sentence does not explicitly allow.” Such an interpretation fails fourth grade logic.

Again, the price of not being ruled by Alabamans is allowing Alabamans to live as they see fit.

Cheers,
Carson

You are absolutely right. If I were in my twenties and single, I would probably have a crush on Chana, too!

(Sorry, just needed to lighten things up around here a little)

A. Information disparity is a significant barrier. For example, there are two surgical technologies, the gamma knife and the cyber knife. One is better for fine reductions and the other for gross reductions. A patient may feel that they have been saved (still alive) and not realize that they might have kept more physical function if they had received treatment with the other technology.

B. Medical quality can be ephemeral; advertising can mislead and spur unnecessary demand; and patients are often times incapable of judging quality at other than a gross level–or worse, make decisions based on non-meaningful factors like private rooms, good hospital food, and the charming personal manner of the provider.

C. Medical professionals are unable to voluntarily regulate their own conduct. Oftentimes, they would not refer a patient to a particular provider because they know that one surgery is likely to become three surgeries because a particular surgeon is incompetent. Rarely is an incompetent provider stripped of his/her license. Self-referral to provider-owned technology is responsible for the proliferation of MRI, CAT, PET and other high dollar diagnostic procedures. We are becoming an irradiated nation at the hands of the very people who have pledged to do no harm.

D. 100,000 people a year die unnecessarily from medical care. On the other hand, if a plane or train crashes or a wall falls on a bricklayer, there are full blown investigations to identify root causes; corrective action is mandated; and behavior changes. Where is the medical version of NTSB? OSHA?

2. Social goods cannot be distributed upon the basis of ability to pay.

A. A hemophiliac child needs RH factor and it may cost between $600K and $800K per year to keep the child alive. It is absurd to insure a certainty: it only adds to the cost (profit margin, risk charges, reserve accumulations). Such medical “certainties” should be budgeted for and serve as a learning opportunity to see what works best to improve the length and quality of life of the patient. Only the best and brightest of the medical community should serve such patients.

B. If we remove the expense related to end of life care, serious life-threatening illnesses, and conditions which require very specific medical expertise from the cost of health insurance, we will substantially reduce its cost. And, we make it possible for people to elect how much coverage they need and want to pay for. The cost of the removed care can be paid for via a payroll deduction. Essentially we could establish a national risk pool for serious, catastrophic illnesses and let insurers handle the less risky, less certain health care events.

http://www.plan.bipartisanhealthplan.com

It has some features in common with the Wyden-Bennett bill but is more radical, involving government supplemented Health Funding Accounts and private guaranteed-renewable health policies from birth to death. These replace all other government health plans, including Medicare, Medicaid and SCHIP.

The approach, by design, solves the perplexing problems inherent in pre-existing conditions, guaranteed issue, community rating, and market competition which have been on view in town hall meetings this August and which have frustrated politicians and citizens of both parties.

It also has elements in common with David Goldhill’s recent article in the Atlantic “How American Health Care Killed my Father”.

http://www.theatlantic.com/doc/200909/health-care

Goldhill and I have in common the facts that we are not health care professionals and were brought to the field by the real-life experiences of relatives.

yes, but it should not pitch the doctor against the patient
- what I relaize like about our system since now you have informed me how good I have it, is this feeling that the doctor and I are together in a more or less tacit agreement that in order to get me well we are entitled to in get out of the system all that’s possible. The system is allowed to fight back hindered by all the other actors in a democracy like lobby groups strikes willful negligence etc. To date we never had a demo of patients in favour of doctors’ incomes which they claim has been too much cut down. Maybe if more of us would read blogs like that it wouldn’t take long to come about.

There are two flaws with the fully privatized healthcare arguments, however, and they are the same problems our current system faces – Coverage and Costs.

First, as James raises, is the social equity issue. Coverage. It exists. Period. One function of social insurance is to insure people without regard to their genetic composition, etc. This is not free, and it causes all sorts of incentive problems.

Just giving 1.7 million away to everyone neither does not achieve the social object, as James says. It fails to meet the needs of the neediest, and gives a windfall to those who don’t end up needing it.

Second, just because we accept that there are incentive problems does NOT mean that all efforts to use incentives to ration healthcare should focus on healthcare _consumers_. A general principle of good incentive design is that incentives are aligned with desired outcomes, which requires that the incentives should impact those people with:

– Information
– Power to act
– Who benefit/suffer from non-monetary results of the action (which cannot be redistributed)

The third of these means patients. The former two argue for including providers. And any real solution to our problem needs to provide incentives to both – it’s going to be a hybrid system. Finally, if we want to contain costs, then these incentives MUST include some motivation to reduce consumption.

Now, the hour long focus programs are about celebrities, NPR has taken CNN’s job, CNN spends most of it’s day doing what Nightly news did (surface coverage accompanied by talking heads), and nightly news might have 2 stories that aren’t Interest stories or celeb gossip, and those two stories are the 30,000ft view, barely addressing anything other than “he said/she said”.

Amendment 10 is a catchall, and Article 1 section 8 seems to have addressed taxes and welfare across the nation.

And, additionally, the fact that most of that indirect “tax”, as you call it, is also being taken and given to shareholders, whenever profit is made, for most american insurance companies.

Also, a major breakdown is that the “uninsured who ultimately do not pay” are NOT being taken care of. yes, if you go into an emergency room dying, they will treat you and have to write it off (thanks to the 1986 law), but that’s where the free-ride ends. Any pills, referrals to other offices/specialists, or sickness that is not immediately life threating, does not have to be treated. The poorest in this country are only saved from dying that moment, but are doomed to chronic illnesses and bankruptcy when more long-term diseases set in. So we pay the most expensive (in theory, since most of the bill is written off for tax reasons) treatments for the sick, but never actually are forced to treat them for, say, Cancer, which can cost 1.4x what the average american earns every month.