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Recent Articles
Who Will Have the Right to Say No?
Health care pundit Ezra Klein over at The American Prospect blog has an interesting post that generated a very intelligent discussion among readers (I'm envious) that, for this reader at least, poses a crucial question: Who under any insurance system should get the ultimate right to say no to paying for any particular treatment? Should it be the patient? The doctor? The insurance company? The government?
Until we have a public discussion and resolution of that question, achieving both universal health care coverage AND a health care system that the nation can afford will be impossible. Some will call it rationing. Others will call it evidence-based medicine. Others will suggest anything less than Lexus-care-for-all will create a two-tier health care system because the rich will always be able to buy the latest therapeutic "advance," even if it is still unproven.
Whatever you call it, the bottom line is that someone has to make the decision. And who you think that someone should be probably says a lot about where you stand on the issue of health care reform.
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Comments
These discussion seem to start out wrong side up. It would make more sense to start from the point of triage: what services are vital and essential? What must everyone get, when, where and provided by whom?
The notion that rationing isn't already occurring in the most brutal sense is absurd. There are hundreds of thousands of preventable deaths due to the inaccessibility and unaffordability of healthcare. The Mass plan has moved essential health CARE dollars to useless health insurance policies, providing profits to the commercial insurers at the direct expense of the newly insured who now can afford even less care and services since their money was diverted to insurance.
Madness. Cruel. Inhumane.
the American way.
Agreed, but someone has to determine what health care services are "vital and essential." And I would even add "useful and necessary." But who should that be? I agree that insurance companies have proven themselves unequal to the task. And Medicare, under constant pressure from special interest provider groups like drug and device companies, specialist physician lobbies and provider-sponsored patient advocacy organizations, haven't done a very good job, either.
Very good question! There is so much waste in testing healthy people and then prescribing questionable drugs/procedures for dubious "health issues." If a person declines their doctor's orders, that person invites being dismissed from the practice because the doctor might be sued for not following accepted guidelines and protocols!
We do indeed have a totally backwards system....
This is where second opinions come into play, if only to confirm you're getting the best care. Whenever you're unhappy with your medical care, continue to seek information and meet with other physicians. A doctor who fears so-called accepted guidelines and protocols because of being sued and discourages you from seeking an outside voice is not someone you want to continue your relationship with. You must be proactive and educate yourself.
Great stuff.
I've pointed to yours, on this:
http://shearlingsplowed.blogspot.com/2008/12/gooznews-points-to-american...
There will be no easy answers, here. The trick will be to ask the best -- most illuminating -- questions. And you are doing that, day by day, Merrill.
Thanks!
Like everything else in life, you get what you pay for. The rich do go to private schools, they do drive Maybachs & Bentleys, they do wear Armanis and Guccis.. so why is the expectation that when it comes to healthcare, everyone should be getting a socialism style one size fits all care?