Another big California health insurer has stunned individual policyholders with huge rate increases ”” this time it’s Blue Shield of California seeking cumulative hikes of as much as 59% for tens of thousands of customers March 1.
Blue Shield’s action comes less than a year after Anthem Blue Cross tried and failed to raise rates as much as 39% for about 700,000 California customers.
San Francisco-based Blue Shield said the increases were the result of fast-rising healthcare costs and other expenses resulting from new healthcare laws.
“other expenses resulting from new healthcare laws”
Gee, what a surprise!
The plan is working. Insurance companies’ costs are rising, regulatory agencies are preventing them from raising their rates to cover the cost. They will have no choice but to go out of business, then the government will be the only health insurer left. I don’t like his goal, but Obama knows how to get what he wants.
Will someone please explain how and why….be specific….healthcare costs can rise so quickly? Is it the cost of research? Or salaries? Malpractice?
And please…..let’s not put all of the blame on government.
1) Insurance Companies must cover older children.
2) Insurance Companies cannot deny coverage for pre-existing conditions.
3) No lifetime limits.
[blockquote]And please…..let’s not put all of the blame on government. [/blockquote]
But Obama said cost would go down.
One other reason. Since the government fixes the prices on Medicare/Medicaid, All increases in health cost are funneled to everyone else, which is primarily paid by the insurance companies.
#4. Cennydd13, Behind every door in this snowball is greed. All of the major players think they are entitled and do not care who they hurt. Individuals and small business are taking on the brundt of the costs.
Right. It’s all Obama’s fault even considering that the vast majority of the healthcare reform policies have not come into effect yet. But look what THEY (Blue Shield) actually say:
[blockquote] Blue Shield said the cost of health coverage was being driven up by large hospital expenses, doctors’ bills and prescription drug prices. Blue Shield’s Epstein said other factors also contributed to the three increases in five months.
On Oct. 1, he said, Blue Shield imposed increases averaging 18% and as high as 29%. Those hikes had been delayed for three months while state regulators examined Blue Shield’s filing, costing the company tens of millions of dollars.
Epstein said Blue Shield raised rates again Jan. 1 to pay for changes under the national healthcare overhaul and a new state law that bars insurers from charging women more than men. (Some policyholders will pay less under the state gender law, while others will pay more.) [/blockquote]
Thus, the only healthcare reform effect that they mention is one minor aspect that appears to be a wash. The specific costs that they mention are that hospitals, doctors, and drug companies are charging more. Oh sure….they’re only charging more in ANTICIPATION of some disaster that is all Obama’s fault. That would explain why before we got employer based health insurance this year, our private insurance went up over 20% every year for ten years until it reached 24k. That’s when my husband decided to get out of consulting (which he loved) and be employed by a company (which he hates) so he could get health insurance. But our dysfunctional American “system” isn’t distorting the economics of the workplace. No not at all. And what is happening is no doubt Obama’s fault as even 10 years ago the health care industry was anticipating that he’d show up and screw up their perfect system, so they started wildly overcharging in anticipation.
#8 – I wouldn’t dispute that individuals and small business are taking a major hit. But I would point out that they’re as much part of the “greed” (if you want to use that word) as anybody else. Let’s face it, a large part of the increasing cost is the increasing utilization of goods and services, because we the individuals also have a sense of entitlement. “Society” should pay for my lipitor because I won’t change my diet, and the “risk pool” should cover my risk of sexual dysfunction, etc.
I’m not going to defend the docs, hospitals, healthcare employee unions, pharma, insurers, medical device/supplies manufacturers, and the government bureaucracy; they all have their share of the blame. But ultimately, it comes down to supply, demand, and economics; and if somebody doesn’t like “the system” (as if it’s really a system) or feels it’s unjust, there’s a simple solution: when you need services, pay cash. Like anything else, you use it, you pay for it. I know, that doesn’t seem realistic these days, but the thought experiment ought to help sharpen the focus of our deliberations. It exposes all sorts of hidden assumptions and points toward the root causes.
[b]7. Cennydd13[/b],
To amplify what [b]JustOneVoice[/b] writes at comment [b][7][/b] consider my relatively recent experience. I am assuming that you, like myself, are covered by Tricare (actually since last October I am covered by Medicare with Tricare for Life as secondary insurer, but the analysis still holds). Medicare and Tricare use the identical reimbursement rates for all covered medical procedures, I am unsure if Medicaid has significantly different reimbursement rates. If you have had any sort of major medical event (even just including a brief hospitalization) take a look at your Tricare Explanation of Benefits (EOB). When my daughter was struck by a car while she was crossing the street in May 2007, she was taken to the premier hospital ER in Seattle (Harborview Medical Center[b]*[/b]) with two ring fractures of the pelvis, a cranial fracture at the lower rear of the skull and a subdural hematoma (a collection of blood on the surface of the brain), and multiple fractures of the small bones that comprise the left eye socket. She was in the ICU for about 2-3 days and in another ward for a total hospital stay of 5 or 6 days before being released home. Thankfully, she recovered very well, although given the pelvic hardware that remains, she will never give birth naturally. The total bill for just the hospital stay was $70,000. That sum does not include the ambulance charges, the ER visit, the orthopædic surgeon, anæsthesiologist, the other surgical costs, or meals and medications. Of that sum Tricare covered about $20,000. If you examine the footnote, below, you will also realize that, excluding doctor’s fees, there are no significant profits included in the cited costs, as it is a County-owned facility.
In the short term, the hospital “eats” the difference, but of course, if they actually did that, they would eventually go bankrupt. So the majority percentage of what any procedure actually costs (in this case about 5/7ths or 71%) must be passed on to other patients. They can’t do this retroactively, so next year they will raise all charges in an attempt to recoup the unreimbursed expenses. Next year this process will be repeated again, and so on until this is cycle either remedied by a free market solution or health care is rationed by some governmental or quasi-governmental body.
Hope that helps explain one of the bigger drivers of the inflation in health care costs.
[i]Pax et bonum[/i],
Keith Töpfer
_____________________
[b]*[/b]—From Harborview’s href=”http://uwmedicine.washington.edu/Patient-Care/Locations/HMC/About/Pages/default.aspx”>About Harborview web page: [blockquote]The medical center is owned by King County, governed by a board of trustees appointed by the county and managed by the University of Washington.[/blockquote] [i]Ergo[/i], seeking large profits is not the only, and perhaps not even the major, contributor to the severe escalation of health care costs.
The first part of the footnote in [b][11][/b], above should read:
*—From Harborview’s About Harborview web page:
Want to know why health care costs are rising? Part of it is that people are increasingly unhealthy. My dad, God love him, always complains about the cost of health care, but that doesn’t stop him from drinking his daily 2 liter of Coke. It is no surprise given his weight and his choices that he gets sick about 10 times a year more than I do, not to mention now that he is older he is risking an increase in chronic diseases because of his inactive and unhealthy lifestyle.
It isn’t popular, but neither side in the debate is willing to deal with the fact that people pretty much view “health care” as somebody else paying for their own bad treatment of their body. Sure, even healthy people will get diseases, but objectively we know that certain basic lifestyle changes can reduce the risk of chronic diseases.
I save the system a lot of money because I prefer to try things like rest, vitamins, herbs, etc, before going to the doctor. My wife eliminated her migraines and hundreds of $$$/month treatment by taking Magnesium (and even if it is a placebo effect, who cares…it saves everyone loads of money). Until America gets healthy and lowers the demand for expensive services from chronic and preventable diseases, our costs will continue to rise, and whether we pay for it in the form of exorbitant premiums or high taxes, the result will still be the same.
My wife’s firm announced they are cutting salaries because of increased health care premiums due to Obamacare.
Similarly, our firm was was told by our healthcare insurer that we should adopt an Obamacare qualified plan that both decreases coverage and increases costs to the employee (which would require us to reduce salaries). We refused and said we wanted to continue with our current non-qualified plan. The insurer made us provide an indemnity to them, in case the government goes after them or us for not complying with Obamacare.
I think the anger of the American people over this is going to increase exponentially. We have to get this monstrosity repealed or healthcare in America is going to be permanently damaged.
#14–Listen to what Robert Gibbs said yesterday about the House vote to repeal O’care aka The Christmas Evev massacre of 2009. He said that the Senate “probably” wouldn’t pass a repeal, not that they won’t. There are 23 Dems up for re-election in 2012. What if it does pass the Senate? Talk about a political quagmire for the Prez. Cennydd–I don’t know the full answer to your question, but I do know Obamacare is increasingly unpopular. It will affect votes both in Congress and at the polls. I do know the % of margin allowed by the Christmas Eve massacre, is having an effect on rates, as well as some required procedures. Insurance companies aren’t necessarily projecting 12 months out, either. Heck, If Nancy Pelosi doesn’t know whats in the bill, how are we lay peopel supposed to know? I think part of the problem in California is the insurance companies were already getting hammered by costs and the state wouldn’t let them raise rates opver the last few years. But, rather than argue about the effect O’care it is having on BlueCross/Shield in California, I wish we were actually trying to fix the problem. Federalizing anything other than the Defense Department is NOT the answer.
One other thing–I think insurance carriers are probably trying to force individuals out of their risk pool and into governmental sponsored pools, as these rate hikes appear to effect individual policies, not groups; i.e. the carriers will force all people who can’t get group coverage into state sponsored pools, thus increasing the overall taxpayer costs of O’care.
Thanks Keith. I’m a 100% service-connected disable veteran, as you know, and my primary care provider is Medicare (A & B), my secondary….and the one I choose to use regularly….is the V.A. I’m also covered by Tricare For Life, so I’d say I’m well-covered.
Unfortunately, most Americans aren’t, and it is an affront to my sensibilities that they’re not. I consider that the insurance industry, the medical profession, the accountants, the attorneys for the insurers, and the pharmaceutical firms are all equally to blame for the artificially high costs of our medical care in this country, which is the world’s best.
Yes, people should take better care of themselves so that they don’t need that horrendously expensive care, but we fail to ask the powers-that-be about what they expect people who can’t afford that expensive care to do…..do without and die? Go on welfare? Run their relatives into bankruptcy?
All I hear is that the Healthcare Reform Bill is going to bankrupt the country, and so I ask what in God’s name are the people of this country supposed to do? The system that we have now utterly stinks to high heaven, for God’s sake! People are dying, and have died because they couldn’t afford the treatment they desperately needed!
Maybe it’s time to reactivate the U.S. Public Health Service Hospitals everywhere in the country.
The problem is that there is such a gulf of bureaucratic scar tissue between the provider and the patient. Anytime you divorce payment of a service from the actual person receiving the service, you see costs rise in an astronomical rate compared the average rate of inflation.
The two biggest areas one can see this in are higher education and healthcare. Since the government shields the recipients of higher education from paying the bill as they go (either through Pell Grants, student loans, work study etc.) the costs of these institutions rise to the maximum amount they believe they can get away with charging and the government picks up the tab. The users who don’t see what the education actually costs demand more and demand more help paying for it.
Similarly, with both government and insurance picking up the tab for health insurance, these costs rise dramatically, too. People heavily use healthcare and expect more while demanding more help paying for it.
The good long term answer for both systems would be the reintroduction of a free market into the healthcare and education industries. If Dr. A wants to charge you $75 for 10 minutes of his time, then let Dr. B offer a $59.99 checkup and get patients. If College C wants $20,000 a year to educate someone, let College D offer to do it for $10,000 or even $5,000. What really needs to happen is for the middlemen to disappear and return these industries to situations where the provider and the user work directly together concerning payment.
I don’t see this happening, however. It would cause a good deal of short term uncertainty if it were to be tried, and truth be told people become dependent on that “free” service (of course it’s not really free, but people think it is anytime they don’t have to directly foot the bill) and would howl at it being taken away.
Cennydd13 (#17) – I’m not trying to argue here, but there’s where my thought experiment comes in: People don’t die *because* treatment is unaffordable; they die because they get sick or injured, or simply age. In the big picture, life is 100% fatal. 😉 But if we continue to think that we have a “right” to good health and prolonged life, we will continue to advance the boundaries of science and medicine… and continue to have to pay for it. It simply HAS to be paid for, by somebody. It may be through premiums, direct cash, or indirectly through taxes… but we’ll pay for it. Eventually, the argument will be not whether “Joe” has to choose between food or medicine, but whether “society” has to choose between food or medicine… or have the bureacracy start the rationing of both.
At least for emergency care noone should die for lack of treatment due to EMTALA. It requires any hospital emergency room to treat any patient presenting with a life-threatening emergency regardless of their ability to repay. There are also still a network of “Mercy” hospitals who exist to treat indigents.
Neither of these are cost-effective, but they do exist and should prevent at least emergency cases from dying in the street without care.
As noted above, “Since the government fixes the prices on Medicare/Medicaid, All increases in health cost are funneled to everyone else, which is primarily paid by the insurance companies. ”
Every physician I know, who accepts Medicare anticipates a drop in their salary of greater than 20% (many greater than 50%) despite laying off staff. Medicare (and Medicaid) do not pay costs. If you increase the ranks of Medicare, the price paid by BC/BS MUST go up, but rarely increases as much as the increase in costs.
Those costs include malpractice insurance, and governement regulation. Mostly government regulation. The new computer records (government required) also cost money.
If you want to lower costs then here are some suggestions:
1. No more “cadillac care”. Have everybody pay all costs up to 10,000/year/family (or 20% of net income whichever is less) with a 200,000 catastrophic coverage above that. Insurance is not meant to pay for your viagra or your screening colonoscopy. If you want it, you should pay for it.
2. Get rid of the lottery style malpractice award. Malpractice awards should be for direct costs only, no pain and suffering, and attorneys should have a set fee. Any punitive damages should be paid to the court not to the plaintiff.
3. Emergency care delivered (usually for free) in the ER should fall under sovereign immunity. Physicians are required to go in whether or not they get paid. They shouldn’t have to worry about a lawsuit when they decide whether to operate. (NB People who die following a car accident and who are NOT operated on don’t sue. People who are disabled but survive a car accident due to the skill of their neurosurgeon often sue the surgeon. Many surgeons take this fact into consideration when deciding whether a patient is “too sick” to operate on.
4. For a reduced fee, physicians should be permitted to engage in binding arbitration instead of being subject to lawsuits in nonemergency situations. It’s good enough for stock brokers and lawyers, it should be good enough for physicians.
5. Let anybody who can pass an online course in prescribing different sets of medications prescribe those medications. Folks in Cuba prescribe and monitor their own blood pressure, asthma and diabetes medications. With modest training, we can too. Most folks who are healthy don’t need a “primary care physician”. They should learn to keep their own medical records and titrate their thyroid medications. The rest of the world does it and Americans really are NOT stupider than the rest of the world. We are simply more spoiled and entitled and whiny.
3. Understand that we will all die. All of us. We will not live to be 120 even if we do exercise daily, maintain our weight and eat our vegitables. We might make it to 100 but our last 20 years will be increasingly frail. Old bones are brittle bones (even when exercising and taking calcium/vit d supplements). Somebody needs to pay for 20 years of care for the Old old (and that is assuming that everybody manages to work until they are 78 – which may well be necessary given the increase in lifespan and general health). Right now, the Old old (meaning the over 80 population) is taken care of by Medicare/medicaid with home health aids or nursing homes that are subsidized by increasing BC/BS rates on the young. This system is no longer sustainable. There will need to be some discussion of age based rationing or disability based rationing. The idea of medicine was initially meant to get people back to work, not to simply keep folks ticking until their last brain cell died. It may be necessary to make folks eligible for “comfort care only” once they have been either not working and retired or not working and on disability for let us say 5-10 years. (Exceptions should be made for service connected veterans until they reach 65 (or whatever the new age of retirement might be) at which time the clock could begin). That would encourage most people to work as long as possible and would discourage folks from coming up with bogus “disabilities” like ADHD or “bipolar” illness.
There are only so many nonworkers that any society can carry at one time. We appear to be approaching that limit. We are destroying our children in order to hang on to our entitlements. We may well destroy future generations, but we will not hang on to those entitlements no matter how hard we try. The money does not exist.
How’s that hope and change working out for you? Don’t say we didn’t warn you.
[i] Edited by elf. [/i]
At what point in history did providing health care change from a personal responsibility/choice to the responsibility of the government to provide it?
I would like everyone to have healthy food, a good place to live, and great health care, but I do not think it is the government’s responsibility to provide food and shelter either.
A lot is made of giving up freedom for security, usually in the context of privacy and national security. However the same applies here. If you want the security of guaranteed health care, you have to give up the freedom of making your own health care decisions. Most of us already do this to some degree with our insurance companies. It is a mistake to be forced to do it with the government.
I marvel at all those who adopt the survival of the fittest mentality when it comes to people who need health insurance but are unable to pay the rates demanded by the corporate thieves known as health insurances. Every one of the health insurers in the United States is in no danger of losing their profits. The Corporate Profit Maintenance and Enhancement bill which masquerades as “health reform” guarantees corporate medicine will continue the scandal of American health. The new Congress ought to hold hearings so Republicans can weep at the surplus billions of dollars health insurers are sitting on. Highmark BC and BS has more than $5 billion dollars in excess of its obligations, but has nonetheless jacked up the cost of its Medicare Advantage programs more than 40% this year, and over 100% in the past three years. Please. No pity party for the sector of the American economy which constitutes the largest leech for those who struggle to obtain access to medical care. The Social Darwinists (especially those who call themselves Christians) don’t give a damn about the poor, working or not, and as long as they continue to transfer incomes from the poor to the deserving rich, they will be happy. They can weep for the wretched corporations who brought us to this mess. Those of us who have suffered because the leeches got father, will hold them and their corporate overlords in contempt.
There are other alternative to helping those who need help with health care than a federal system and insurance.
Health care can paid for by private charities, friends, families, churches.
Health care can be provided by free clinics, health care donations.
If necessary health care can be provided or paid for by the government, but preferably at the local level. There is no need to go above the state level.
Christians can and should help the poor and needy DIRECTLY. Having the government do it for you is not the same.
People do not need health insurance. People need health care.
JustOneVoice wrote:
At what point in history did providing health care change from a personal responsibility/choice to the responsibility of the government to provide it?
When we passed Medicare/Medicaid?
“Jesus,” I whined,” “Am I my brother’s keeper?
And all of these babies? Do you expect me to care about them?
And these old people and their medicare take up too many resources.
And look at the immigrants stealing our jobs.
Let them all pull themselves up by their bootstraps.
I’ve got better things to spend my money on.
Let’s spend it on guns and bombs and building walls.
After all, faith has nothing to do with politics.”
#10 I hear you but I have been living this for 14 years. I am 51 with significacant health problems 10 years ago. I consider myself healthy for a 51 year old man. Cash is not an option. I’m going to botttom line my situation (it is way more complicated) . Only the rich can pay cash. My health care for my family is $3,600 per month for poor catostrophic coverage. Pleae let that sink in and then reply. Of course we are responsible for our own well being and our individual health. I get it. Thanks.
#25 Great comment. People do not need health insurance. People need health care. Now is every bit of your net worth on the line?
Sounds like Lee Parker would be a major winner under the health care plan outlined in post 21. So would most young people, future generations and the working poor and middle class.
In 1965 (when Medicare was instituted) life expectancy was 65. Currently it is 78.3. In 1945, when the bulge of boomers has passed the midpoint, life expectancy is anticipated to be 83.1.
The Boomers (my generation) have already enjoyed a prolonged adolescence with low college tuitions, and minimal debt during the first two decades of life. We have handed down high college tuitions and high debt to our children’s generation, rather than curb our sene of entitlement. We also stole from future generations the security of having two parent families, decent schools, a culture free of exploitation in the form of drugs, sex and other pathologies. Our children’s generation had to grow up much earlier because our generation’s narcicissm.
How much vacation should healthy aging Boomers be entitled to at the other end of the spectrum? The 5 years retirement that we paid for? Or do we “deserve” 20 years of playing golf and running around the country with “I’m spending my children’s inheritance” bumper stickers?
And why do our children deserve so much less?
On judgment day he was asked were you your brother’s keeper? He replied, no, but my government was.
Actually what he replied on judgement day was “No, I wasn’t my brother’s keeper, but my government was, and I made darn sure that my kids got stuck with the bill!”
[b]23. JustOneVoice[/b],
It started not later than WWII when the FDR administration instituted wage and price controls. If you were a shipbuilder, like Henry J. Kaiser, you couldn’t hire workers away from another shipyard because wage controls specified how much you could pay, so he (probably among others) realized that even though he couldn’t offer a higher rate of pay, he could offer to provide the worker and his dependents company-paid health “insurance.” In Kaiser’s case, this ultimately became Kaiser Permanente, one of the first HMOs, if not actually the first. Before too many years passed the government decided that, if an employer provided its employees with healt “insurance” the premiums paid by the employer would not be subject to the payroll tax nor would the worker be expected to pay income tax on value of the premiums paid, benefits not allowed to the self-employed. That pertains to this day, a clear violation of the [i]Rule of Law[/i], one of the conditions of which is that all are to be treated equally before the law.
Of course, all of the above also disregards the fact that in discussing Obamacar we are [b]not[/b] talking about healthcare, but rather [b]healthcare financing[/b]. There are also a number of other factors that have not been discussed on this thread which contribute to the mess in which we find ourselves with respect to healthcare financing in the U.S. These include the insane features of Medicare. But that is another story, and it is now late and time for me to think about turning in.
[i]Pax et bonum[/i],
Keith Töpfer
#25 -“Health care can paid for by private charities, friends, families, churches.”
I’d love to see the comments on this site if anyone suggested having their tithes pay for other people’s health care. Would you really want to prove to your Vestry that your cancer treatment is worthy of consideration? Your *actual* Vestry, not some idealized one. Even that one guy who was a total jerk to you at the last retreat after you beat him at cards – he gets a vote. He’d probably vote to let you have the colonoscopy, but no anesthesia.
The real crime of Obamacare (treason) is that it bends the health care cost curve in the wrong direction and that it increases the number of people on federal programs. This is an obvious recipe for disaster.
But this administration has consistently used manufactured crises to move the country to the left: stimulus, dodd-frank financial “reform”, START, etc.
People accuse Glen Beck about being paranoid telling people about [url=http://en.wikipedia.org/wiki/Cloward–Piven_strategy ]cloward-pivens[/url] strategy of getting so many people on the federal dole that the resulting crisis forces a socialist turn of the government. I think he is not paranoid enough.
The thing the liberals are missing in this debate is what we are trying to fix. Access to health care in America is not a problem. Cost is the problem. I can make an appointment for next week with the best doctors in America. Whether I can pay for it or not is a whole other issue. O’care tried to fix access which was never a problem. It doesn’t fix cost, but actually increases cost (see headline, above). That’s why we need to scrap it. I can’t speak for any of the others on the blog, but as a conservative, I don’t believe people should be without health care, so don’t even accuse me of not wanting to help my brothers/sisters. But we found out in 1994 that this idealized governmental health system is wildly unpopular, which was proved again in 2010. It is wildly unpopular because most people can easily figure out that it won’t work. It si being forced on the “flyover” by millionare elitists. What we need is a basic level of health care, to include prevention and education, and get the government out of it otherwise. I have long been a advocate of income based subsidies and totally getting rid of Medicare/Medicaid and the massive number of government employees and regulations which go along with it, and substantially drive up costs. When people are paying for their health care they will be more prudent with their money than they will with someone elses. I have also been an advocate of getting rid of common law medical malpractice and replacing it with a a no-fault income, medical and disability based system similiar to workers’ compensation. The problem I have with the current process is most people in the argument want to use “next to god america i” catch phrases but don’t want to admit the current system is a total failure and then come up with new solutions. I don’t claim to be right, but at least I’m thinking about “out of the box” solutions, understanding that the current box is rotted to the core.
Healthcare insurance premiums should be based solely on one’s ability to pay, and no other factor, and this should made to apply to every insurance company.
What should the premiums cover? Who decides? What other things should be based on “one’s ability to pay”? Food, shelter, heat/AC, transportation? Who decides how much food, what kinds of food, what kind of transportation? Is someone required to do something or change their lifestyle to keep this insurance? Who’s pays the difference? How much is one’s ability? What if someone would rather spend their money on education or food? What happens when there is not enough money to subsidize insurance to cover what people want?
It is a nice idea to have the government take care of everyone, but we have seen what happens when this happens. It seems mean to let people rely on themselves or the charity of others, but in the long run it has been shown to have the best results for the most people. When the state tries to do too much for too many, it collapses on itself. When thing are good, the people vote for the government raises benefits, but during a down turn, the benefits are not reduced, and usually increase. When an individual is in charge of their resources, they can better make decisions on what is affordable and what is not. There are hard decisions to be made about who gets what. In good times, it is hard, in bad times it is even harder. In either case I would prefer that the individuals make that decision, not the government.
“Healthcare insurance premiums should be based solely on one’s ability to pay, and no other factor, and this should made to apply to every insurance company. ”
Does ability to pay have anything to do with willingness to work? Should healthy folks be allowed to come up with bogus illnesses (ADD or bipolar simply to name the more obvious) simply to get out of working, so that they will have no “ability to pay”? What about folks who were laid off at a white collar job and don’t want to work at Wal-Marts? What about healthy, active older people who could work but would rather not since (after all) it is work?
How does one decide who really has no ability to pay, and who could work if they really wanted to and would work if nobody else paid?
There is one overriding fact that only a few here have commented on, and most of those comments are oblique, so some of you may have missed them. That omission is a simple fact, related to the difference between [i]free goods[/i] and [i]economic goods[/i]. A [i]free good[/i] is one which is available in essentially unlimited supply, one example of which would be oxygen in the atmosphere. You can breathe as much of it as you want, to the point of serious hyperventilation. Doing so entails no almost no direct costs (the only example of direct costs in doing so of which I can think would be if you hyperventilated to the point of passing out and lost time from work, had to be taken to the hospital or died). An [i]economic good[/i] is one which can only be acquired via either purchase, capital investment or a combination of the two. You can either buy steel fenceposts, or dig, smelt, and cast or forge the fenceposts yourself in your own garage using your own smelter, and casting furnace and dies.
Medical care is, by and large, an [i]economic good[/i]. Even in the case of charity, some portions of one’s health care require someone to purchase them—the doctor and nurse donating their time to treat the beneficiary amounts to them paying for their own services to the beneficiary by foregoing treating a paying patient or working unpaid after their shift. No amount of wishing or hoping otherwise will make medical care a [i]free good[/i]! All [i]economic goods[/i] are rationed, either by the government, the producer, the market or the consumer. So, when it comes to [i]health care [b]financing[/b][/i], which is in fact what we are really discussing, you have those choices available to you. We have seen what a poor job the government does by looking at Medicare (see my comment [b]#11[/b], above for an idea of how well that is working from a financial standpoint). The only means of rationing [i]economic goods[/i] that has had reasonable success in the history of the world, especially the modern world, has been done by certain free markets. I say certain, because most people don’t understand, either viscerally or intellectually, what is actually required to have a truly free market, which is one in which the [i]Rule of Law[/i] operates and in which there are strong real property rights enforcable by the courts. Everywhere that things have been centrally planned there tends to be dissatisfaction with the result, because the options available to the individual are limited by the simple fact that a bureaucracy, even a very large one, cannot account for the differing wants, needs, wishes and priorities of everyone in the population. It can’t be done even if we place certain reasonable limits (again based on the [i]Rule of Law[/i]) on which wants, needs and wishes are permitted. The priorities of the totality of the population is simply too large, and their changing circumstances make them too volatile to enable us to meet them unless the bureaucracy consists of the entire populace.
But what that latter describes essentially amounts to something very clost to a true [i]free market[/i] because when everyone is part of the bureaucracy, each person can determine their own priorities within the available hierarchy of possible services. [b]JustOneVoice[/b] at comment 38 has got it exactly right. The best solution (because there is no perfect solution) is for individuals to be the one’s to make the choices about what best meets their needs and abilities. Doing so, it would then become our responsibilities as Christians to help in meeting the needs of the poor and outcast, as our Lord bids us to do.
[i]Pax et bonum[/i],
Keith Töpfer
I think part of the problem is that no matter how much we criticize other people’s health choices, ultimately health is not something the individual can control, so putting the whole thing down to individual responsibility is unfair. Out of every 1000 pregnancies, a certain number will go sideways and incur huge costs. There are ways to guess which ones but most of the time it is a surprise. Is it better to have everyone throw a little into the pot so that the unlucky ones have care, or are we as a society going to say Sucks To Be You Hope You Can Write A Check For Three Weeks Of NICU Care? You should have known better! Unless we are really going to say that if you can’t pay for care you can’t have it at all, the only system of financing that really makes sense is one where the risk us shared across the whole population.
Otherwise we have the current system, where costs are just shifted around so those who can pay, pay more than they would if the risk was shared, and those who can’t pay get care late when it costs the most. I really blame our illusion of control here, mixed with some ugly social Darwinism.
Is not us, sorry. iThumbs.
And anyone who wants to give my bipolar niece a job is welcome to. Nothing involving sharp objects, please; she doesn’t handle criticism well. I get that disability fraud sucks but maybe we cam avoid disparaging the mentally ill by implying that they are faking.
#39–I agree with your basic sentiment, as I am a lawyer who deals with medical/insurance fraud every day. BUT bipolar is not a made up disorder. Living with a bipolar child can be a living hell.
My child (adopted at age 3) would have qualified as being mentally retarded at 5. She is average in intellect currently (after enormous amounts of work and therapy, none of which was paid for). She would also have qualified as having both bipolar illness and conduct disorder at age 13-17. And it was “living hell” . However the trouble with doing the psych thing with the medications and “counselling” is that it validates the disease. Some diseases are best treated as sins not diseases. The disease model does not work well for most of the supposed “diseases” (all invented in committee by a handful of academic shrinks) in the DSM III. At any rate she has no evidence of bipolar illness now, is 20 years old, a junior in college and works 20 hours a week at a clothing store. (She was not worth much during her first few jobs of which the most …umm… “therapeutic” was selling vacuum cleaners door to door, but she appears to be an asset to her employer now).
There are many conditions that are best treated as disorders of character, not disorders of either mind or body even though I have no doubt that some people are more suseptible to being angry, or frightened or for that matter overweight. We expect obese people to lose weight if they wish to get their knees fixed and that expectation is often motivating. Our local neurosurgeon refuses to operate on anybody who hasn’t stopped smoking for six weeks, and it is surprising how most people suddenly manage this despite their “nicotine dependance disorder”. Cowardice in battle may well simply reflect “panic disorder” but it would still be punished as cowardice. Back when this was better understood we had less “panic disorder”. We also had no bipolar illness and no ADD. When I grew up in Washington DC public schools there were NO kids with ADD, class size was 35 and you could hear a pin drop in class. Now more than 1/2 the class has some sort of psychiatric disorder that makes it impossible to attend.
There are made up disorders, and then there are disorders that are caused by Society’s preference to validate sin and weakness, rather than to do the difficult work of calling anger, cowardice, sexual promiscuity and abberance, gluttony and sloth sins rather than weaknesses. We all have weaknesses. They were less evident back when they were treated in the confessional rather than in psychiatrists office.
#41 While I agree that some degree of risk sharing is appropriate, pregnancy is a poor example. Injury acquired in the line of duty during war, or during police/fire work would be a better example for the need for risk sharing, particularly as no insurance company would write a policy for someone sent into battle.
There is a one hundred percent fool proof way of avoiding pregnancy. It is called abstinence. It is not to much to ask that people wait to have children until they can afford them. At that time a catastrophic care policy (as outlined in my note above) would be reasonable to purchase BEFORE mariage or engaging in sex.
But I agree with the appropriateness of risk sharing. That is why I favor invoking the insurance model as a catastrophic coverage policy ONLY, after the first 10,000 dollars or 20% of net income (whichever is less) is paid out. (For the military the us should pick up the 10,000 for injuries caused as a result of service).
#44–What great sin did your daughter commit that she needed to repent of at age 3? Or may son at the same age? I agree that we are are society of victims, but saying that a toddler can over come mental illness in the confessional booth is just about the darndest thing I ever heard. Praise God your daughter and my son have overcome the disease, but it was prayer, unwaivering love and support and Providential healing that allowed my son, and I presume your daughter, to survive and overcome.
Forgot to say–and a brilliant THERAPIST who identified the problem and two brilliant DOCTORS who were brutally honest with my son about the components and make up of his disease and what HE needed to do to overcome it. I belive God sent those three people to us.
The problem with your catastrophic coverage model is that it totally dis-incentivizes preventative care and routine screening and maintenance, which is the key to overall cost containment. Making insurance not kick in until 20% of one’s income is spent on health care (unless you’re making over $50k/year, which is probably a job with decent benefits) turns it into a game of dodge-the-doctor-for-as-long-as-possible for the people who can least afford to get sick. It’s hard enough to get people to do Unpleasant Cancer Screenings without also making them pay through the nose for the privilege. So instead of treating Stage 1 cancer, you’re treating Stage 2 or 3. And the patient is more disabled at that point.
I believe in the model of Kaiser’s HMO (non-profit), which stresses/incentivizes preventative care and lifestyle changes. Meet people where they are, and help them see a better way forward. If shame cured obesity and inactivity, we’d all look like models, zipping by on our bikes in a blur of spandex. It doesn’t. Telling people that they are valuable and can do better…I think I’ve heard that from someone before. Go forth and smoke no more, go forth and exercise (using these FREE ideas, or we can get you a discount on a gym membership) and track your progress on our website, go forth and learn about healthy cooking in our classes and buy produce on your way out at our on-site farmer’s market.
Kaiser’s doctors are salaried, all records are electronic, there are front-line Advice Nurses to triage urgent appointments over the phone (awesome for the freaked-out new parent who over-reacts to every sniffle! I’m sure the Advice Nurse saved us hundreds in co-pays by keeping us out of the office when all the wub needed was some tylenol and a humidifier). And they’ll dog you to the ends of the earth if you try to skip your Unpleasant Screening Test (male or female division). You need to get a referral to get past your primary care doctor to a specialist, but usually you can make the request via email and skip an office visit with your PCP.
They had some rough years when you really, really didn’t want Kaiser, but now it’s hard to find anyone with a major gripe about it. I think this kind of care should be available to everyone. If you want to buy more from a doctor in private practice, knock yourself out, but as a baseline, it’s a good model. Which is probably why the White House has praised it several times. It’s easy to see why the for-profit insurance companies and some doctors wouldn’t want this model to spread, though. My Kaiser plan costs half as much (employer + employee contributions) as the next option offered by my employer, a for-profit HMO with almost identical benefits that uses doctors in private practices who contract with the HMO. I was with that HMO before, and I’ll take Kaiser any day.
What great sin did your daughter commit that she needed to repent of at age 3?
A toddler can’t overcome mental illness. Mental illness is quite rare at age 3. What she had was auditory processing disorder (which debases verbal iq) and visual processing disorder (that debases performance iq) not to mention sleep apnea (which causes hyperactivity in children) in addition to a severe language disorder, and severe protein calorie malnutrition causing short stature, diffuse weakness, and incoordination.
All components were treatable but took not only about 3 hours/day of home speech/language/therapy for 2 years, (which pulled her IQ up from about 68 to 80 by age 6) plus a good deal of physical therapy (though that was mostly in palatable forms such as swimming until she developed muscle tone, gymnastics until she developed balance, karate until she developed coordination etc) She then required approximately 5 hours of tutoring nightly 6 nights/week for the next 7 years.
By the time she was 13 her IQ had normalized but by then she was angry (justly so) at what she perceived as the loss of her childhood etc. etc. etc. Ergo the bipolar illness the acting out, sneaking out, lying etc. etc.
I agree that it was prayer, unwaivering love and support and Providential healing that allowed my daughter, to survive and overcome. However, if I had listened to the various pediatric psychiatrists and educators who told me that my daughter was first, mentally retarded, then ADHD and bipolar with conduct disorder etc. and if I had gone on with their suggestions of medications, accomodations and “accepting her and loving her just as she was” she would now still have an IQ in the 70s, and be unable to control her temper, attend, learn or work.
There were plenty of times when, after working 3 jobs to pay for her therapies (none of which were covered by insurance) and then sitting up with her to go over reading, that I wondered whether I would survive her childhood. There were even more times when I wondered if I was making an “idol” of academic/mental normalcy by making her work so hard to overcome her disabilities.
And there was a time in my life, when she was about 14, that I thought she would never forgive me and that she would always hate me. However I did not do what I did because I wished to have her love. I did what I did in order to give her a future. And Thank God, she seems to have forgiven me. And she is normal. She even wondered, a few months ago, at the parent of a peer with “ADHD/Bipolar” whose parents went the accomodations/medications route. She said the reason her friend hates her parents is because “she knows they don’t love her. They let her throw her life away. They never even tried to save her.”
“The problem with your catastrophic coverage model is that it totally dis-incentivizes preventative care and routine screening and maintenance, which is the key to overall cost containment”
Unfortunately that isn’t the case. Actuarial analysis has made it clear that smoking reduces costs from Social Security, while only slightly increasing costs from Medicare. Previously more people died before they hit 65 of emphysema, lung cancer and MI. If they look after themselves, they die at 90 of Alzheimer’s disease, Parkinsons disease and end stage multiorgan failure.
If the goal is to lower costs, then not having preventitive care is more “cost effective”. If the goal is to keep everyone healthy then understand that this will prolong life expectancy which will increase costs over the 20 extra years lived. Therefore, the solution would appear to be to end retirement, and make sure that anybody who is healthy enough to work does work. (See post 21). Then it might well be cost effective to engage in preventive care. Unless that happens it will be more costly, not less.
But me, I think that if folks wish to live longer, they should indeed, not smoke, get their colonoscopies etc. However there is no reason why their children should pay for what is eminently a good thing for the individual.
Did anyone see today’s NYTimes op ed piece by David Brooks on Obamacare? You should read it. For me, it was an eye-opener. Larry
What about a woman who chooses to carry a child, her chances of carrying to term are very low, child likely will be born with severe handicaps, outcome chances are known prior to conception, mom and dad choose to conceive anyway. Child is indeed born with tremendous life altering handicaps, crushing expense, to exceed $250,000 in the neo-natal intensive care unit in first few months of life. Then, after hospital release, years of care and special therapies.
If the cost were to be born by the family, would they make this choice? As the bearer of these costs, what do I get to say about such a choice? Am I in the land of John Galt? Do we finally sigh a deep sad sigh at the birth of each new child knowing that we will pay for his upkeep? Is this Atlas Shrugged and the Fountainhead?
When you ask me to pay for your choices, I am burdened monitoring your use of my money. Pay for your own life, I am happy to let you enjoy it.
#52 – Are there really rational adults going through the kind of expensive genetic counseling/testing necessary to make that determination ahead of time and then saying, aw heck let’s do it anyway? Or is this a straw baby?
Oh, why was this man born blind…who sinned..?
Ps it’s not your money anyway it is God’s, and none of us are worthy of the blessings we have received in this life.
I’ve said this before, but as I see it the problem with the insurance model of health care coverage is that it isn’t appropriate for all types of expenses.
I think you can divide medical expenses broadly into three categories:
1) Routine — these would be your annual checkups, your OTC medications, and the like. Usually these aren’t that expensive, and most people should be able to afford them without much difficulty if they budget appropriately.
2) Catastrophic incidents — you have an accident, or need surgery, or something on that order. You have a one-time large expense — it may be quite large — but after that’s over, things go more or less back to normal. This is the kind of expense that the insurance model is meant to cover, and insurance companies will cheerfully write you policies for this kind of thing all day long — from their perspective, it’s all about managing risk, and they have vast experience in doing that and making money off of it.
3) Chronic — this is where you pick up some ongoing condition that requires significantly expensive care. It’s not hard to acquire a chronic condition that no normal household can afford to pay for for very long without help, but insurance companies hate this kind of thing — and rightly so, because once you come down with the condition, it’s no longer a risk, it’s a guaranteed expense, and the insurance model isn’t built to work with cases like this. This is why the insurance companies will try their damnedest to drop you if they can, once you have such a condition. They can’t make money off of you, except by raising your rates to the point where you might as well just pay for your condition yourself, except that if you could afford to do that you wouldn’t need the insurance in the first place, so basically you’re just out of luck.
As I see it, it’s that third category that’s the real problem; and any solution based on “insurance” won’t work because insurance is fundamentally inapplicable to this kind of expense. What would work, I don’t know.
I would like to expand on the routine cost. Paying an insurance company or the government, to then pay someone else the routine cost, is an unnecessary added expense and buracracy.
I have to disagree that health isn’t controllable. Yes, there are genetic factors, accidents, unforeseen circumstances, that are out of a person’s control, but we know objectively that obesity, inactivity, smoking, eating too many trans fats and too much sodium, etc, raises the risk of chronic and expensive diseases including diabetes, cancer, and heart disease. Sure, there is the occasional runner everybody knew who ate well and died of a heart attack, but we know that an obese junk food eater is more likely to get heart disease. I said it once on here, and I’ll say it again, the “health care debate” today typically ignores health entirely, and is more about how to get somebody else to pay for expensive drugs, procedures, etc, to treat chronic diseases that are at least partially preventable.
The CDC predicted that 1 in 3 kids born after 2000 will develop type-2 diabetes at some point in their lives, Adolescents are showing signs of heart disease, and depression cases among the young are skyrocketing. This crisis can only get worse unless we start to take more individual responsibility for our mental, spiritual, and physical health, but this solution pretty much cuts into the profits of a lot of the groups that lobby Washington, so it is better economics to keep us sick and dependent upon the government and big pharma for our every need (instead of just occasionally when we might need them).
Health care through the state (especially single payer which is the Obama 1st choice, the choice of champion Socialists) is that the we are not even addressing the issue of fraud. The above examples only outline the possible outcome of member’s poor choices. [The case described above is real.]
Now move on to fraud. Doctors who do not provide services but bill taxpayers. Hospitals who do not carefully bill or overbill. Cheats and frauds. The disconnect between taxpayer money and the citizen receiving services is the problem. If it is not your money, you will never care enough to fight for proper service. Govt provided services are never efficient. By placing govt in the administrator seat you remove any incentive for efficiency. Proven time and time again. I will not let them use my money for any such thing. I have lived in this world and I have seen govt run programs. Sorry, I know better. Only the need to meet a bottom line makes for good choices. Health care is better in the doctor’s and receiver’s hands. I cannot afford all that I would choose to do so I will make the best choices I can — just as in every other aspect of my life.
My dad died of cancer. After being diagnosed, he asked if treatment would provide any add’l longevity, doc said not much, maybe give him a few months. Dad said “Great, I’ll won’t be back. Thanks for your help.” He never returned, saying that treatment would only drive up insurance costs for others in his group.
“the “health care debate†today typically ignores health entirely, and is more about how to get somebody else to pay for expensive drugs, procedures, etc, to treat chronic diseases that are at least partially preventable”
Chronic diseases are partly preventable in the 20s through 50’s. They are less preventable in the 60’s and they are vastly less preventable in the 70’s. It is not possible to prevent them in the 80s. Your heart will produce only so many beats. After that you will need a pacemaker. Your bones grow thicker as you age (even though they will be softer). Everybody will get spinal stenosis if they live long enough. If you have spinal stenosis in your neck, you will either require neurosurgery on your neck or you will need somebody to assist you because of your paralysis and incontinence. Either way, it will be expensive. Neurons age and die. Most everybody will get senile dementia if they live long enough. Miss the heart attack at age 55 and you are more likely to hit the dementia at age 75. But the heart attack kills you quickly (and therefore is cheap). The dementia kills very very slowly and your nursing home costs will be far higher than the price of the stent that “saved” you 20 years earlier.
Thus, preventing chronic diseases in the under 65 population is a good strategy for Blue Cross or Kaiser Permanente which only deals with younger people and stops when Medicare kicks in. It is a terrible strategy for Medicare because the costs that would normally be borne for 3 years with a patient who dies at 68 go on for 33 years for the patient who dies at 98. It is an even worse strategy if the same folks (that would be us) who pay for Medicare pay for Social Security because again the costs of retirement are also borne for 33 years not three, in addition to the costs of elder medical care.
Unfortunately, while folks who die in their 50’s die quickly (of a heart attack or a car accident) those who die in their 80’s die slowly with increasing dementia, congestive failure, renal failure, pulmonary compromise with repeated hospitalizations and the like.
Preventive care only works if it can keep folks healthy until they are off the insurance rolls. That would be Kaiser, who signs off at 65. Preventive care would only work for Medicare if Medicare/SS recipients were to continue to work (and therefore not collect and instead continue to pay taxes) until just before they died.
This is why Obamacare places such great emphasis on “End of Life counseling”. The plan only works if folks who are likely to need a great deal of chronic care agree that they don’t want it.
I’m having a hard time reading all of the dismissive responses in regard to Ross’ #3. I have systemic Lupus and Crohn’s Disease; a friend of mine has Multiple Sclerosis. We were both stricken in the prime of our lives. I guess we were losers in the gene lottery and that can’t be helped but folks like us do whatever we can to maintain as much functionality/independence as possible and not have to resort to assisted living or nursing home placement. That requires treatment and therapy which may be longterm but is still less expensive than needing placement.
To read other Christians stating that since there’s no hope of curing us and so we won’t burden future generations, we should just be “kept comfortable” is disheartening and puzzling. If we can’t afford treatment and, subsequently, can no longer care for ourselves, what then? Institutionalization? Homelessness? Euthanasia? Many of us have no family who could take us in and support us financially. And do you really think that the churches are in a position to provide homes and round-the-clock care-giving?
Sorry, but such illnesses cannot be cured or even substantially improved “in the confessional” or by eating more veggies. Those with serious, chronic diseases may not meet your standards for having full and productive lives but we are still living human beings. If I were to refuse the medications that keep my kidneys, in particular, fuinctioning well and died from renal failure, that would morally be considered as a kind of suicide. So, what do you call it if treatments are only made available to those with the means to procure them? Thinning the herd?
Some trust the government to take care of them better than their neighbor. Maybe for some it would be better, but I don’t think it would be for most.
“If we can’t afford treatment and, subsequently, can no longer care for ourselves, what then? Institutionalization? Homelessness? Euthanasia? Many of us have no family who could take us in and support us financially.”
I don’t know what the solution is. I do know that everybody who does not die quickly will eventually die slowly. Me I have a living will and a durable power of atorney to ensure that I will die quickly. My hope is to remain alive as long as I am able to contribute to my family, and to make sure my kids are on their feet.
My mother (age 82, having survived breast cancer and a pacemaker still works 20 hours a week). When she no longer is able to live alone she will live with us. Her bedroom is kept ready for her, and if she needs an inhouse assistant we will find one in the area.
If my brother or other immediate relatives need help/housing they know they are welcome. We bought a larger house because we anticipated that we might need to house relatives/friends.
We also have in the past two years supported three other local families, paying their rental expenses for a period of several months (up to a couple of years for two of them) until they got on their feet. However those were friends.
As to how other individuals manage, I do not know. Before Social security, their relatives looked after them. However the Boomer generation abandoned the social contract between both husband and wife and between parent and child. They put their faith in government instead of in family and friends. Government is now running out of money, and the next generation that the Boomers never invested in don’t have any money, but only huge debts. I don’t know what the solution is. However adding further debt to those future generations, in order to ensure that we all get what we are “owed” is not a “Christian” response either.
“As I see it, it’s that third category [chronic disease] that’s the real problem; and any solution based on “insurance†won’t work because insurance is fundamentally inapplicable to this kind of expense. What would work, I don’t know.”
What would work is for regulations to be eased such that patients (and their relatives) can take more responsibility for themselves. There is no reason why someone with multiple sclerosis cannot learn the various medications used in the treatment of the disease (there are only 6 immune modulators), together with the dozen or so other treatments/therapies (antispasmodics, agents for neurogenic bladder et) available, and learn to manage their own medications. However right now the government prefers to simply license and regulate physicians to have a monopoly on medical practice, so as to generate tax revenue. In other countries, patients buy their Avonex at the local drug store (actually a cheaper knock off made in India) and give it to themselves. That is illegal in the US.
Most chronic diseases could be managed by motivated patients or by those who love them. They would not initially be managed as well as by physicians, however they would improve with time. Even physicians “practice medicine until we get it right”. Patients can too, however this does require not only the willingness to take responsibility for a disease and do ones homework, but also to understand that mistakes will be made and there is no point in running to a lawyer to find somebody to sue. That will require a seachange in US attitudes however if it ever comes, I think we may be pleasantly surprised at how much easier and cheaper life can be when we don’t expect somebody else to take care of all our problems.
Good op-ed piece on health care “reform” bill in the NYT – [url=http://www.nytimes.com/2011/01/07/opinion/07brooks.html?_r=1&partner=rssnyt&emc=rss]Buckle Up for Round 2[/url]. Kendall+ might want a separate thread. Best quotes:
[blockquote]False projections. The new system is based on a series of expert projections on how people will behave. In the first test case, these projections were absurdly off base. According to the Medicare actuary, 375,000 people should have already signed up for the new high-risk pools for the uninsured, but only 8,000 have.
More seriously, cost projections are way off. For example, New Hampshire’s plan has only about 80 members, but the state has already burned through nearly double the $650,000 that the federal government allotted to help run the program. If other projections are off by this much, [b]the results will be disastrous.[/b] [/blockquote]
Poor projections? You don’t say!
[blockquote] So, what do you call it if treatments are only made available to those with the means to procure them? Thinning the herd? [/blockquote]
Obama care does not guarantee access or affordabilty of treatments. It tries to increase the number of people insured. Some of those declaring bankrupcy today for medical issues have insurance. So Obama care does not solve the problem, my help it very title, will probably drive many good providers out of business, but the country further in debt, and put absolute control of insurance coverage and premiums in the hand of the government.
What do you call it when the government mandated insurance policies will not cover your treatment?
As to what is considered “suicide” in the Catholic church it is forbidden to refuse food and water. Medications, and procedures may certainly be refused. My best friend (one of our deacons, aged 78) had multiple medical problems including Parkinson’s, heart disease requiring a defibrillator, renal cancer and fought hard to survive, because he wanted to make sure his kids and grandkids were okay. He was in a great deal of pain and was on dialysis 3days a week for 3 years. He used to come to dinner at my place weekly the last year, and I got to know him well. Once he was satisfied that his kids and grandkids would make it he stopped all treatments. He had good insurance, and assets but he did not wish to run down his assets, but preferred to leave an inheritance to his children.
Nobody every acused him of suicide, and most of the priests in the area came to his funeral. He fought the good fight, and if anybody heard “well done” from the Lord it would have been him.
Oh by the way, as to my friend who died 2 weeks ago, he loved life. He would have continued to keep ticking if he had been allowed to have hemodialysis at home. Letting him do hemodialysis at home would have cost Medicare less money, and would have allowed him to not have to get up at 4am 3days a week to spend the entire day in a center many miles away. It would also have allowed him to take less fluid off 5 days a week instead of huge amounts of fluid 3days a week which would have greatly helped his pain and dizziness.
But medicare has its rules. Even though it would have been cheaper for medicare to let him have home dialysis, they wouldn’ t let him. He was smart enough to use it, and his family would have helped, and he looked into renting the unit and found he could have rented it for less than his transportation costs to dialysis 3x/week but government regulations insist that it be provided only via certified nurses in a center rather than by family at home. This required that he pay for a “care giver” to take him to dialysis and back and to watch him after it was done.
Again, if government would reduce their regulations, it is amazing how inventive people can be in looking after themselves and the people they love. And it would be cheaper, too.
The only answer is for Christians to step up and provide the Christian care we are supposed to, tithe, tithe a full 10 percent at a bare minimum, shrink government, shrink medicare, shrink social security SSI, SSDI and all the other socialist programs which are rife with fraud. Person to person, local community to local community, town funded social programs. The effect would be immediate and profound. Taxpayers would no longer tolerate the size of govt nor the level of municipal, state and federal taxation.
When the distance between payer and receiver is grown, as in Massachusetts, as when the welfare program was moved from the the towns and communities and taken over by the State of Mass in the 1970s, the costs grow exponentially. Mass is now over $2,000,000,000 in debt. Much of that is the social spending. When done locally, both costs and demands shrink. There is no eternal well from which to pay for care. There is only the reasoned and careful consideration of that funded by a local community to its citizens by its citizens.
Uh oh, there we go again with that word citizens. The federal govt won’t even secure our borders so a citizen is whom? They have guards at airports and leave our borders unchecked. Just nice families coming in right? Thanks to the Kennedys we no longer have reqd sponsors for immigrants. Excepting Jack, the Kennedys did more damage to the US than any family in our history.
What do I do if the government iinsurance won’t pay for certain treatments? I do as everyone else does when they don’t have the money or private insurance won’t pay. Find something else and make do.
I hope that those of you who believe that this should all become church ministry realize that even many of the religious orders in this country have signed on to Social Security and Medicare. Even with their own members trained as nurses and convent infirmaries on hand, they were unable to meet the expenses of caring for their elderly members on their own. There were frequent appeals to help the Orders take care of their elderly sisters and brothers but they fell short.
So, if the religious communities can’t manage caring for their own without government help, then how on Earth could such groups be expected to care for the masses?
Home dialysis is [url=http://news.yahoo.com/s/ap/20110108/ap_on_he_me/us_med_home_dialysis]now permitted[/url]
[blockquote]So, if the religious communities can’t manage caring for their own without government help, then how on Earth could such groups be expected to care for the masses? [/blockquote]
The government isn’t doing this for free, they are taking every penny of it from us. If the government did not take so much and provide so little, think of how much more there would be available for us to take care of others. I believe the community (through the church, other organizations, and individually) could help significantly more people, in a better manner, with a fraction of the money and adverse side effect than Social Security, Medicare/Medicaid, and Obamacare.
By having the government do it, you have the additional side effect of: “I paid my taxes, it’s not my problem.”
Who do you trust more, yourself, your family, and your community or the federal government?
[blockquote]The government isn’t doing this for free, they are taking every penny of it from us. If the government did not take so much and provide so little, think of how much more there would be available for us to take care of others. [/blockquote]
Indeed this is true. With income taxes at record highs and threatening to ever increase, with municipal tax, state tax, sales tax, excise tax, fees, cap & tax, the endless stream of taxes we struggle to gather our tithe.
We pay nearly 50% of our income to govt; and with this the US is $14,000,000,000,000 in debt, enslaving my great grandchildren. They will be slaves to the likes of Nancy Pelosie, Harry Reid, Barney Frank.
With every $1 dollar collected, govt spends between $1.30 and $1.51, depending on which study you believe.