Actually... no.

1/3 of health care costs today are the result of administration (paperwork). There can be a lot of cost savings here.

Other countries have longer life expectancies with a lower cost of health care. This means we're doing it wrong.

Only if you are willfully ignorant of the difference between other countries and the U.S.

Is it possible that costs in the U.S. are out of control due to the tax exemption on employer health care? Is it not also possible that people choose to consume more health care with their own money?

Simply stating that other countries have a longer life expectancy does not an argument make. We have a huge variety of lifestyles and cultures as compared to other countries. Mormons in the U.S., for instance, live 10 years longer than anyone else.

And your comment about administration may be technically true but don't assume that it would be any more efficient if the services were delivered by the government. Right now Medicare has $100 billion/year in fraud and overuse. And they haven't even gotten close to funding it enough. Nobody wants to change anything so it keeps growing.

@Mark - Don't take me the wrong way, I'm not backing the current proposal. However, the bulk majority of the arguments against it are very very poor and the anger brewing around misinformation is only hurting us all.

I doubt that there's a significant cost increase per capita as a result of people buying more health care with their own money than they need. While I'm sure there are cases of this, I would have to see some crazy hard facts. If anything, I suspect those that are paying for health care out of their own pockets are getting less care than they actually need.

And life expectancy is an excellent measure of the quality of health care. Too many arguments are based on, "I know this guy from Canada who says it sucks there" stories. You can find a story to fit any point of view you want. Stats are a *better* look into the quality of our system.

Still, I hear what you're saying. Lots of factors impact life expectancy. However, the World Health Organization still ranks us behind 37 other countries:

http://www.photius.com/rankings/healthranks.html

Mark, it's time to fight fire with fire- you are full of it! The way to cut costs is to have a public option, and make the private companies compete. As far rationing-that's just plain stupid. If this fails, and if you or anyone else in your family is denied a lifesaving procedure, you don't have the right to complain.

Why can't insurance companies compete fairly, i.e. without a tax subsidy?

I'm just going to ignore that last sentence.

Mark - I hear you and you might have a case here. I am, unfortuantely, not knowledgeable enough to debate that point.

Can you explain how the tax subsidies current work and how they lead to increased cost for the public?

Can you also explain how this change would serve the uninsured public? (a very big part of the public)

I don't understand how you think that healthcare isn't a right. How do you (Mark O) figure that people don't have a right to or deserve healthcare? How is that a "lie?"

Lauren - I tend to agree that healthcare isn't a "right"... unless, of course, we decide collective to make it a "right" to our citizens.

Making health care a "right" is part of the decision we're beginning to face, as it comes with significant change and significant cost.

If you have a right to health care, then you have a right to force a doctor to treat you. If the doctor refuses, then you have the right to detain him, try him, and send him to jail. That's how rights work. I would prefer health care to be thought of more as a voluntary relationship.

Health care is a scarce resource. The current plan is to simply mandate that everyone get into an incredibly expensive bureaucratic system with much less choice. This will only make health care more scarce, and will lead to rationing and worse health outcomes, as there will never be enough tax money to cover this plan. $1 trillion is an outright lie, just like when they said Medicare Part D (which I'm not totally opposed to) would cost $350 billion. Now it's looking like $900 billion.

Scott, I encourage you to read this article:

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

The problem with health care in America is that we have turned what used to be a tiny part of the market, health insurance, into a vehicle for providing nearly all health care services. This is a total waste, subsidized by the tax benefit of paying for insurance with your pre-tax dollars. The more you spend on a better plan, the greater the subsidy, so we are looking at $250 billion/year in subsidies to the upper and middle classes. I would prefer the market sort things out, so take away that tax subsidy and you'll see this "crisis" quickly go away.

Of rational, actors, medicare fraud, and other things.

http://www.youtube.com/watch?v=zs7ds9x2z9I

I don't want health insurance reform to subsidize Wall Street profits.

I would agree that health insurance companies peddle too much insurance. Dental and vision are rip offs. Most people would be better off putting money aside for these services. Then there's coverage for alternative medicine -- acupuncture, chiropractors, naturopathy.

People need evidence based medicine. They need to be insured against financial hardship.

Nevertheless, you can't make an argument for free markets and argue that insurance companies be limited as to products they can sucker people into purchasing. 

Some people are opting for catastrophic insurance. For instance, Health Saving Accounts which are really a form of under-insurance. Most of these plans don't even cover prescription meds. But they do cost as much as full coverage plans did 8 years ago. And the cost of these catastrophic plans is rising at double digit rates along with the rest of Wall Street care.

Healthcare is not a "right" as defined by the Constitution.  This is a fundamental perversion of the concept of Constitutional rights as defined by the Founders. 

Those on the left don't wish to acknowledge this, but the Constitution (and many other historical documents of governance) is founded principally on the premise that our rights are NOT created, given or taken away by popular opinion, consensus or government action; they come from God and the government is obligated by God to acknowledge their existence and to not take or restrict them without the due process of law.

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness."

President Obama describes the Bill of Rights as "negative rights" because it acts to restrain the government from restricting those God-given rights.  He seeks to declare "positive rights" which defines what government is obligated to provide.

But it is fundamental that the rights given to every person by their Creator are innately possessed by them.  This independence of thought and action is what is not to be abridged without due process of law. 

So a "right" is not something that anyone can give you, just something they can take away (e.g. criminals lose liberty when properly tried and convicted.) 

The obligations imposed on government are very limited and not defined as an individual "right." 

So the right we have is to pursue good health.  We do not have a right to healthcare. If the government forbade us from receiving care we had the ability, through whatever means, to receive then THAT would arguably be unConstitutional.

But that usually defeats the purpose of government control of healthcare costs.

The article I posted from the Canadian gentleman about healthcare indicates that even the highest Court in Canada acknowledged that it could not outlaw treatment outside the state system under their Constitution.    That had apparently been the status of the law until recently.

Martin, why do you think insurance companies would only offer sub-optimal products? If there's demand for something there will be supply, provided a free market allows it. And true competition, not public competition, will make sure that the insurance companies are honest and uphold their contracts.

HSA plans cost too much for reasons I have already mentioned. Level the playing field and you'll see the greatest level of coverage for everyone, and the highest quality. You will absolutely not get that with government control.

As for the list of abuses highlighted by Bernie Sanders, most of them were examples of what I was talking about with Medicare and Medicaid. If you are a for-profit company, and you "discover" a way to get free money from the government, the temptation will be too great to pass it up. This is purely rational. But when individuals are in charge of their own health care spending, those practices will disappear.

James said,

"So a "right" is not something that anyone can give you, just something they can take away (e.g. criminals lose liberty when properly tried and convicted.)"

It is my Christian duty to inform you that you are using God's name in vain. That is to say, you are using his name to further YOUR OWN position.

For all we know, Jesus didn't even speak out against slavery, let alone guarantee life, liberty, and the pursuit of happiness.

Natural rights is simple nonsense: natural and imprescriptible rights, rhetorical nonsense - nonsense upon stilts.

On the contrary, it is not "my" position, it is the position of the Founding Fathers and is the greatest protection we have.  Intellectual honesty has to be objective or it is not honesty. 

Why do you assume that I am a Christian?  What POSSIBLE relevance do your comments have to what the Founding  Fathers' approach to rights was?  Did I quote Jesus or the Bible?

I am talking about THEIR frame of reference and writings. 

Facts are stubborn things, but they should be embraced and understood rather than attacked.  I think that is your "Christian duty", whatever that is. Or better yet, your civic duty.  You sound like one of those town hall screamers.

The problem is that the shouters aren't interested in any answers- they're paid to disrupt, and spread vicious lies. The reason the insurance lobby is trying so hard to disrail this is because they're afraid that the plan actually will force them to compete, rather than have a monopoly, as they've had for decades.

Who's being paid to disrupt and spread lies?

http://washingtondc.craigslist.org/doc/npo/1299047025.html

Not all of the "shouters" are paid... in fact, I suspect not many are. Folks are angry at government. A well organized effort can guide this anger at any topic. You know how an upset person can "snap" because of something that would normally be a simple misunderstanding? This is that, on a grand scale...

A *lot* of what's going on is extremely complex. Money may be the driving force, but it's not as direct and simple as some would like to believe.

I believe that gilbert barrett was refering to lobbyists as "shouters" that get paid.

It is one thing for people to have irrational fears. Don't we all? We also have reason, some more than others, to face our fears.

But on this occasion, on this particular issue, fear is being deliberately bred, nurtured, cultivated, exploited.

James, you are the first person I've seen to bring any level headed dialog to the outrageous allogations made about the health care reform bill.

Concerning #2: You're suggesting that having a government provided plan is somehow a worse option than having people go un-insured altogether. What's better, to be "stuck" with government run benefits or to be "stuck" with nothing? It's a fairly weak argument.

With regard to #3: You don't make a case here. You support a reform measure to force the inclusion of pre-existing options, but still stand against a public option... in defense of the comment about "soviet style..." but you really don't make a case of any kind.

#3 and #1 are related, however

You've not presented any argument showing that a 100 year old grandmother would lose any of the benefits she currently has, which is the key point you're missing. I know my parents are stuck without any coverage at all. Once their monthly premiums on their privately provided policy went over $1500 a month, they could no longer afford it. Then my father had a heart attack. I sure wish my parents had *some* level of coverage.

By the way, Canada has a 3.8% higher life expectancy than we have here in the USA.

#4. and #5 - Speculation and not substance.

Thanks for trying!

Let's analyze what Obama actually said:

"But what we can do is make sure that at least some of the waste that exists in the system that's not making anybody's mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn't going to help. Maybe you're better off not having the surgery, but taking the painkiller.

And those kinds of decisions between doctors and patients, and making sure that our incentives are not preventing those good decision, and that -- that doctors and hospitals all are aligned for patient care, that's something we can achieve."

Now, what the President said is the the "good decision" is often to just forego surgery. In a great many cases today that decision is between the patient and doctor, and to some extent (sometimes too much) the insurance company. But it's a decision where the patient chooses between the resources needed for a surgery and the benefits of getting that surgery. In a government-paid system, there is no reason not to get the surgery so costs increase. This will only lead to higher costs with no good way to control them. How, you might ask? The President said, "making sure that our incentives are not preventing those good decision", which I believe means that he wants to incentivize doctors to go for the pain pill. If that's not what he meant please correct me.

So what happens when the "incentives" become onerous? When a doctor who orders too many expensive surgeries is labeled "wasteful" by the government health plan and is reprimanded and possibly punished financially? Then what happens? Eventually you need to ration, and someone will have to decide. If not a bureaucrat, then who?

What he said was that this decision should be betwwen the patient and their doctor, but if the doctor was able to look at the patients complete chart, maybe the patient wouldn't be having surgery over and over for the same condition, they could discuss other options. Your selective hearing needs to be checked- hope it isn't determined a pre-existing condition!

Scott,

I have said many times in other posts that I (all of us) want reform.  It is the type of reform we disagree about.

It has been stated repeatedly by those who wish to stifle the dialogue that the choice is reform vs. keep the status quo.  That is not true.  The debate is between the plan that includes a government option and a plan that does not include a government option and whatever provisions with which folks take issue.

So under any reform plan your parents would be covered, but not everyone likes the house bill.  So my "weak" argument was in fact not an argument at all.  I was merely pointing out the inaccuracies in the story. 

You seem to acknowledge the fact that I am FOR reform in your criticism of my response to point #3, so your response is completely off-base.

I cannot reply to your response to #3 because I cannot make sense of it.  Again, what "case" are you referring to?  Do you have a question you would like me to respond to or make a case for a particular point of view?  I am merely pointing out that the bill can accomplish it's ends, if you believe it will, without necessarily including a "government option".  We already have competition and can increase it through other means.

Again with #3, we can have reform that would have covered your Dad without a government option.  And I am VERY sorry to hear that.  My Dad had a quadruple bypass and then had to have a couple of follow up procedures, and then had to have a back fusion.  They then gave him a dangerous medication that almost killed him.

I hope your parents are doing OK.

Concerning the life expectancy isssue, there are several reasons for that not necessarily related to the quality of the care provided.  When you look at catastrophic situations, however, like prostate cancer the survival rate is materially HIGHER in the USA. See the non-partisan www.factcheck.org.

Concerning #4 and 5, if you think that the Democratic-lead Congressional Budget Office is merely speculating and not offering substance, I don't know what to say.  That is balderdash.

It is in fact rank speculation that the government option is an indispensible component to Healthcare Reform when there is no example anywhere, especially in the single-payer systems, where it has been superior in any way other than covering more people which we can and SHOULD do without it and without reducing the quality.

Again, before I get more hostile posts, I AM FOR REFORM and if we can reduce or eliminate the profit motive then GREAT.  But even under the House Bill the insurance companies exist and must make a profit.  The CBO estimates the cost difference to be no more than 10%.

The Senate is working on a bi-partisan plan that is based upon non-profit entities providing insurance.  We need to wait and see all the Bills. 

I would still oppose all of these restrictions on insurance companies, it will do nothing but raise price. You want to subsidize insurance, fine. It's called Medicaid, and it can be turned into a subsidy on private insurance.

If you believe the issue of pre-existing conditions is a market failure, then the government can help with a risk pool of some sort.

But all of these regulations will only serve to reduce competition and further entrench special interests in the protection of the government.

Mark - There are many clear cases where doctors are over-prescribing treatments to paitents. This is a huge issue. The average citizen is not particularly well educated in medicine and will generally take the advice of their doctors. It is a rare few that truly want to learn, understand, and make an educated decision for themselves. This leads to a lot of control landing in the doctors hands. It's fairly reasonable, "if this highly educated doctor tells me I really need to take this test, he must be right."

There are many places in the US where doctors across the board over-prescribe. This is well studied and well documented. The results become clear when a large area spends significantly more on tests and treatments, yet the local population is nor more healthy (often, less, actually) than in other locations.

James - You siad, "So under any reform plan your parents would be covered." That doesn't even begin to make sense. "Any" reform plan is going to ensure that my parents have coverage? How do you figure?

I'm not particularly for a government run program either. However, we rank 38th in quality of care according to the WHO... while the 37 countries ahead of us have government based systems. This is a strong indicator that a government program could be a good way to go.

However, the key point of this blog post relates to the grossly inaccurate claims made about the current proposal. To that extent, I'm am shocked and amazed by the level of FUD being generated around this proposal. It's completely distracted from any real discussion or debate around the topic.

Again, I hear you about life expectancy. I recently began reading "In Defense of Food" and can clearly see where many of our health problems now may be linked to what's become of our conversations around food and nutrition. (not that I didn't suspect this before readin the book).

However, the rankings generated by the Wolrd Health Organization were considerably more complex than simply looking at life expectancy.

At least we agree we need reform. Honestly, I'm all for a lot less government than we have no. (Ron Paul fan, actually). Still, I think the attacks on the current proposal are not based on logic so much so as fear.

Some days... like today... I fear we've become too complex and too large to find a truly workable solution. I believe, firmly, that a government solution can work and a private solution can work... when either is executed correctly... I also believe that the private solution we've done so far is failing.

The problem is that not everyone is covered under Medicaid, which is why we need reform that would allow everyone to be covered.

P.S. The regulations would not reduce competition because the regulations would be applied to the public/government insurance, not to the private insurance companies. There will be no directly forced change to private insurance companies. There will only be indirect forced change on private insurance companies in the form of "if you want to compete with the public insurance, then you've gotta give the people a good option."

Scott,

Because I read the House Bill and apparently both sides agree on the "pre-existing condition" inclusion.

And, with all due reespect, there have been PLENTY of logical and reasonable arguments made NOT based on irrational fear.  Have you been reading these blogs?  Or just what I have put on this page?  Part of the post includes the following:

"Health care influences life expectancy, of course. But a life can end because of a murder, a fall, or a car accident. Such factors aren't academic-homicide rates in the United States are much higher than in other countries (eight times higher than in France, for instance). In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don't die in car crashes or homicides outlive people in any other Western country."

Lauren,

Read the bill. The entire industry will be regulated, to a whole new level.

And history has shown that regulation always reduces competition and increases cost. It should only be relied upon when absolutely necessary. Rather than mandating a company take everyone who signs up, which ruins their whole business model and makes them more likely to deny treatment, we should look to free market solutions for reforming health care.

Except, of course, in every other country that has regulated basic health insurance. (cf. Switzerland, Netherlands, etc.)

Timothy, you just made me think a bit harder. Indeed Switzerland has a regulated system, in that it forces insurers to cover everyone regardless of health, so that you pay the same as anyone in your age group and location:

http://www.sj-r.com/opinions/x1641102040/Morton-Kondracke-For-health-care-system-alternative-consider-Switzerland

The cool thing is that the system encourages competition by letting insurers work out the details as to what is covered and what they charge. That would be a huge step up from our current system, and while it's still more restrictive than I would like, it allows markets to do their job.

The proposal in congress that's most like the Swiss model is the Patients' Choice Act. HR 3200 seems like a terrible idea by comparison.

Well, Mark, you should read your cited page a little more closely.  Someone's been feeding you some bad info on the Swiss, but it's not the Healthcare Economist, who freely points out:

*  the government defines a what the insurance benefit will be for all standard health insurers, [like HR 3200 and unlike the Patient's Choice Act -- also unlike your description]

*  premiums are community rated, meaning that sick and healthy individuals pay the same price within each age group (the age groupings are 0-18, 19-25, >25 years old).  [A stricter rating regulation than HR 3200]

*...10% coinsurance rates up to an annual ceiling [a stricter regulation than HR 3200 -- we'd cap it at 10% of your income, the Swiss at $420 -- http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/]

That's hardly letting insurers working out the details as to what they're covered and what they charge. Additionally, insurers are forbidden from making a profit on basic care [http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/]

Unmentioned in that Health Economist link is that pharamaceutical prices are directly set by the government -- something even HR 3200 doesn't do.

Also see...

http://healthcare.change.org/blog/view/swiping_ideas_from_the_swiss

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Well I saw the age group thing. I guess you can force them to cover certain conditions. How about letting states do that, as they do now? Just open up competition across state lines.

I'm operating from the assumption that the market is working rationally according to the incentives it has been given. Nobody is evil, but there are negative outcomes which can be avoided. I'm just saddened to see that the only solutions we are looking at involve mandates and more regulation. Markets are amazing at delivering what is needed to those who need it.

And by the way, if you want proof that this is not a free market and has not been since 1954 and certainly not since 1973 (HMO act), see this copy of a hospital bill from 1950:

http://www.workingmomsagainstguilt.com/2008/04/cost-of-having-baby-in-1950.html

Delivering a baby has not changed much since 1950. They are comparable services. You are looking at a bill which includes 5 nights stay, with all the bells and whistles, for $86.33, or about $736.10 in today's dollars. Today that would cost you at least $5000. Free markets drive the cost of things down, not up. There is something amiss here, and part of the reason is that we went off the gold standard in 1974 which allowed prices to rise continuously and unfairly based on market power. Even ignoring that factor, the market has been choked by government regulation.

I understand people are angry at capitalism for the problems in our health care market, but I would suggest they turn their anger towards the government, like the town hall protesters are doing these days.

That would be great, if both sides were actually listening to what's being said, and proposed, rather than imagining a conspiracy around every corner.

That's a very judgmental statement.  By you both.  We are listening, and in fact Mr. Foley and I have come to an agreement on some facts.

Noone has said anything about resenting their neighbor getting something others are not.  In fact the reform we all want wpould put us all on an equal footing.  We just disagree over the extent and type of government involvement.

I for one am not believing in a conspiracy.  But President Obama and Nancy Pelosi seem to believe in one.  No?

Barbara,

If he means to simply leave it between the Doctor and patient, what is the moral dilemma whether to "to give" it to her.  If she wants it, she'll get it. 

When he additionally ties the issue to the cost, he seems to be raising whether or not the cost at that time and circumstance justifies "giving" the treatment to her despite compassion. 

So what are we to conclude?  That the dilemma is whether the cost given her condition should be discussed with her as she makes her decision?  Or that she should be persuaded NOT to do it?  Or that it should not be offered as an option?

Under any of the three scenarios, that is a scary proposition.  I wouldn't want to feel guilty about exercising an option I normally would accept but for the cost.  Or to be denied the option or even being advised of it.

If I choose to forego the procedure for quality of life issues, then great.  Or I am just ready to go, fine.  It's my decision, free from undo pressure.

Barbara, I take issue with your assertion that for-profit companies drive up the cost. Profit is a motive for people to increase supply, and as prices change, people alter their behavior, which ensures the most efficient and equitable distribution of resources.

If you took all the profits of all the insurance companies in America, that would be enough money to pay for FOUR DAYS of health care for Americans. See this article on the sad state of our health care system today, and how the proposals currently on the table will only serve to entrench it for another generation:

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

How is that a reasonable solution? Why not instead of requiring documentation of citizenship, let immigrants pay out of pocket?

You will never cut down on Medicare fraud and abuse. The solution is to phase out Medicare.

I do agree with you on making plaintiffs pay if they lose.

What is your reasoning for dismissing healthcare as a right?

Consider that suffrage, a valued right, was extremely limited at this nation's founding. That property rights at were not considered violated when, in the early years of US case law, ferry owners successfully sued bridgemakers for unfair competition or states ruled against the building of roads to compete with toll roads. Our modern sensibility is that these were incorrect positions despite their being apparent truths to our founders.

The civilized world, apart from the US, has long held healthcare to be a basic right. The Universal Declaration of Human Rights, Article 25, adopted by the UN, at US urging in 1948, includes medical care as a fundamental right. http://www.un.org/en/documents/udhr/#atop

Reasoning is not an issue of capital letters, shouting, dogmatic adherence to certain economic theories, or the product of personal, internalized enlightenment. It thrives on discussion, not pronouncements.

Harold, which of the following statements are true?

1) Health care is a right.

2) Life-saving health care is a right.

3) $10,000 per year worth of health care is a right.

4) You have a right to free association, and so do doctors and everyone else.

IMO, numbers 1 through 3 are equivalent, because they require someone to be deprived of something in order to provide for someone else. Number 4 seems to make more sense as it doesn't deprive anyone of anything in order to fulfill it.

Harold,

Please review the other dissertations on "rights" here as defined in our founding documents.  We the people have built our entire system on this:

"We hold these truths to be self-evident...."

Implicit therein is the idea that we were establishing a foundation that we agreed upon, and was not going to be subject to debate because it would threaten the immuteable and eternal acknowledgement of human rights.

"....that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness."

I will not restate what was stated earlier.  It is clear that the UN document is different than our Constitution despite borrowing heavily from it.  Let's look at that provision.

Article 25.(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

 It is clearly an assertion that people have a right to an "adequate standard of living."  To use your argument, then every government should produce and provide for every citizen the other items:  food, clothing, housing, and a job in the event of "lack of livelihood."

That is simply impractical and has failed everywhere it has been tried.  But in the US we have one of the highest standards of living in the world.

The UN document is perhaps very noble, but if we have all been "endowed" (which is the word it uses as well) with a doctor, house, food, clothing, employment then why don't we all have it?  Because it is not a right we possess.  They are ends that we have a right to pursue unhindered by government.

To the extent that government offers assistance, that too is noble.  But is is not a right.  It is a blessing of liberty.

It is interesting that in the next article it reads:

Article 26.(1) Everyone has the right to education. Education shall be free, at least in the elementary and fundamental stages. Elementary education shall be compulsory. Technical and professional education shall be made generally available and higher education shall be equally accessible to all on the basis of merit.

It does not mention free healthcare.  It does mention free ducation.  But beyond declaring the service of education to be a right, it limits it.  And then only guarantees equal "access" or opportunity for higher education.

I submit that the drafters, while having noble intentions, clearly have misunderstood the concept of rights or poorly drafted it and have inadvertently bit off more than any government can chew in providing for all it's citizens.

Again, if you have a right to something material, then the government must see that you get it.  But we don't have a "right" to goods and services.  We have a right to be free from governmental hindrances of our liberty to pursue these things.  "The pursuit of happiness."

Government may have an obligation to allow equal access (e.g. to the voting booth, to the courts, to contract for services with the income you have.)  Everybody has the same opportunity.  But everybody doesn't have a right to what they do not have the ability to achieve.

Moral obligations do not all translate into individual rights.  A doctor may have a moral obligation to assist a dying man, and a law may have even been enacted to require him to render aid under certain circumstances, but that does not mean that the dying man has a Constitutional right to the treatment.

James, the 9th Amendment speaks to rights that we have which are not enumerated. The right to an attorney is not Constitutional. Is the Miranda law wrong? Constitutionally, juries are to be impartial, not of our "peers" or even picked by our lawyers. Do we have a right to enter into contracts, marriages, to procreate, to privacy? None of these is enumerated. They were not self-evident. If any of these are taken away, should we say that they were not of enduring value?

The US subscribes to the Universal declaration. For one, I would see that we adhere more closely to it and believe our society would be better off to acknowledge these rights and act to further them as prescribed.

My wife works with the mentally challenged and disabled, they cannot achieve even a meal for themselves and rely on an amalgam of state, charity, and family funds for support to which, according to you, they are not entitled by right simply as human beings. Whether or not you are a Christian, I am, and I pray that none of us find our value solely in the subjectivity of others.

Harold, I appreciate the compassionate perspective you are adopting and I applaud you for it.  I myself have a disability, so I do have a personal stake in this issue, but I am bound by facts.    The things you are describing are not described as the rights that are self-evident.  Life, liberty and the pursuit of happiness are.  These give effect to them, and PROTECT US FROM and RESTRAIN the government from violating our rights.  If the government is not actively preventing you from getting medical care, it is not depriving you of your right to something you have been endowned with by nature and nature's God.  Believe me, if anyone who understood Constitutional law thought the Constitution guaranteed you the right to demand medical care of all kinds even if you couldn't pay for it, the ACLU would have taken the case by now.  As I said, a moral obligation is not synonymous with a Constitutional right.  We can still decide to do it as a nation, but it is not owed by the government as a right, nor is food, clothing, housing but we do it.  

Mark,

I think more recent info is even more favorable to the US concerning that statistic.  I comment is made about that issue in the post of the article on Canadian healthcare.

I definitely sympathize with your experience.  My Dad also has had serious health issues.

Concerning "rights" however, again they are innate and the Constitution prevents government action to deprive you of it.  It is not a provision of a service.

If the government refused to allow you to purchase insurance, or pay for the procedure yourself (as was outlawed in Canada until the highest court overturned the long-standing prohibition), that would be abridging your right of (I think) all 3---life (possibly), liberty and the pursuit of happiness. 

Additionally, if the government board denied a a patient an appropriate procedure solely because of the cost (as happens in England and Canada) that would be unConstitutional in my view.  I would certainly sue over it.

So the catch-22 is that (1) if the government takes upon itself the obligation of providing insurance and healthcare, and/or (2) restricts an available appropriate option through this proposed legislation solely because of the COST and (3) you otherwise have the means to pay for it OR they provide it for others and deny it to you because you are too old, too sick or some other value judgment when you and your doctor agree it is appropriate; that would be unConstitutional.

The point is that you have a right to pursue life, liberty and happiness through appropriate means as long as you have the means (cash or insurance or government-provided) to pay for it.  And if the government intervenes to limit your access or choice merely because of the cost while your neighbor get's it, that's unConstitutional in my opinion.

If there is simply no means to pay for it or you don't get it for free and the government isn't blocking access, you have not been deprived of a Constitutional right.  It has not impeded your ability to obtain what you wish to pursue; it's just not helping you obtain a service.  Otherwise there would have been plenty of lawsuits already trying to get people healthcare, whether they can pay or not, regardless of the economic burden on society.

Someone may ask, "If it is unConstitutional for the government to actively limit my access to medical care of my choice, then it must be a "right.""

It is only a "right" to the extent that you have the ability to pay for it and the government is actively preventing it.  It is not the care itself that is the "right", it's the ability to receive it unimpeded by the government due merely to cost. 

And if the government imposes on the private sector or the "government option" a cost/benefit analysis that discriminates against one group by denying care provided to others based solely on cost when the patient and doctor want it, that is unConstitutional in my view.

It is somewhat analogous to a college education.  If you can pay for it or get a government loan or scholarship, great.  If the government doesn't help you get it then no right has been violated.   It is a little different with healthcare because that impacts your health directly rather than education.  But the principle is fundamentally the same.  We don't have a "right" to the service of an education any more than a college education or home ownership.

I'm so sorry for your medical difficulties. It is very tough. The problem is not the Quality or Access. The problem is Cost. If you get "free" health care, you will lose both Quality and Access. I know. My aging parents live in Norway and though I live in the States now, my entire family has been born under and raised in the Norwegian system. They ALSO have the public/private option like Obama has proposed. The system is mathematically broke and without the North Sea "oil fund", Norway would have been bankrupt years ago. Do not even get me started on WHY the Norwegian government closes and consolidates hospitals all the time and WHY they have machines and devices still in use from the 60's...People come to America for medical care because we’re the BEST. Free market competition has kept every industry NOT under government control very affordable. Consider computers, cell phones or elective type surgeries. All go DOWN in price and UP in quality WITHOUT government intrusion. The mess we’re in NOW is BECAUSE OF government regulation. It’s like giving the banks who CAUSED the financial mess the responsibility to FIX it themselves. Who is stupid enough to let them do this?? Of course, our Government, would, that’s who. There are more first generation Norwegians (like me) who live in America than who live in Norway. Please don’t let go of the last shred left in our constitution. Without it, we’re a fascist country no mater how Obama packages it.

In what way does the federal government intrude into the business of health insurance companies? Does it mandate that health insurance companies use one particular formula of risk adjustment over another? Does it mandate that health insurance companies reject people with preconditions or rescind the insurance of paying clients after they become seriously ill? Does it force them to defraud medicare recipients?

To date, there is no federal regulatory agency watching over the health insurance industry. Rather, the individual states function as regulators. The health insurance industry's efforts to gain control of the health insurance commissioner, and candidates for the post, through massive campaign contributions are ubiquitous and success is regular.

When you say "defraud medicare recipients" you mean defrauding Medicare or in other words defrauding taxpayers, right?

And I am happy we can agree that state regulations have allowed monopolies to form in health insurance, and if companies were allowed to compete across state lines, there would be less corruption and more competition.

The civilized world, apart from the US, has long held healthcare to be a basic right. The Universal Declaration of Human Rights, Article 25, adopted by the UN, at US urging in 1948, includes medical care as a fundamental right. http://www.un.org/en/documents/udhr/#atop

I don't know what to tell you, Harold. Nobody has a right to a certain "standard of living", because everybody values things differently. There's no way to judge what standard should apply to everyone, and once you make that judgment it's easy to deny people the ability to choose for themselves. That way madness lies.

Rights not explicit in the Constitution, aside from Miranda:

The Right to a Fair Trial, Right to a Jury of Your Peers, Presumption of Innocence, The Right to Vote, The Right to Travel, Judicial Review, The Right to Marriage, The Right to Procreate, The Right to Privacy.

What we have is the Bill of Rights:

Amendment IX: The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

We have rights retained from English Common Law, rights conceived of by the Enlightenment, rights which have developed over time, which seem to exist by reason.

Some of these rights have limitations or preconditions - must be 18 to vote, must be heterosexual to be married. We have even accepted search and seizure as legitimate when we offer up the probabale cause of wanting to visit the Liberty Bell. After all, it is probable that we have other aims in visiting a historical site and less likely than we want to enjoy it, right?

I would pose this, the creation of a single-payer for fundamental services and provide a significant degree of universal coverage coupled with reform and regualtion of practices to deliver a better level of care does not preclude the sale of services beyond this scope of care or employers from offering extensive policies as perks. Even if the highest level of care were that offered by current federal programs or to public employees, there would still be room to cover luxuries and leave choices for care above a certain level to the individual. That places no limit on the care and leaves choices available price but can assure that no one will die waiting for the essentials. If you have faith in the market, you must believe that the market for above-basic care will still be there to fill your demand.

We can then focus our debate on what makes up the basics and make the a discussion of care rather than coverage.

Like I said, madness. You're suggesting that some kinds of health care are "luxuries" while others are "essentials". This is just patently false. The only people who can decide the difference between the two are doctors and patients, certainly not the government. What was considered luxury just 10 years ago is now thought of as essential. Why do you think Canadians are utilizing some of the better services available in the U.S.? Because their universal system decided certain new and "unproven" treatments were not essential. How in the world would this kind of attitude toward health care lead to fewer deaths?

Harold,

If we the people choose to create that system we can.  As have others.  But it is not because the recipients have a Constitutional right to it. 

I think single-payer is not the way to go.  If you read the article I copied on this page, you will see that even in Canada they are now allowing for a mix of private market care because of the long waits and sometimes sub-standard care.

People seem to be fond of pointing out not everyone gets healthcare here.  While we need to make some changes, but waiting six months for an MRI to find out you are three months too late to avoid terminal cancer is just as bad.

We can do better.

The government rigidly controls utilities. If it didn't, you wouldn't ewant to see what your rates would look like. I'm on the inside of a utility and I can tell you that the best friend you have is your rate-payer advocate.

Bus lines are already state-run, so are the trains, and the water companies - what part of Oz do you come from?

All your groceries are governement subsidized, have you ever looked at agribusiness? Even the shelves at your local WalMart are stocked by US policy, foreign aid, protected sea lanes, and treaties.

And the phone services? Please...none of that came about without much public subsidy.

The entire economy we are in in a post-war contrivance of subsidies and planned obsoloescence.

If you want to be truly independent and avoid governement subsidy, there are some great spots in Africa where you can buy that existence.

Maybe if the government didn't rigidly control utilities, prices would be lower. You have no idea if that's the case because it's never been tried.

Public transportation makes sense from an infrastructure perspective so I'm not opposed to it, but more often than not, cities will make the wrong decisions and waste billions on unproductive train lines. In some cases it would have been far cheaper to buy a Prius for every train commuter. And when the wrong decisions are made, everyone suffers because resources are misdirected. There's no such thing as a free lunch, after all.

I am in favor of dropping all subsidies for agribusiness. Probably $100 billion/year in direct costs and trillions in opportunity costs. Politicians are considering a fast food tax, so it's not like people are opposed to having food costs go up.

Aren't you at least somewhat upset that Americans get hundreds of calories per day from high fructose corn syrup? It's completely insane, and wouldn't happen without government intervention.

Thank you for making my point, Harold. If health care is a "right" to be provided for free (through taxation), then so should water, electricity, and food. Why not add those to the "General Welfare" clause of the Constitution? You are only partially right to suggest that "government rigidly controls" things like utilities, etc, because there is tremendous competition. The government (in most cases) just outlines the rules for free markets to compete in. Utility Companies and Grocery Stores are not owed by the government like Health Care would be.  The government should do the same. Make rules for fair competition and "Get Out Of The Way"!!

Mark,

I certainly do oppose and have worked against agribusiness subsidies. I advocate for locally grown organics. The corn story is an absolute travesty as is th eehtanol subsidies that keep it afloat.

I can also tell you about utility deregulation and the effects that it's had on the grid and infrastructure. Grid maintenance is not profitable and the investor-owned power companies raked it in on the open market leaving the structure to rot. Now, public money is being injected to fix the lines because people need power for their lives and business despite the power companies' irresponsibility. The utilities are paying for it by having rates suppressed and being forced to earn profits through easing the burden on the grid - funding efficiencies that are cheaper quicker than building new generation and delivery services.

As to rate controls, there are huge fluctuations in the open market. The rates are regulated in such a way  that the increases reimburse the power company for the aggregate of the annual fluctuations rather than trying to bill the customer on an hourly interval. Because of the volume of market information involved in making the rate determination, the State board reviews the accounting  and makes sure that the increase is not more than what's needed to reimburse the utility. There are hundreds of pages to these tariff filings. Some are bigger than HR 3200. Smart grid could change that but it would lower profits and the utility doesn't want that. They've no intention of working against themselves. They own the lines, they own the meters, they don't have to give you what they don't want to give. State boards or some large aggregation of customers is neededto balance interests against such a monopoly. The ultimate solution may be micropower but technology isn't there, yet.

Let me also say this about the ephemeral world of the electric market, they are trading generation capacity. That capacity never really makes it to your lines from the entity which generates it. The enormous competition? Well, it depends on where you are and whether you can participate in dereg. It's usually reserved for commercial and aggregate users. Contracts guarantee rates for blocks of power purchased and penalties for failing to use all the power in the blocks. In other words if you promise to buy 10,000 kWh @ $.07/ kWh and only end up using 8,000 kWh, you will pay either for the remaining 2,000 anyway or some part of it as a penalty. It isn't fun to micromanage power and try to forecast weather a year in advance to guide your purchase. Oh, and the 2,000 kWh you paid the penalty on and didn't use? Someone who bought too little and needed something in a pinch will pay a premium for it and you won't see a dime.

Lousy contract, huh? well, pick your dereg supplier and the contracts are all alike. I've even done blind auctions and the terms were identical and the players knew each other. Competition? even where the open market obtains, the suppliers agree on the rules. Hey, can't stop them from talking to each other. They all know each other from having worked at the same firms, gone to the same schools, attended the same conferences. If one changes, they all change. if one finds an angle, they all take it. There is very little innovation.

That sounds like a highly regulated market, and while I understand that certain companies can form a monopoly, while others can collude to restrain trade, I can't imagine that happening on the energy supply side. The grid is probably not "smart" because the energy suppliers have had no incentive to make it smart, why do that when you can work the system and all the reimbursements from state boards?

Reverend,

With all due respect, Michael Moore is acknowledged by the honest and objective Liberals to be the furthest thing from an objective documentarian.  He is nothing more than an extreme left-wing propaganda peddler who produces hit pieces.

If you want to get some straight facts, try some non-partisan sources like http://www.factcheck.org/2009/07/obamas-health-care-news-conference/  They indicate, for example:

Summary

President Obama tried to sell his health care overhaul in prime time, mangling some facts in the process. He also strained to make the job sound easier to pay for than experts predict.

Obama promised once again that a health care overhaul "will be paid for." But congressional budget experts say the bills they've seen so far would add hundreds of billions of dollars to the deficit over the next decade. He said the plan "that I put forward" would cover at least 97 percent of all Americans. Actually, the plan he campaigned on would cover far less than that, and only one of the bills now being considered in Congress would do that. He said the "average American family is paying thousands" as part of their premiums to cover uncompensated care for the uninsured, implying that expanded coverage will slash insurance costs. But the nonpartisan Kaiser Family Foundation puts the cost per family figure at $200. Obama claimed his budget "reduced federal spending over the next 10 years by $2.2 trillion" compared with where it was headed before. Not true. Even figures from his own budget experts don't support that. The Congressional Budget Office projects a $2.7 trillion increase, not a $2.2 trillion cut. The president said that the United States spends $6,000 more on average than other countries on health care. Actually, U.S. per capita spending is about $2,500 more than the next highest-spending country. Obama's figure was a White House-calculated per-family estimate. 

Also read the Congressional Budget Office report that is headed by a Democrat.  It is here.

Also read the CBO's response to the President's assertion that great savings will be realized by emphasizing preventative care here. 

http://www.cbo.gov/ftpdocs/104xx/doc10492/08-07-Prevention.pdf

 Check out the posts above by Canadians and the distortion of life expectancy numbers.

"The mission of the Cato Institute is to increase the understanding of public policies based on the principles of limited government, free markets, individual liberty, and peace. The Institute will use the most effective means to originate, advocate, promote, and disseminate applicable policy proposals that create free, open, and civil societies in the United States and throughout the world."

http://www.cato.org/about.php

I have no objections to citing Cato, but let's not pretend they're facts uninfluenced by an ideology that it is their prime function to disseminate.

Timothy,

I respect you and appreciate your passion and intellect, but with all due respect, you posted a large article with supporting links for it's assertions to moveon.org. 

And again, with all due respect, are you saying that you and the folks at www.change.org are "uninfluenced by an ideology" in your presentation of facts?

I pointed out some distortions and misrepresentations on healthcare from the whitehouse website in it's alleged "reality check."  I asked you as a service to your readers to review it and point out all the misrepresentations.  I think we already agree on one or two.

In the interest of an objective fact-based discussion, will you be responding to that request?

James, your link to Cato remains, and I have not altered it.  However, you presented it with the line, "Those just interested in facts more than ideology will enjoy the read."  Well, I doubt Cato themselves would believe that to be so -- their "About Us" page is open and transparent.  It seemed appropriate to chime in and make that clear to those who hadn't heard of it.

MoveOn's reputation precedes it, from its politicial advocacy campaign work to stop the Iraq war, as well as campaigns to keep the federal courts moderate, support campaign finance reform, oppose the repeal of the estate tax, and reduce America's dependence on oil. 

Change.org is a social entrepreneurship venture empowering movements for social change.

None of the above organizations is ambiguous in its ideological outlook.  Nothing wrong with that, but the phrase, "Those just interested in facts more than ideology will enjoy the read" promises more than it delivers.

James,

I'll trust Cato when you trust Michael Moore. Both have an agenda, let's keep putting our own ideas out there. The adherents to Cato propaganda like to talk about not helping the homeless because homelessness is voluntary.

Unless I've misjudged, that isn't you. You seem conservative and principled, not libertarian and amoral.

Tim, I will concede the point and withdraw.  Are you going to favor us with your analysis?  Thanks.

Harold, I actually do not follow the CATO Institute so this is news to me.  I am simply doing research and it seemed some things were being described as Nirvana.  Anyway, I never heard that homeless thing; I'll have to take your word for it---but I still can't imagine anyone taking MM as a serious political/social commentator.  His blatant dishonesty is shocking and my analysis was primarily based upon reading comments by a few Democrats who make a living making real documentaries.

Barbara, there would be plenty of competition for insurance, hospitals, and doctors, if there were no government regulation. They only have monopolies because government has made it hard for new competitors to enter the market.

People in the insurance industry are obviously concerned for the future survival of their business, and will lobby hard to prevent the government from changing that. I'm merely suggesting that the current plans will only serve to entrench the current system and all its special interests and privilege. A far better plan would be to repeal all the regulations and tax exemptions which have gotten us to this place.

Thanks Barbara for your thoughtful reply. 

You are actually mixing two separate incidents.  The one you and I both saw about the woman who asked about surgery for her 100-year-old Mother (I think it was a pace-maker?) he did not mention the money.  He did say that she might have instead been given a pill.  The mother had the surgery under the current system and lived to 105.  The woman asked if her "spirit" and other intangibles would be taken into account whether she would be allowed the surgery.  He said no.

But the most important point, which was in the question and implicit in his answer and even in your defense of it, is that someone other than the doctor and patient were going to be making the decision if she would be "given" or "allowed" or as you said "should get" the surgery.  (You wrote: "someone asked if a very old person should get a surgery if there were other factors involved and the person may not live very long."  That is for noone else to determine but the patient and the doctor.  We agree on that, but I think you are interpreting it the way we both want to be, regardless.

Further proof is the second instance where Mr. Obama specifically referred to the "moral dilemma" of "giving" his terminally ill grandmother surgery.  (Who is doing the "giving"? Whether to give her the surgery was the question giving rise to the moral dilemma.)  And he did immediately thereafter reference the fact that the dilemma arises because end-of-life care represents the bulk (I think he said 80%) of healthcare costs.  He definitely connected the two as giving rise to the "moral dilemma."

I respectfully submit that the answer is clear, and it is not a "whatever the doctor and patient decide" system.  Otherwise controlling costs is in jeopardy.

I agree with you, especially your statement:

"the problems should be approached in order, over time: universal care, funding methods, cost containment and best practices. Satisfy the human need first and the finances later."

I also agree that health care is a right and not a commodity, though it appears many people writing comments here do not agree with that.

Again, a moral obligation is not synonymous with a Constitutional right.  A group of folks can decide that the world is flat, but that doesn't make it true.

A Constitutional right is defined as a matter of Constitutional law and legal interpetation, not public or personal opinion.  Again, if it were a legal  "right" the ACLU would have already filed suit.  And we would be obliged to provide it even if it bankrupted the entire country or we had to pay 90% of our income to taxes. :o(

Now, that doesn't mean that Universal Healthcare is not a good goal if it can be achieved.  Everyone should be for it if it can be done.  Can it?  We're trying.  The question is how.

So we have the same goal.  I guess that is ultimately what really matters. :o) 

Good thing the CEO of Whole Foods hasn't lobbied government for regulations to prevent you from going to a competitor.

Again, the battle is not pro-reform vs. anti-reform.  It is between what types of reform and the economics associated with various options.

Please be wary of this tactic from those who want to paint the House Bill as the only reform to be had.  We can do better.

That should teach that CEO to keep his mouth shut!  He should not be allowed to suggest there might be better alternatives. People will boycott your store! Just shut up Whole Foods CEO!  You don't desreve a voice. Not it in "our" country! That CEO is a VEGAN!?

And those dam greedy doctors need to get it, too. How dare they think they should make any money. They should have become oil and insurance company executives, or entertainers, if they wanted to be millionaires !

I like a good argument, Barbara, so let me see if I can rebut yours.

You seem to think that big business is very good at lobbying government, which it is, but in the same breath you argue that we need more regulation. Who do you think writes the regulations? Lobbyists of course. It doesn't matter who is in power.

Insurance companies have monopolies in every state because regulations have ensured that nobody new can get in the market. This is no accident, as these companies have successfully prevented competition across state lines and have been happy to go along with state regulations as to which services must be covered. Big companies can handle the extra services but small companies can't.

Hospitals lobby state governments to prevent new hospitals from opening. The AMA has a lot of influence on how legislation is crafted. When Medicare was enacted, they managed to get fee-for-service to be the main reimbursement method, and since the fees charged by Medicare are such a huge factor in hospital operations, every single actor in the market has lobbied for the different prices of different services. New services come on the market and the price stays too high for too long as a result. In a free market they would only be able to charge whatever a customer pays them, which would tend to fall over time.

Just look at the market for Lasik eye surgery. It has never been regulated by government, and was never reimbursed by private insurance nor by Medicare. Since its introduction the price of that surgery has gone from thousands of dollars to less than $1000 today, and you can find someone to do it in every city in America.

I'm not a big fan of campaign finance regulation, because it seems to be against the First Amendment.

But beyond that, I think the problem is not that politicians are controlled by private companies, it's that they have the power to affect the private market in the first place. If you take away the power from politicians nobody will want to lobby them in the first place. I know this is idealistic but it's important to recognize where the problem lies.

Hear hear! If they pass a plan and don't put Congress on it, they will have no credibility.

I am weary explaining Constitutional law to laymen.  It is not a Constitutional right.  PERIOD.

We have many laws that impose and obligation on folks, like compulsory education, but the provision of the service is not a Constitutional right.  It never was and it is not today.  Healthcare is the same, as is housing, etc.

If we choose to provide it, like education, as a moral imperative, fine.

The question is what is the best system?

It is the best system in the world innterms of quality.  What we are debating is ACCESS.

And the Mainstream Media did not do it's job in informing the public about what was in his books.  Or what he really meant by "change." And those that tried were persecuted for it.

The MMM was in the tank for Obama from day one.  The dereliction of their duty is absolutely criminal.

James,

I disagree. The ninth amendment clearly states: 

"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people."

There are rights retained from common law and rights that were, as yet, unacknowledged by our founders, and they knew it. As our republic developed, rights of property and suffrage changed and expanded, rights of personhood and liberty were altered, a perceived right to secession was defeated.

Even in terms of natural rights, our founders were not always in line with each other or even with all of their own thinking or with some who have originalist tendencies participating on this blog: "Whenever there is in any country uncultivated lands and unemployed poor, it is clear that the laws of property have been so far extended as to violate natural right." --Thomas Jefferson to James Madison, 1785. ME 19:18, Papers 8:682

The very foundation of the Constitution, that the power of government lies in the people, is an issue of common law. Such being the foundation of our system, precedent and reason will over time discover the extent of our rights all of which are within the boundaries of the Constitution because our founders corrected their omission in the Bill of Rights.

It was never the intent of our founders to narrowly focus or reduce all issues to a few conspicuous phrases but to lay the foundation for the expansion and discovery of our rights and freedoms.

Harold,

I certainly agree with some of what you said, but you have yet to give me an example of a "right" similar to providing the service of healthcare.  Common law is not synonymous with constitutional rights.  Common law is merely laws that are not statutory.

The Fathers' description of rights is consistent in every respect with what I have described.  We have enacted laws like "Good Samaritan" laws, but not in recognition of a "right", but a conscious decision to impose a duty for the common good.

Now, at the risk of ending an enjoyable dialogue, whether it is a Constitutional Right or not is irrelevant.  I was just responding to a statement of another.

If it is the will of a sufficient number of people, and viewed by enough people as a moral imperative, we will have the universal healthcare the people want.

Billing costs are high because we have to file every single darn doctor's visit and treatment with an insurance company, as a claim. This makes no sense. We need to return health insurance to an actuarial model, and have a free market where the individual patient makes decisions with their doctor, and prices come down all the time.

Pam,

Your story about the stroke victim reminds me of the time I practiced medicine, in my younger days (early 90's).  As a surgeon, I treated a woman in a vegetative state in a nursing home, for a thrombosis of the artery in her leg. The fact is, most people are writhing in pain when they suffer this calamity. But, this lady was in no pain. She was not aware enough to feel any!  But, after a time, she survived and the leg became a problem with nursing home care. She was brought to the hospital and the decision was made, by me and the  family, that she had to have the black dead leg amputated.  She had a slight wound infection, but died one night, in her sleep, unrelated to any of this.  She was a no-code. (I was criticized for that, too!)

For taking care of this lady, I was sent to the medical review board because I had not placed her on strong IV antibiotics ($1,000/day) for her skin drainage (treatment I was taught in surgical training was not really needed)  I did treat her with oral antibiotics to prevent it from being the thing that killed her. That would be a post-op death on my statistics!?! 

This has been going on for years and the lack of respect of people is one of the reasons I am no longer practicing. Granted treating chronic pain patients cost me my license, I still feel that being too rebellious and going against people who would rather treat a patient like this, with no regards to her quality of life or un-needed waste of medical money, is why I do not practice anymore.  I stopped being employed by ER's because I would not fill in items so they could charge the patient more, when it was not needed!  I did not think doing a full history and physical, at the cost of $150 more on the hospital charge, was right for sewing up a kid's lacerated finger!  And that is all it was for, to make more money!  It had nothing to do with a successful outcome of the healing of the laceration!

The system has been broken for years and something has to be done. Too bad, that the way they are doing it will not cut costs at all, because the people in charge think nothing about ethics and good moral decisions.  The government will never control the crooks in the medical business! 

I just hope these advisory panels don't start limiting care on people because of their age or, mental status or any other disability. It could be way too easy for them to do something like that! I have been there and seen it.  A person willing to do one thing wrong from money is apt to do it more than once!

So Michael, would you say that it's the insurance companies, hospitals, or doctors that are "evil"? Or is it actually nobody evil, just some seriously f'ed up incentives?

I'm sorry to hear you lost your license. Do you think it was a fair decision? Do you think the entire licensing system is in need of reform?

Michael,

"For taking care of this lady, I was sent to the medical review board because I had not placed her on strong IV antibiotics ($1,000/day) for her skin drainage (treatment I was taught in surgical training was not really needed)  I did treat her with oral antibiotics to prevent it from being the thing that killed her."

Please explain for us laymen how oral antibiotics were necessary and an IV antibiotic was not.  I am not a physician, but once a leg gets black does it not mean there is necrotic tissue?  And does that not also mean that the most aggressive treatment may be needed to prevent the resulting infection (perhaps gram stain negative?) from entering the blood stream?

How did the facility allow the problem to get to the point where the leg was black and dead?

Did the family sue?

If the IV antibiotic is significantly more expensive, wouldn't the hospital want to do it to make money?  Your point seems to be that they were drumming up the cost.

Just curious.