Health care reform and end-of-life care

Tevi Troy reports on what President Obama told the New York Times about his health care proposals and end of life care:

He tells the story of his grandmother, who got an expensive hip replacement, then died two weeks later. President Obama says he “would have paid for that hip replacement just because she’s my grandmother.” At the same time, however, he notes that “whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question.” Furthermore, he recognizes that Americans don’t want to hear that we will not provide expensive late-stage care, a la England. As the president puts it, “If somebody told me that my grandmother couldn’t have a hip replacement, and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.”

His answer to this question, however, is also somewhat upsetting — and not just because he calls denying care to the terminally ill “very difficult” and “upsetting,” but never “something we won’t do.” He says that “there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place.” And not only will this be difficult, he claims, but he has trouble imagining “the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance.” It is unclear what this group will look like, but the notion of some empyrean body, developed outside the normal political channels, making health-care decisions for the country, is a notion that makes me very, very nervous.

Does it make you nervous? Won’t state-controlled, state-dispensed health care open the door for such cost-saving measures as euthanasia?

About Gene Veith

Professor of Literature at Patrick Henry College, the Director of the Cranach Institute at Concordia Theological Seminary, a columnist for World Magazine and TableTalk, and the author of 18 books on different facets of Christianity & Culture.

  • Mary Ann

    It is a cause to be nervous since those who are so ready ro rid the world of “unwanted” unborns and old people will fight with every ounce of their strength to keep convicted murderers from the death penalty. Never mind the astronomical cost of supporting an inmate on death row every year compared to Grandma’s hip replacement surgery. It does not feel like a safe time to be entering my “golden years”

  • Mary Ann

    It is a cause to be nervous since those who are so ready ro rid the world of “unwanted” unborns and old people will fight with every ounce of their strength to keep convicted murderers from the death penalty. Never mind the astronomical cost of supporting an inmate on death row every year compared to Grandma’s hip replacement surgery. It does not feel like a safe time to be entering my “golden years”

  • Ryan

    Where can I go? What countries still offer the freedoms I grew up with in the United States if this is our future (as well as the many other directions the new administration wants to take).

  • Ryan

    Where can I go? What countries still offer the freedoms I grew up with in the United States if this is our future (as well as the many other directions the new administration wants to take).

  • LAJ

    Actually, from what I’ve heard, it costs more to have someone on death row than it does to keep them in for life because of all the appeals. Not that I’m against the death penalty. Obama is basically saying that he would want his own grandma to get hip surgery, but he doesn’t really care about anyone else’s grandma.

  • LAJ

    Actually, from what I’ve heard, it costs more to have someone on death row than it does to keep them in for life because of all the appeals. Not that I’m against the death penalty. Obama is basically saying that he would want his own grandma to get hip surgery, but he doesn’t really care about anyone else’s grandma.

  • Bruce

    One unspoken issue here is the tendency toward looser standards once an “unethical” door is opened. This is anecdotal, but I’ve had conversations with Brits here in America (Here, among other reasons, for the health care) that in England, they are drifting toward denying more and more health care to healthier and healthier individuals. People are dying from cancers that are treatable there, not because they are terminal, but because it “costs too much” to treat.

    It doesn’t matter the safeguards. Once people’s self interest is related to denying others healthcare, the Robespierrian drift will happen. In the meantime, is it true that America is the only place left on the planet where drug companies can afford to do serious R&D? That door may also close when the government runs the health care industry. You can argue theoretically against this as Ralph Nader has tried to do, but you can’t ignore the fact that we are developing each new generation of life-saving drugs for the world.

    I’m not saying there are easy answers to all of this. The situation as we find it is not encouraging, especially to those who have been left without health insurance. We were in that situation for many years, and in a county where the average cost of health care is 55% above the national average, we ran up bills for silly little procedures at a rate that took our breath away. But if the nasty, brutish market is not allowed a substantial say in this field, we will probably end up like Canada, or even worse, Britain.

  • Bruce

    One unspoken issue here is the tendency toward looser standards once an “unethical” door is opened. This is anecdotal, but I’ve had conversations with Brits here in America (Here, among other reasons, for the health care) that in England, they are drifting toward denying more and more health care to healthier and healthier individuals. People are dying from cancers that are treatable there, not because they are terminal, but because it “costs too much” to treat.

    It doesn’t matter the safeguards. Once people’s self interest is related to denying others healthcare, the Robespierrian drift will happen. In the meantime, is it true that America is the only place left on the planet where drug companies can afford to do serious R&D? That door may also close when the government runs the health care industry. You can argue theoretically against this as Ralph Nader has tried to do, but you can’t ignore the fact that we are developing each new generation of life-saving drugs for the world.

    I’m not saying there are easy answers to all of this. The situation as we find it is not encouraging, especially to those who have been left without health insurance. We were in that situation for many years, and in a county where the average cost of health care is 55% above the national average, we ran up bills for silly little procedures at a rate that took our breath away. But if the nasty, brutish market is not allowed a substantial say in this field, we will probably end up like Canada, or even worse, Britain.

  • Joe

    “Obama is basically saying that he would want his own grandma to get hip surgery, but he doesn’t really care about anyone else’s grandma.”

    That is actually a completely rational position (it may not be compasionate – but it is rational). Now take Obama out and replace it with his independant health care supervisory board and you lose even the incentive to give Obama’s grandma the new hip.

  • Joe

    “Obama is basically saying that he would want his own grandma to get hip surgery, but he doesn’t really care about anyone else’s grandma.”

    That is actually a completely rational position (it may not be compasionate – but it is rational). Now take Obama out and replace it with his independant health care supervisory board and you lose even the incentive to give Obama’s grandma the new hip.

  • http://www.toddstadler.com/ tODD

    Have I missed a large headline here? Does Obama’s health-care reform include the complete dismantling of private health care? Will there only be government-provided health care, under his new plan?

    If not, then what is everybody complaining about? If your grandmother wants a hip replacement at the age of 90, she or you will still be able to buy one, no matter how expensive or effective anyone may think it’ll be.

    The only question I see here is whether Medicare — or some un-named plan for the non-elderly — will pay for that hip replacement.

    Now, I’m assuming that those complaining about this Obama interview likely oppose the idea of government-run health care in the first place. So why are you arguing that, if we’re going to have some form of it, that it should pay for whatever treatment you think it should?

  • http://www.toddstadler.com/ tODD

    Have I missed a large headline here? Does Obama’s health-care reform include the complete dismantling of private health care? Will there only be government-provided health care, under his new plan?

    If not, then what is everybody complaining about? If your grandmother wants a hip replacement at the age of 90, she or you will still be able to buy one, no matter how expensive or effective anyone may think it’ll be.

    The only question I see here is whether Medicare — or some un-named plan for the non-elderly — will pay for that hip replacement.

    Now, I’m assuming that those complaining about this Obama interview likely oppose the idea of government-run health care in the first place. So why are you arguing that, if we’re going to have some form of it, that it should pay for whatever treatment you think it should?

  • http://www.hempelstudios.blogspot.com Sarah in Exile

    I think that all this talk of health care is more and more complicated. In general, I tend to be more “free market,” but recently I looked at what we spend on insurance. Medical, vision, dental, short-term disability, long-term disability and life insurance. We spend A LOT. That doesn’t include any goings to the doctor, dentist or getting new glasses that might happen. I am in a high tax bracket and I have to space out any doctor’s visits and my husband and I have to go to the dentist at different times of the year. Thank God we aren’t on any prescriptions. The cost is oppressive just for normal, healthy people even people who work for fortune 500 companies and have what would be considered good insurance.

    Now, take me, who has a chronic disease that “regular” medicine cannot treat. So I go to chiropractors, accupuncturists and naturopaths. I spend a lot on supplements and herbs. AND THEY HELP.

    Even if we had socialized medicine, I’d still be paying out of my pocket. So would many other Americans.

    We can’t win. Americans are still the unhealthiest people in the developed world and we don’t live as long.

  • http://www.hempelstudios.blogspot.com Sarah in Exile

    I think that all this talk of health care is more and more complicated. In general, I tend to be more “free market,” but recently I looked at what we spend on insurance. Medical, vision, dental, short-term disability, long-term disability and life insurance. We spend A LOT. That doesn’t include any goings to the doctor, dentist or getting new glasses that might happen. I am in a high tax bracket and I have to space out any doctor’s visits and my husband and I have to go to the dentist at different times of the year. Thank God we aren’t on any prescriptions. The cost is oppressive just for normal, healthy people even people who work for fortune 500 companies and have what would be considered good insurance.

    Now, take me, who has a chronic disease that “regular” medicine cannot treat. So I go to chiropractors, accupuncturists and naturopaths. I spend a lot on supplements and herbs. AND THEY HELP.

    Even if we had socialized medicine, I’d still be paying out of my pocket. So would many other Americans.

    We can’t win. Americans are still the unhealthiest people in the developed world and we don’t live as long.

  • John C

    Most developed states have some form of national health scheme.Australians are quite proud of Medicare despite underfunding and the occasioal scandal. The notion that a universal health scheme is the first step on the slippery slope of socialism is ridiculous. I might add that the majority of Australians support euthanasia.

  • John C

    Most developed states have some form of national health scheme.Australians are quite proud of Medicare despite underfunding and the occasioal scandal. The notion that a universal health scheme is the first step on the slippery slope of socialism is ridiculous. I might add that the majority of Australians support euthanasia.

  • http://lionswardrobe.blogspot.com Eric R.

    I think the Church needs to get ready to do what they can to help those in need. One thought/proposal that I’ve had is this: The Church needs to start certifying its own doctors, medical researchers, pharmacists, nurses, medical schools, etc. The process need not be any less strenuous than it is now, but if efforts were to start now, I think that we will find the process is largely underway with Catholic hospitals, medical schools, etc.

    This would take a lot of effort, coordination, and capital, but it would circumvent the entire socialized medical program (to say nothing of FOCA), and it would allow Christians to support their neighbors in this body and life, even though the state say they are no longer worth sustaining. This is one way we can show God’s love to our neighbors. I’d also bet that the more libertarian congressmen and political parties would support us in our efforts, which could help ease the transition.

    If this were to come together under the auspices of religious love and conviction, I’d love to see the fallout when Obama and his totalitarian crew try to overpower them or force them out. It would take an authoritarian decree to overpower the Church, and at that point, everybody would realize that “religious liberty” — including the freedom to care for the sick and impoverished — is simply a formality and is never actually defended.

  • http://lionswardrobe.blogspot.com Eric R.

    I think the Church needs to get ready to do what they can to help those in need. One thought/proposal that I’ve had is this: The Church needs to start certifying its own doctors, medical researchers, pharmacists, nurses, medical schools, etc. The process need not be any less strenuous than it is now, but if efforts were to start now, I think that we will find the process is largely underway with Catholic hospitals, medical schools, etc.

    This would take a lot of effort, coordination, and capital, but it would circumvent the entire socialized medical program (to say nothing of FOCA), and it would allow Christians to support their neighbors in this body and life, even though the state say they are no longer worth sustaining. This is one way we can show God’s love to our neighbors. I’d also bet that the more libertarian congressmen and political parties would support us in our efforts, which could help ease the transition.

    If this were to come together under the auspices of religious love and conviction, I’d love to see the fallout when Obama and his totalitarian crew try to overpower them or force them out. It would take an authoritarian decree to overpower the Church, and at that point, everybody would realize that “religious liberty” — including the freedom to care for the sick and impoverished — is simply a formality and is never actually defended.

  • Joe

    tODD – One of the main reasons I oppose gov’t run health care is because of the gov’t’s ability to limit choices. Obama’s plan is still not finalized (as far as I know) but in the interview he suggested that an independent review board be created to determine whether or not we as a society are going to pay for certain services. So, I am not arguing that gov’t run health care should pay for everything, I am arguing that gov’t run healthcare is a bad idea because it won’t (and can’t) pay for the care that people may want. (I have other objections too). I don’t want to give up the choice to buy more care.

    Including the option to continue to buy extra care would probably make it more palatable to some objectors.

    Sarah – just remember that we don’t have a free market in health care right now. So the options are do nothing or socialize medicine. We can blow up the health care industry as we know it and bring in more true market principles.

  • Joe

    tODD – One of the main reasons I oppose gov’t run health care is because of the gov’t’s ability to limit choices. Obama’s plan is still not finalized (as far as I know) but in the interview he suggested that an independent review board be created to determine whether or not we as a society are going to pay for certain services. So, I am not arguing that gov’t run health care should pay for everything, I am arguing that gov’t run healthcare is a bad idea because it won’t (and can’t) pay for the care that people may want. (I have other objections too). I don’t want to give up the choice to buy more care.

    Including the option to continue to buy extra care would probably make it more palatable to some objectors.

    Sarah – just remember that we don’t have a free market in health care right now. So the options are do nothing or socialize medicine. We can blow up the health care industry as we know it and bring in more true market principles.

  • http://www.toddstadler.com/ tODD

    Joe (@8), again I ask my question: where has anyone read that Obama’s plan precludes the ability of citizens to buy private health care? All the reactions here seemingly assume that there will be no ability to go to a doctor and pay (out of pocket) for whatever procedure you want. Where are you getting that idea?

  • http://www.toddstadler.com/ tODD

    Joe (@8), again I ask my question: where has anyone read that Obama’s plan precludes the ability of citizens to buy private health care? All the reactions here seemingly assume that there will be no ability to go to a doctor and pay (out of pocket) for whatever procedure you want. Where are you getting that idea?

  • http://www.newreformationpress.com Patrick Kyle

    tODD,

    Check out this video- it answers your question.

    http://www.breitbart.tv/html/330913.html

  • http://www.newreformationpress.com Patrick Kyle

    tODD,

    Check out this video- it answers your question.

    http://www.breitbart.tv/html/330913.html

  • http://www.newreformationpress.com Patrick Kyle

    Looks like that video is in “copyright dispute” Sorry.
    The video shows Dem Congresswoman Rep Jan Schackowski admitting to the cheers of a crowd that the ultimate goal is the destruction of all private healthcare insurance. She relates a conversation she had with the representative of the health insurance industry in which he says he’s afraid of what is going to happen regarding private health insurance, and she tells him he should be. Then she goes on to talk about single payer gov’t insurance to the cheers of the crowd.

  • http://www.newreformationpress.com Patrick Kyle

    Looks like that video is in “copyright dispute” Sorry.
    The video shows Dem Congresswoman Rep Jan Schackowski admitting to the cheers of a crowd that the ultimate goal is the destruction of all private healthcare insurance. She relates a conversation she had with the representative of the health insurance industry in which he says he’s afraid of what is going to happen regarding private health insurance, and she tells him he should be. Then she goes on to talk about single payer gov’t insurance to the cheers of the crowd.

  • DonS

    A major problem with our current healthcare system is that too many people have completely free access to healthcare. Because of this, they overuse the system, and this drives up costs for everyone else (supply and demand still rules).

    If you have to provide your own health insurance, as I do, you quickly learn that a high deductible policy costs about 1/4 of the price of a “Cadillac” first dollar plan. To address the costs in the system, and ensure that it is accessible to all, everyone needs to pay SOMETHING for care. Not enough to deter them from seeking medical care for genuine health problems, but enough to deter them from running to the emergency room every time they have the sniffles. Health care needs to be seen as valuable to its consumers, and its consumers need to be aware of the cost of providing care, so that it is consumed wisely.

  • DonS

    A major problem with our current healthcare system is that too many people have completely free access to healthcare. Because of this, they overuse the system, and this drives up costs for everyone else (supply and demand still rules).

    If you have to provide your own health insurance, as I do, you quickly learn that a high deductible policy costs about 1/4 of the price of a “Cadillac” first dollar plan. To address the costs in the system, and ensure that it is accessible to all, everyone needs to pay SOMETHING for care. Not enough to deter them from seeking medical care for genuine health problems, but enough to deter them from running to the emergency room every time they have the sniffles. Health care needs to be seen as valuable to its consumers, and its consumers need to be aware of the cost of providing care, so that it is consumed wisely.

  • http://www.newreformationpress.com Patrick Kyle

    Gotta love you tube

  • http://www.newreformationpress.com Patrick Kyle

    Gotta love you tube

  • Joe

    I never said Obama even has a formal proposal – i don’t think he does yet. I am just referring to the interview he gave to NYT Mag. In it he suggests that we need a board to give us guidance on what treatments should be made available in certain situations because of the cost factors. I am not saying that Obama is going end all private health care (if I came off that way it is just sloppiness – not intentional). My only point is that this is not a good idea.

  • Joe

    I never said Obama even has a formal proposal – i don’t think he does yet. I am just referring to the interview he gave to NYT Mag. In it he suggests that we need a board to give us guidance on what treatments should be made available in certain situations because of the cost factors. I am not saying that Obama is going end all private health care (if I came off that way it is just sloppiness – not intentional). My only point is that this is not a good idea.

  • fws

    “…why you have to have some independent group that can give you guidance”…

    this SHOULD look like congress. REPRESENTATIVE republican government as opposed to democracy.

    Our founders did not believe in democracy. Neither do I.

    I HATE the initiative process in california where 51% can actually change the constitution on a whim. This is wrong.

    Gay marriage imposed by court order was unwise. I argue that prop 8 was even less wise. Means matter often as much or more than ends.

    Dr Vieth, the authors of this article could have used this as a teaching moment. instead they use it to stoke fears.

  • fws

    “…why you have to have some independent group that can give you guidance”…

    this SHOULD look like congress. REPRESENTATIVE republican government as opposed to democracy.

    Our founders did not believe in democracy. Neither do I.

    I HATE the initiative process in california where 51% can actually change the constitution on a whim. This is wrong.

    Gay marriage imposed by court order was unwise. I argue that prop 8 was even less wise. Means matter often as much or more than ends.

    Dr Vieth, the authors of this article could have used this as a teaching moment. instead they use it to stoke fears.

  • http://www.toddstadler.com/ tODD

    Patrick, I watched your subsequent YouTube link (@13), and, sorry, but it does not show “Congresswoman Rep Jan Schackowski admitting to the cheers of a crowd that the ultimate goal is the destruction of all private healthcare insurance.”

    What it does show is her talking about a government-run health care system operating in parallel with private ones, and her claim (which can be debated independently) that the government system will be so much better, that private health care companies should be scared — that is, because they are currently so inefficient, bloated, horrible, etc. And I think very few here would argue the latter points very much. Private health care is pretty lousy.

    But what I do not get from that speech (which was edited, so I can’t get the full context) is that a well-run private health care company — one that offers more or is better-run than the government one, which shouldn’t be too hard — would have anything to fear from Obama’s plan.

  • http://www.toddstadler.com/ tODD

    Patrick, I watched your subsequent YouTube link (@13), and, sorry, but it does not show “Congresswoman Rep Jan Schackowski admitting to the cheers of a crowd that the ultimate goal is the destruction of all private healthcare insurance.”

    What it does show is her talking about a government-run health care system operating in parallel with private ones, and her claim (which can be debated independently) that the government system will be so much better, that private health care companies should be scared — that is, because they are currently so inefficient, bloated, horrible, etc. And I think very few here would argue the latter points very much. Private health care is pretty lousy.

    But what I do not get from that speech (which was edited, so I can’t get the full context) is that a well-run private health care company — one that offers more or is better-run than the government one, which shouldn’t be too hard — would have anything to fear from Obama’s plan.

  • http://www.toddstadler.com/ tODD

    Joe (@14), can you name me one health care plan — private or otherwise — that does not limit treatments based on cost factors? Even if you’re paying for your own health insurance, you have to make the same decisions. There are some things you can pay for, and others you can’t. So why is the fact that the government-run health system will have to make those calls so shocking? Why do people here so oppose limiting care, when their own current health plans also do that?

  • http://www.toddstadler.com/ tODD

    Joe (@14), can you name me one health care plan — private or otherwise — that does not limit treatments based on cost factors? Even if you’re paying for your own health insurance, you have to make the same decisions. There are some things you can pay for, and others you can’t. So why is the fact that the government-run health system will have to make those calls so shocking? Why do people here so oppose limiting care, when their own current health plans also do that?

  • Rudi

    To Sara (7)
    Not living as long is a blessing, not curse. This from a 78 yr old, but I do not want to be helped along.

  • Rudi

    To Sara (7)
    Not living as long is a blessing, not curse. This from a 78 yr old, but I do not want to be helped along.

  • Joe

    tODD – my health care plan allows me to buy what ever I want. Sometimes that means I have to pay for 100% of it. I get to make the choice of whether to pay for it or not. That is not necessarily true of gov’t run health care systems. As I said, it could still be available to me and that would make gov’t run health care more palatable.

  • Joe

    tODD – my health care plan allows me to buy what ever I want. Sometimes that means I have to pay for 100% of it. I get to make the choice of whether to pay for it or not. That is not necessarily true of gov’t run health care systems. As I said, it could still be available to me and that would make gov’t run health care more palatable.

  • http://www.toddstadler.com/ tODD

    Um, Joe (@21), you’ll notice that, per your own description, your own health care plan has made decisions on what they’ll pay for — some things they may cover entirely, some things only partially, and some not at all. This is exactly what the government is going to do. Unless you can show me otherwise (and no one yet has), the government will also “allow you to buy whatever you want”, sometimes “allowing” you to pay 100% for it.

    Of course, even when you’re paying 100% for it, I’ll wager that decisions are made as to whether something is necessary or effective, and I’ll further wager that you don’t make all the purchases you could want — or at least that would be the case in certain situations. When one is paying for one’s own health care, one is necessarily limited to what one can afford, not merely “what ever I want”, because funds are limited.

    So why, again, is it so shocking when the government also has limited funds and has to limit care?

  • http://www.toddstadler.com/ tODD

    Um, Joe (@21), you’ll notice that, per your own description, your own health care plan has made decisions on what they’ll pay for — some things they may cover entirely, some things only partially, and some not at all. This is exactly what the government is going to do. Unless you can show me otherwise (and no one yet has), the government will also “allow you to buy whatever you want”, sometimes “allowing” you to pay 100% for it.

    Of course, even when you’re paying 100% for it, I’ll wager that decisions are made as to whether something is necessary or effective, and I’ll further wager that you don’t make all the purchases you could want — or at least that would be the case in certain situations. When one is paying for one’s own health care, one is necessarily limited to what one can afford, not merely “what ever I want”, because funds are limited.

    So why, again, is it so shocking when the government also has limited funds and has to limit care?

  • DonS

    These slides, issued today by the Senate Finance Committee, should put to rest any notion of a parallel private insurance system, at least for any period of time. http://www.thenewatlantis.com/docLib/20090514_SFCCoverage51409.pdf

    Only four options are being proposed, and only pre-existing private plans not meeting the requirements of one of these options, will be permitted to continue to exist. But these grandfathered plans will not be permitted to enroll new subscribers, so they will not be viable for long. Employer health plans will be essentially phased out. Single payer, here we come. Canadians come to the U.S. to avoid 1-2 year wait lists for routine (and sometimes urgent) procedures. Where will we go?

  • DonS

    These slides, issued today by the Senate Finance Committee, should put to rest any notion of a parallel private insurance system, at least for any period of time. http://www.thenewatlantis.com/docLib/20090514_SFCCoverage51409.pdf

    Only four options are being proposed, and only pre-existing private plans not meeting the requirements of one of these options, will be permitted to continue to exist. But these grandfathered plans will not be permitted to enroll new subscribers, so they will not be viable for long. Employer health plans will be essentially phased out. Single payer, here we come. Canadians come to the U.S. to avoid 1-2 year wait lists for routine (and sometimes urgent) procedures. Where will we go?

  • Bruce

    An option that we used for fifteen years was called Christian Care Medi-Share. Unfortunately, this plan did not do anything marketwise to effect medical care, but it is an example of Christians banding together (Eric R.; Comment #9) to help share medical costs. It wasn’t great coverage, but meant we were able to avoid financial ruin while keeping our kids healthy. We also use a wide array of natural stuff (such as eating healthily, chiropractic, homeopathy) which was at least in part the result of not having the great coverage.

    I think part of the problem we’ve had in this country is a certain large portion of the population has had for years grade A insurance coverage which has allowed them unlimited doctor visits and a certain freedom to abuse their health (this idea may have to be unpacked a bit), while another large portion has had no coverage at all. We found out after years of no coverage that the clinics actually charge the people with no insurance much higher rates than they charge the insurance companies. I mean: a 15 minute consult costing us $300, come on. This is along the lines of giving discounts to high volume clients, of course. But we felt we carried a much higher burden as uninsureds than was fair.

    My hope is that we can look honestly at the shortcomings of the European and Canadian systems and be more creative in how we advance coverage to more people. I’m a bit cynical that, given the players, the size of the population, and the almost unlimited possibilities for corruption, we’ll be able to do that.

  • Bruce

    An option that we used for fifteen years was called Christian Care Medi-Share. Unfortunately, this plan did not do anything marketwise to effect medical care, but it is an example of Christians banding together (Eric R.; Comment #9) to help share medical costs. It wasn’t great coverage, but meant we were able to avoid financial ruin while keeping our kids healthy. We also use a wide array of natural stuff (such as eating healthily, chiropractic, homeopathy) which was at least in part the result of not having the great coverage.

    I think part of the problem we’ve had in this country is a certain large portion of the population has had for years grade A insurance coverage which has allowed them unlimited doctor visits and a certain freedom to abuse their health (this idea may have to be unpacked a bit), while another large portion has had no coverage at all. We found out after years of no coverage that the clinics actually charge the people with no insurance much higher rates than they charge the insurance companies. I mean: a 15 minute consult costing us $300, come on. This is along the lines of giving discounts to high volume clients, of course. But we felt we carried a much higher burden as uninsureds than was fair.

    My hope is that we can look honestly at the shortcomings of the European and Canadian systems and be more creative in how we advance coverage to more people. I’m a bit cynical that, given the players, the size of the population, and the almost unlimited possibilities for corruption, we’ll be able to do that.

  • http://lionswardrobe.blogspot.com Eric R.

    I don’t really care about a parallel health insurance system. I want a parallel health care system. Our own doctors, our own nurses, our own hospitals, our own pharmaceutical companies, our own medical school, our own Hippocratic Oath, our own policies, our own certification, etc. If Obama and all the socialists want to require all patients to go to government care facilities and to see only government-approved physicians, let’s exercise the free market and create competition. We’ll see which one of them offers better care. If it does get up and running, only a few things can happen.

    1. Obama lets it happen (or can’t stop it from happening), and private health care provides better care than government-run facilities. The free market would eventually win because the government facilities will eventually see fewer and fewer clients.
    2. Obama lets it happen (or can’t stop it from happening), and government facilities are far superior to the privately run, privately funded system. In this case, the free market wins again because the inferior system will go out of business.
    3. Obama squashes the effort for any reason whatsoever. The free market will continue to win out, but it will hurt the poor because only the rich will be able to pay off private doctors to supplement their government pay.

    It would be difficult, but I think you’d find enough doctors willing to adapt their practice to pro-life values (and a lot of them might even accept a pay cut) if the only other option is to become an employee of the federal government.

    I talked to a liberal doctor here in St. Louis. He’s opposed to socialized health care, and he gave his reason like this: “What do I do if I’m required to treat some guy who’s been shot, and some gang-banger has a gun to my head telling me that he’ll kill me if I operate?”

  • http://lionswardrobe.blogspot.com Eric R.

    I don’t really care about a parallel health insurance system. I want a parallel health care system. Our own doctors, our own nurses, our own hospitals, our own pharmaceutical companies, our own medical school, our own Hippocratic Oath, our own policies, our own certification, etc. If Obama and all the socialists want to require all patients to go to government care facilities and to see only government-approved physicians, let’s exercise the free market and create competition. We’ll see which one of them offers better care. If it does get up and running, only a few things can happen.

    1. Obama lets it happen (or can’t stop it from happening), and private health care provides better care than government-run facilities. The free market would eventually win because the government facilities will eventually see fewer and fewer clients.
    2. Obama lets it happen (or can’t stop it from happening), and government facilities are far superior to the privately run, privately funded system. In this case, the free market wins again because the inferior system will go out of business.
    3. Obama squashes the effort for any reason whatsoever. The free market will continue to win out, but it will hurt the poor because only the rich will be able to pay off private doctors to supplement their government pay.

    It would be difficult, but I think you’d find enough doctors willing to adapt their practice to pro-life values (and a lot of them might even accept a pay cut) if the only other option is to become an employee of the federal government.

    I talked to a liberal doctor here in St. Louis. He’s opposed to socialized health care, and he gave his reason like this: “What do I do if I’m required to treat some guy who’s been shot, and some gang-banger has a gun to my head telling me that he’ll kill me if I operate?”

  • Joe

    tODD – I think we are talking past each other. I am expressing a fear that the end product we’ll get may eliminate any parallel private health care options. I am not accusing Obama of proposing a plan that does right now. My fear is primarily based on the fact that very few gov’t programs get smaller or give up more power overtime. You may think my fear is not rational. And that is fine; I am not asking you to share my concern I was just expressing it. I have not even asked anyone to disavow Obama’s plan (whatever it may be at this point).

  • Joe

    tODD – I think we are talking past each other. I am expressing a fear that the end product we’ll get may eliminate any parallel private health care options. I am not accusing Obama of proposing a plan that does right now. My fear is primarily based on the fact that very few gov’t programs get smaller or give up more power overtime. You may think my fear is not rational. And that is fine; I am not asking you to share my concern I was just expressing it. I have not even asked anyone to disavow Obama’s plan (whatever it may be at this point).

  • http://www.toddstadler.com/ tODD

    Don, the PDF you linked to (@23) is interesting, but its provenance is not clear, seeing as it is not actually found on the Senate Finance Committee’s Web site (nor can I find that exact PDF on their site). Having never heard of TheNewAtlantis.com, and not being sure who made that PDF, I’m going to have to remain suspicious.

    But I did find a somewhat similar PDF at the Senate Finance Committee’s site, with the same title and date, only much more content. Perhaps your PDF is a summary of this official document — though whether an authorized summary or Powerpoint version of it, we don’t seem to know.

    Anyhow, a skimming of that PDF at the Finance Committee’s site leads me to question your bold assertion that “These slides, issued today by the Senate Finance Committee, should put to rest any notion of a parallel private insurance system.” Just look at the first page: “Description of Policy Options” (emphasis mine).

    And then there’s this final paragraph in the introduction:

    This document and the options described in it are intended to spur discussion regarding proposed options for policies that the committee is scheduled to act on in June. While these proposed options are jointly offered for discussion, not all the options in this document have the support of Chairman Baucus or Ranking Member Grassley.

    So go ahead and skim that official, much more detailed document, and tell me you still think that there will be no place for new private plans, or for private plans to accept new subscribers. I don’t see that at all, though I admit I do not have the time to read the document in full. Yes, it does say that if new plans/subscribers are to exist, they must meet certain standards, but then, private plans must already meet certain government-mandated standards, as I understand things.

    So I still maintain that all this talk (or hinting or fear) about no private options under “Obama’s”* proposal is completely baseless.

    *You’ll note that the Senate Finance Committee, which isn’t even endorsing the ideas in this PDF, isn’t Obama.

  • http://www.toddstadler.com/ tODD

    Don, the PDF you linked to (@23) is interesting, but its provenance is not clear, seeing as it is not actually found on the Senate Finance Committee’s Web site (nor can I find that exact PDF on their site). Having never heard of TheNewAtlantis.com, and not being sure who made that PDF, I’m going to have to remain suspicious.

    But I did find a somewhat similar PDF at the Senate Finance Committee’s site, with the same title and date, only much more content. Perhaps your PDF is a summary of this official document — though whether an authorized summary or Powerpoint version of it, we don’t seem to know.

    Anyhow, a skimming of that PDF at the Finance Committee’s site leads me to question your bold assertion that “These slides, issued today by the Senate Finance Committee, should put to rest any notion of a parallel private insurance system.” Just look at the first page: “Description of Policy Options” (emphasis mine).

    And then there’s this final paragraph in the introduction:

    This document and the options described in it are intended to spur discussion regarding proposed options for policies that the committee is scheduled to act on in June. While these proposed options are jointly offered for discussion, not all the options in this document have the support of Chairman Baucus or Ranking Member Grassley.

    So go ahead and skim that official, much more detailed document, and tell me you still think that there will be no place for new private plans, or for private plans to accept new subscribers. I don’t see that at all, though I admit I do not have the time to read the document in full. Yes, it does say that if new plans/subscribers are to exist, they must meet certain standards, but then, private plans must already meet certain government-mandated standards, as I understand things.

    So I still maintain that all this talk (or hinting or fear) about no private options under “Obama’s”* proposal is completely baseless.

    *You’ll note that the Senate Finance Committee, which isn’t even endorsing the ideas in this PDF, isn’t Obama.

  • Don S

    tODD: well we really can’t yet get too far into the weeds on this, because we are still in the early proposal stage, obviously. There is not yet any introduced legislation, for example, so it is difficult to say what specifically will be proposed. But, the funding mechanisms for these new programs which I have seen have pretty much all called for taxing, in some way, employer provided health insurance. This will, necessarily, seriously change the landscape in the private insurance world, and there is no question that private options will be more limited than today. If “grandfathering” is part of the package, private plans will ultimately disappear, as enrollees die , no new enrollees are permitted, and the remaining insured pool becomes increasingly unprofitable as it ages. It will be interesting to see how things develop, however.

  • Don S

    tODD: well we really can’t yet get too far into the weeds on this, because we are still in the early proposal stage, obviously. There is not yet any introduced legislation, for example, so it is difficult to say what specifically will be proposed. But, the funding mechanisms for these new programs which I have seen have pretty much all called for taxing, in some way, employer provided health insurance. This will, necessarily, seriously change the landscape in the private insurance world, and there is no question that private options will be more limited than today. If “grandfathering” is part of the package, private plans will ultimately disappear, as enrollees die , no new enrollees are permitted, and the remaining insured pool becomes increasingly unprofitable as it ages. It will be interesting to see how things develop, however.

  • http://www.newreformationpress.com Patrick Kyle

    tODD,
    She may not have said the words “WE -WILL-DESTROY- PRIVATE -HEALTH-CARE.’ but that is exactly what a government run single payer plan will do.

    You said” Private health care is pretty lousy.”

    Really? My insurance is great, and when my wife was working and we had double coverage it was SWEET! The best doctors and hospitals… no waits, we can get the earliest open appointments, often the same or next day.

    I work in a retail store the city of Claremont, Ca (Pomona College, Scripps, Harvey Mudd, Claremont Mckenna,- yes, that Claremont) I find it interesting when I debate many of these students. When pushed, they will all finally admit that it is imperative that care be rationed in such a way that some people will die to keep health care available and affordable for the majority.

    Sorry dude, but that is b*))$&)t. Say what you want, but I think it is the heighth of naivete to think that letting the government make those decisions will be good for you or your family. If you want to throw yourself and your loved ones onto the government’s mercies, by all means go ahead.

  • http://www.newreformationpress.com Patrick Kyle

    tODD,
    She may not have said the words “WE -WILL-DESTROY- PRIVATE -HEALTH-CARE.’ but that is exactly what a government run single payer plan will do.

    You said” Private health care is pretty lousy.”

    Really? My insurance is great, and when my wife was working and we had double coverage it was SWEET! The best doctors and hospitals… no waits, we can get the earliest open appointments, often the same or next day.

    I work in a retail store the city of Claremont, Ca (Pomona College, Scripps, Harvey Mudd, Claremont Mckenna,- yes, that Claremont) I find it interesting when I debate many of these students. When pushed, they will all finally admit that it is imperative that care be rationed in such a way that some people will die to keep health care available and affordable for the majority.

    Sorry dude, but that is b*))$&)t. Say what you want, but I think it is the heighth of naivete to think that letting the government make those decisions will be good for you or your family. If you want to throw yourself and your loved ones onto the government’s mercies, by all means go ahead.

  • http://www.newreformationpress.com Patrick Kyle

    These two links are collectioons of Newspaper and magazine articles from the English and Canadian press that show what socialized medicine is like for those who live with it.

    http://www.liberty-page.com/issues/healthcare/socialized.html#britain

    http://www.liberty-page.com/issues/healthcare/socialized.html#canada

  • http://www.newreformationpress.com Patrick Kyle

    These two links are collectioons of Newspaper and magazine articles from the English and Canadian press that show what socialized medicine is like for those who live with it.

    http://www.liberty-page.com/issues/healthcare/socialized.html#britain

    http://www.liberty-page.com/issues/healthcare/socialized.html#canada

  • Larry

    To answer the question, yes. My wife who is in health care is constantly telling me this and that doctors and nurses on the ground, daily in the trenches already know that it, government health care (GHC), will not be a “pausability” if GHC goes, but a certitude.

    It will sneak in subtlely at first couched under “X” person is old and his/her lifestyle (e.g. smoking, over eating) lead to this, he/she shouldn’t be given “Y” (that which would save their life). It’s easier to “sell” to the public that way because then the public can justify it “legalisticaly” by saying, “It’s sad but if he/she just would not have smoked/eaten so much” or “Well he/she is 60 something and has led a good life.

  • Larry

    To answer the question, yes. My wife who is in health care is constantly telling me this and that doctors and nurses on the ground, daily in the trenches already know that it, government health care (GHC), will not be a “pausability” if GHC goes, but a certitude.

    It will sneak in subtlely at first couched under “X” person is old and his/her lifestyle (e.g. smoking, over eating) lead to this, he/she shouldn’t be given “Y” (that which would save their life). It’s easier to “sell” to the public that way because then the public can justify it “legalisticaly” by saying, “It’s sad but if he/she just would not have smoked/eaten so much” or “Well he/she is 60 something and has led a good life.

  • http://www.toddstadler.com/ tODD

    Don (@28), um … so have you now walked back your assertion that your PDF “should put to rest any notion of a parallel private insurance system”? It’s not clear. Because not only is there no “introduced legislation”, did you notice that there isn’t an overt proposal in that PDF of mine? They’re still discussiong the “options”!

    And your fixation on the whole “grandfathering” thing seems to miss that, grandfathered private companies aside, the options repeatedly discuss the existence of private companies that will be necessary under the new plan. Honestly: have you read through it, or at least skimmed it? If so, point me to a place in the PDF I cited where it precludes the existence of private companies (again, putting aside the grandfathered, existing private insurers).

  • http://www.toddstadler.com/ tODD

    Don (@28), um … so have you now walked back your assertion that your PDF “should put to rest any notion of a parallel private insurance system”? It’s not clear. Because not only is there no “introduced legislation”, did you notice that there isn’t an overt proposal in that PDF of mine? They’re still discussiong the “options”!

    And your fixation on the whole “grandfathering” thing seems to miss that, grandfathered private companies aside, the options repeatedly discuss the existence of private companies that will be necessary under the new plan. Honestly: have you read through it, or at least skimmed it? If so, point me to a place in the PDF I cited where it precludes the existence of private companies (again, putting aside the grandfathered, existing private insurers).

  • http://www.toddstadler.com/ tODD

    Patrick (@29), you said “DESTROY-ing]- PRIVATE -HEALTH-CARE” is “exactly what a government run single payer plan will do.” Really? Have you read through that Senate Finance PDF at all? Noted how it relies on the existence of private companies, operating through an “exchange”? I mean, maybe I’m misreading the options being batted around, but as far as I can tell, nobody else here has read that much.

    And while I’m glad you have great, private insurance, that hardly is the case for everyone. Get out and talk to some people, perhaps those less well off than you. I’m fairly middle-class, as far as I know, but I have friends who can’t afford health insurance, and so they don’t go into the hospital until things are truly bad. And I have private insurance, but I frequently have to wait a week or more just for an appointment, at which point I may get a referral to the doctor I actually need to see.

    And, you know, I’ve said this before, but all health care plans ration care! Your private one does, and even if you were paying for doctors out of your own pocket, you would, because money is finite in all these cases.

    You think that it’s better for some corporate bureaucrat to decide how much of your care to ration than the government. Fine. You’d rather your health matters to be decided based solely on corporate profitability. Fine. But please don’t pretend that it’s going to be oh-so-different under the options currently being discussed, at least without reading those options.

  • http://www.toddstadler.com/ tODD

    Patrick (@29), you said “DESTROY-ing]- PRIVATE -HEALTH-CARE” is “exactly what a government run single payer plan will do.” Really? Have you read through that Senate Finance PDF at all? Noted how it relies on the existence of private companies, operating through an “exchange”? I mean, maybe I’m misreading the options being batted around, but as far as I can tell, nobody else here has read that much.

    And while I’m glad you have great, private insurance, that hardly is the case for everyone. Get out and talk to some people, perhaps those less well off than you. I’m fairly middle-class, as far as I know, but I have friends who can’t afford health insurance, and so they don’t go into the hospital until things are truly bad. And I have private insurance, but I frequently have to wait a week or more just for an appointment, at which point I may get a referral to the doctor I actually need to see.

    And, you know, I’ve said this before, but all health care plans ration care! Your private one does, and even if you were paying for doctors out of your own pocket, you would, because money is finite in all these cases.

    You think that it’s better for some corporate bureaucrat to decide how much of your care to ration than the government. Fine. You’d rather your health matters to be decided based solely on corporate profitability. Fine. But please don’t pretend that it’s going to be oh-so-different under the options currently being discussed, at least without reading those options.

  • http://www.toddstadler.com/ tODD

    And Patrick (@30), are you aware that there are other countries besides UK and Canada that have “socialized medicine”? In fact, nearly every other major country has it. Do you think the UK and Canada are the best implementations? Or are they perhaps among the worst, which is why opponents of “socialized medicine” trot them out every time this discussion comes up? What countries do you think have better implementations? Do you know? Have you looked?

  • http://www.toddstadler.com/ tODD

    And Patrick (@30), are you aware that there are other countries besides UK and Canada that have “socialized medicine”? In fact, nearly every other major country has it. Do you think the UK and Canada are the best implementations? Or are they perhaps among the worst, which is why opponents of “socialized medicine” trot them out every time this discussion comes up? What countries do you think have better implementations? Do you know? Have you looked?

  • DonS

    tODD @ 32: I haven’t walked back on anything. I think it is quite clear that private insurance will be phased out if a government plan comes in, and the proposals you and I have linked to (different slide sets for basically the same concepts, I believe) bear that out for the reasons I discussed above. But show me a proposed plan that offers a credible ongoing viable parallel private industry, if you want to argue otherwise. Yes, sure, private companies are still mentioned, but it appears to me that they will be plan administrators rather than actual insurers, a role the government will take over. As you know, Medicare uses private insurers to administer many of its programs, but its still government insurance.

    My original post above (#14) still reflects my view. The only way to control costs and limit rationing is to move to a model of low cost high deductible plans, combined with HSA’s to cover the deductibles. I love my plan, which, once the deductible is reached, covers every dollar of ongoing expenses for the year, and also fully covers, with no deductible or copayment, all preventive health care. My HSA covers my deductible, and may be carried over from year to year. Once you are 59 1/2, those funds can be used for non-medical expenses with no tax penalty (you do have to pay income taxes on the funds if they are used for non-medical expenses). Why not go to that model, and subsidize the premiums and fund the HSA’s for those under certain income limits? Because the HSA is your savings account, you have an incentive to be more careful about using it for trivial doctor visits, and to be a little more careful about costs, but it is available if you are sick. I think we should scrap Medicare and Medicaid, and go fully in this direction.

  • DonS

    tODD @ 32: I haven’t walked back on anything. I think it is quite clear that private insurance will be phased out if a government plan comes in, and the proposals you and I have linked to (different slide sets for basically the same concepts, I believe) bear that out for the reasons I discussed above. But show me a proposed plan that offers a credible ongoing viable parallel private industry, if you want to argue otherwise. Yes, sure, private companies are still mentioned, but it appears to me that they will be plan administrators rather than actual insurers, a role the government will take over. As you know, Medicare uses private insurers to administer many of its programs, but its still government insurance.

    My original post above (#14) still reflects my view. The only way to control costs and limit rationing is to move to a model of low cost high deductible plans, combined with HSA’s to cover the deductibles. I love my plan, which, once the deductible is reached, covers every dollar of ongoing expenses for the year, and also fully covers, with no deductible or copayment, all preventive health care. My HSA covers my deductible, and may be carried over from year to year. Once you are 59 1/2, those funds can be used for non-medical expenses with no tax penalty (you do have to pay income taxes on the funds if they are used for non-medical expenses). Why not go to that model, and subsidize the premiums and fund the HSA’s for those under certain income limits? Because the HSA is your savings account, you have an incentive to be more careful about using it for trivial doctor visits, and to be a little more careful about costs, but it is available if you are sick. I think we should scrap Medicare and Medicaid, and go fully in this direction.


CLOSE | X

HIDE | X