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How Doctors Die (2011)

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Re: How Doctors Die (2011)

#81

Post by gtaylor »

javert wrote: post #75
_delirium wrote: post #52

Earlier quoted context omitted.

Ah, well that's where we disagree. I can't control what genes I'm born with, and I don't think there's anything wrong with socializing those risks across the population. Let's say there's a 1% risk of me being born with some condition. I think it's perfectly fair for me to pay 1% of the cost of treating that condition, whether I'm born with it or not. I don't see why I should pay 100% the cost if I get unlucky in the…

I can't control what genes I'm born with, and I don't think there's anything wrong with socializing those risks across the population. What's wrong with it is that you're initiating force against me, and making my life manifestly worse. I mean, as someone who can pay for my own healthcare, this is what I get out of socialized medicine in the US: (1) Less money to spend on my own healthcare issues (2) Regulations that…

You know, these posts sound a lot like "I've got mine, screw you."

Am I rare in that I wouldn't mind paying a little more if it'd mean that the country would be legitimately happier/healthier? Whether that be socialized healthcare, single-payer, or any combination.

Re: How Doctors Die (2011)

#82

Post by redler »

javert wrote: post #75
_delirium wrote: post #52

Earlier quoted context omitted.

Ah, well that's where we disagree. I can't control what genes I'm born with, and I don't think there's anything wrong with socializing those risks across the population. Let's say there's a 1% risk of me being born with some condition. I think it's perfectly fair for me to pay 1% of the cost of treating that condition, whether I'm born with it or not. I don't see why I should pay 100% the cost if I get unlucky in the…

I can't control what genes I'm born with, and I don't think there's anything wrong with socializing those risks across the population. What's wrong with it is that you're initiating force against me, and making my life manifestly worse. I mean, as someone who can pay for my own healthcare, this is what I get out of socialized medicine in the US: (1) Less money to spend on my own healthcare issues (2) Regulations that…

You cover a lot of ground here -- socialized medicine, Obama, government regulation, "initiation of force", the fall of the Soviet Union. But just to select one:

"...as someone who can pay for my own healthcare..."

What should be done about the people who cannot?

Your profile reveals that you're an Ayn Rand fan; I don't believe Rand provided an answer to this question, other than to posit that harnessing the collective resources of society to address it, in any way, destroys essential freedom. Do you propose that "The Virtue of Selfishness" would be an effective and moral organizing principle for modern society?

Re: How Doctors Die (2011)

#83

Post by javert »

quasque wrote: post #72
javert wrote: post #71

Earlier quoted context omitted.

No, the system you describe is chillingly brutal and callous. It is your system that is done at the point of a gun, not mine.

I don't think one could conceive a metaphor more archetypal of the US than "done at the point of a gun" -- but what do you mean by that, in terms of the UK health system?

"Done at the point of a gun" means that you're being forced to do it. If you say "no," they take what they want anyway, and lock you up.

Re: How Doctors Die (2011)

#84

Post by quasque »

javert wrote: post #83
quasque wrote: post #72

Earlier quoted context omitted.

I don't think one could conceive a metaphor more archetypal of the US than "done at the point of a gun" -- but what do you mean by that, in terms of the UK health system?

"Done at the point of a gun" means that you're being forced to do it. If you say "no," they take what they want anyway, and lock you up.

Doing what? Being forced to pay taxes? That happens in every country and is surely a more general complaint, if it is indeed one at all.

Re: How Doctors Die (2011)

#85

Post by jonpeda »

bstewartny wrote: post #30

I dont know. Its one thing when you are 65 and all your kids are grown up. Its a whole other thing when you are 50 and have young children at home. I have a friend with 4 young kids. He has stage 4 cancer requiring constant chemo and pain, but he is going to fight it with everything they have in order to be there as long as possible with his kids - and maybe beat it.

Some people choose to stop fighting, gain a few weeks or months of reduced pain and better (temporary) health, and settle affairs as best they can. Remember, if chemo doesn't work, then it is a longer, more painful demise.

It's a hard tradeoff. Maximize the quality time you have, and prepare for your family's future -- especially before the diagnosis comes.

Re: How Doctors Die (2011)

#87

Post by fernly »

richardlblair wrote: post #10

I've saw this article back in 2011. Sometime after that I had conversations with my Grandmother and Mother about their wishes. I now know their expectations, and they know mine. It's important to think about death, and these situations. It's even more important to express your feelings to those who have the power to impact how you will be treated.

This is very good, but you need more than verbal undertakings. You need paper, in particular you need a Medical Power of Attorney, a notarized document authorizing you to make medical decisions on behalf of your Mother and Grandmother (and your Mother, for the Grandmother) (oh, and mutually reciprocal ones for you and your spouse if any).

Without that paper, hospital personnel may ignore you when you say what she wanted, in fact may feel they are legally required to ignore you.

And the paper needs to be accessible on short notice (not in a bank safety-deposit box). It's a good idea to have a copy filed at her primary care doctor's office.

Re: How Doctors Die (2011)

#88

Post by Rinum »

djt wrote: post #44
ChuckMcM wrote: post #25

Earlier quoted context omitted.

I suppose if the goal was karma farming then to be complete you would first repost a highly ranked story and then you would repost the highest ranked comment on your repost. And presumably if the same people read it again and voted again then you would capture the most possible re-karma points :-)

Luckily karma doesn't mean anything :D

Does it not? I thought higher karma results in your submissions and comments being ranked higher/viewed more.

Re: How Doctors Die (2011)

#89

Post by SoftwareMaven »

javert wrote: post #76
SoftwareMaven wrote: post #56

Earlier quoted context omitted.

Having been denied insurance because of a procedure that I underwent to make me considerably more healthy, I call bullshit. How do you "not cover" the result of a procedure that impacted every aspect of my life while covering everything else? Naked capitalism and healthcare can't work together (and this coming from somebody who strongly believes the government has way too many fingers in way too many pies). The prior…

I do think government regulation (in particular, the tax benefit for companies providing insurance) have made the situation far worse than it needs to be. In the end, it's an incredibly complex problem that should not be handled in at the Federal level Then you are arguing on the wrong side. You are like the Republican Party. You argue that one thing is practical, but another thing is moral. You cede the moral high g…

I'm not "arguing on the wrong side". When you have 300 million people, you have a choice: rule by fiat or slice things into smaller pieces, because 300M people are never going to agree. State populations, on the other hand, are much more closely aligned, making an intractable problem at the federal level tractable at the state level (like many other problems). I'll get back to the government regulation in a minute, but first...

I'm not asking "you" to cover my procedure. I'm asking to be allowed into a shared risk pool at any cost due to having had a procedure. Regardless, when you buy into a shared risk pool, guess what, you have to share the risk. You can't say "I'm not sick, so I shouldn't have to pay for sick people." Your option is to buy in or not. As a personal insurance companies have smiled upon, a person has their choice to not buy in or not; for those of us they frown at, we don't have choice to buy in (short of being part of a corporate plan).

And that gets back to where the regulation has caused problems: it's set the entire industry up to have insurance companies be the customers of medical care instead of individuals, leading to all kinds of weird incentives.

For healthy people and relatively rich people, naked capitalism would be fine for healthcare. However, government is (well, should be;) about more than just building roads and bombers. It should be an embodiment of a shared responsibility we have to each other. I put reasonable[1] levels of healthcare in that shared responsibility.

I think a single-payer system, especially in the US, would fail horribly. I think we need more competition and not less. I think, most importantly, the customer for medical care (ie the person who ultimately sees the bill) should be the individual (failure of any price consciousness is another part of what got us into this situation).

But I also think everybody should have access to good quality care at prices they can afford. Today, there is an entire middle-class (not "The Middle-class") that makes too much for medicaid and too little for insurance that are just screwed. Have cancer? Too bad if you want to fight it, because one dose of the medication costs more than you make in a day. That is just inhumane and pure capitalism doesn't care. So the alternative is to quit your job so you can qualify for medicaid, but even that sucks (for bureaucratic, lack of competition, and lack of price sensitivity reasons) and is worse for the patient and our economy both.

So I believe capitalism plays a very important role in this, but I don't think, by itself, it can solve it. My perspective on this shifted a lot after going to work for myself and not being able to provide healthcare for my children after my COBRA ran out.

1. Being kept alive for years on a ventilator is nowhere near reasonable.

Re: How Doctors Die (2011)

#90

Post by tsotha »

_delirium wrote: post #39
javert wrote: post #38

Earlier quoted context omitted.

Please realize that the current horrible insurance system is almost entirely a product of government regultory practice.

I disagree; government regulatory practice is mainly taking some of the worse edges off the inherently broken model of "healthcare as insurance". I'm thinking particularly of major conditions. I think regular office visits could probably be paid for out of pocket, but the real money is going towards hospitals, and that's also where free-market solutions don't work at all. In particular, I don't see how an unregulated…

>I disagree; government regulatory practice is mainly taking some of the worse edges off the inherently broken model of "healthcare as insurance".

But the government put some of those edges there in the first place. The biggest reason you have to have insurance in the US now is without it you're going to pay 5x what the insurance company pays for the same procedure. Because they're buying medical care in bulk and you're not.

One way you could deal with that is form a co-op to negotiate prices the same way insurance companies do, but without the insurance part. But you can't, because it's illegal.

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