Say the government gave you free health care and only required an annual appointment with a doctor

[1932]

and you were free to refuse any test suggested by the doctor, and even could refuse to go, or answer the doctor's questions truthfully if you did go, and say that you had symptoms for a disease that could be treated cheaply at an earlier stage, but your refusal to describe your symptoms to the doctor (based merely on your sense of libertarian freedoms) meant that the disease was diagnosed at much later (and therefore, more expensive to treat) stage. Which of the following do you think is an appropriate response:

[Colobo]

1. I don't want the government telling me when I should go to the doctor.

I decide that, not the government.

[1932]

3. That's your choice. Do you think taxpayers should pay for that choice if the cost could have been

avoided or reduced by you making a different choice?

[Mumble]

34. And if you don't get sick...

by the same token the government owes you a big bonus check. Or if you drop over dead in an instant, your family gets the hospital money you saved the government!

[1932]

36. Isn't free health care the bonus check? Dropping dead is a huge social cost, by the way.

There's an opportunity cost to society if you die young. And if you die after society has invested time and money educating you and trainging you to do a valuable job, there's a loss as well.

[GreenArrow]

44. health care is a human issue

not a business issue.

[Cameron27]

2. As a woman who's very personal choices have debated

by male government officials for years, I say the government better not tell me when to see my doctor. How do other countries with universal healthcare handle these issues btw?

[Kutjara]

4. They're having terrible problems managing healthcare costs.

The UK is considering rationing healthcare based on the contribution a patient is likely to make to society. There's also talk of charging people who smoke or are obese for illnesses related to their "lifestyle choices."

One way or the other, healthcare has to be paid for. If people won't take responsibility for themselves, then either the government will have to do it for them or they'll have to live with the consequences of their decisions.

[MADem]

11. Lifestyle choice? Now, there's a slippery slope. When will they start refusing people

who engage in risky sex? Or who skateboard a lot? Or who tan too much? Those are "lifestyle choices." And that term, well, that's a loaded one--the slope gets more slippery, still.

And how does one measure a "contribution to society?" Joe Blow is a banker who forcloses on people, he makes a great wage, but is he worth more than Ima Schmuck, who works part time at the chip shop for a small pay packet, but is a full time caregiver to her ill mother, who otherwise would end up in a council old age home at great state expense?

Who develops the metrics, plugs in the numbers, makes the decision? Is it wealth-based, a popularity contest (two letters of recommendation from the mayor and the vicar, and you're at the top of the list), or age-based (old people, ta hell wid' ya)?

[Kutjara]

51. To an extent, the choices are already being made.

In the case of organ transplants, hospitals already have criteria for preferential treatment based on age, number of dependents, general level of health and a range of other factors. So a 35 year-old father of four young children will be placed higher on the list than a seventy-year-old retired heavy smoker.

[Prophet 451]

14. No, we aren't

The shout for rationing healthcare is coming from a few fringe groups, it's not anywhere on the legislative radar or ever likely to be.

There is talk of charging the obese or smokers. I and a good portion of people are wildly opposed to either since firstly, smokers pay so much tax that we bankroll the bloody NHS and secondly, the "culinary culture" (for lack of a better term) of modern Britain tends toward obesity.

[Cameron27]

16. Thanks for the info.

[Kutjara]

52. There's rationing and then there's rationing.

The NHS currently rations healthcare, by restricting access to drugs and treatments deemed too expensive. This BBC article gives a brief glimpse of the current situation: http://news.bbc.co.uk/2/hi/health/251988.stm

Rationing based on patient's lifestyle choices isn't a million miles from this. It already occurs in the case of organ transplants, where hospitals have guidelines for prioritizing recipients based on a range of "lifestyle" criteria.

The NHS is in crisis, one that will deepen as treatments become ever more expensive and the population continues to age. Either taxes will have to go up, care will have to be rationed, or the NHS itself will collapse.

[1932]

5. You can always make that choice. But should others pay for the consequences of your choice.

What if ten women could have gotten better treatment for their breast cancer if your expensive-to-treat problem were, with your cooperation, caught earlier?

Do you think that you should still get totally free health care if you make that decision?

[wtmusic]

6. That's the price of freedom

and the check against doctors overmedicating and overdiagnosing.

We pay every day for the choice some make by not outlawing cigarettes, motorcycles, ?...

Where does it stop?

[1932]

37. It's an avoidable unreasonable price. And it hits people who are sick and want to be healthy and

their friends and family pretty hard, since you are taking valuable resources from them.

[wtmusic]

63. You could say the same thing about cigarettes

and truth is, there is nothing to stop hypochondriacs from completely abusing the system with false medical claims.

Everyone in such a system is at the mercy of those who want to be "sick" and those who don't care enough to prevent it. Yet somehow it works.

[Cameron27]

7. Yes, if the government is offering universal health care,

then everyone deserves it regardless of how many doctor's visits they make. A mandatory ban on alcohol would save plenty of money in healthcare costs too, is that included? Where the hell is Edwards going with monitoring a person's health?

Forget it. Kucinich has it right.

[CTyankee]

60. Once you are in the health care system you are monitored.

I am being monitored as an unfortunate result of complications from abdominal surgery last spring. The way this all started was that I was seeking medical help for repeated attacks of diverticulitis which caused me lots of pain. I feared a future "big" attack with a 911 call in the middle of the night and possibly dire outcomes. So I went for preventive surgery. Long story short, I developed scar tissue that blocked my intestine, resulting in another surgery. My recovery progress is now being monitored by my surgeon.

My blood pressure is also monitored by a cardiologist so I can adjust my medication when needed. I choose to comply since I know from my own family how stroke can kill if b.p. isn't controlled.

I could go on, but you get the point. If you get into the system (because of extreme pain, for instance, that you want relief from), you can expect some kind of monitoring of your progress. I don't find that offensive to my sense of liberty at all. And if you want painkillers, there is nothing wrong with the doc requiring some kind of examination. Otherwise, we get into a Dr. Feelgood situation, docs who irresponsibly over-prescribe drugs for irresponsible people.

[Prophet 451]

19. Usually

You are encouraged but not required to get periodic check-ups. Here (Britain), it's recommended you get a check-up every six months or so but it's never been required.

[Cameron27]

20. I don't mind encouragement, that's all that the medical profession

is allowed to do now, and I'm not about to accept the government going beyond that.

[Prophet 451]

21. Forgot, one exception

If you are on long-term medication, the doctor's are obligated to ask you to come in for an appointment every few months to monior the long-term effects of the medication. You aren't obliged to attend but they are legally prohibited from continuing to prescribe your medication if you don't.

EXAMPLE: I suffer from two long-term complaints, depression and a stomach complaint called reflux oesophagitis. Every three or four months, I'll get a little message on my repeat prescription form asking me to come in for a "Medication Review". I'm not obliged to do so but the doctor's are prohibited from filling my repeat prescription unless I do so.

[Solon]

23. Now that makes sense actually...

It could be a safety review to test for side effects, or a way to make sure those drugs aren't improperly used.

[Prophet 451]

28. Both

Plus a way of making sure that the patient continues to need the medication.

[Cameron27]

50. Well that makes sense, and is pretty much the same guidelines

that MD's have to follow now.

[GreenArrow]

45. that's the correct approach

Encouragement rather than a required obligation.

[avrdream]

31. In Australia, taxation is fairly high to pay for it but universal health care exists.

No one MAKES anyone go to the doctor but most people are sensible enough to go when they have a problem. It's amazing how free health care motivates ILL people to get seen and, for the most part, they go before things have gotten to that bloody expensive stage that the OP talks about. Seriously, folks, this system works quite well down here. Women get their pap smears and mammograms, men get their prostates checked and most kids get their vaccines.

The problem with we Yanks is that we haven't seen anything different so we think we have to make check-ups mandatory. We don't understand the value of educating the public about preventive care. That education causes people to get seen early and the government in Oz isn't holding a gun to the people's heads to make them go in.

It took me coming down here and practicing for a few years to see that universal health care is ABSOLUTELY possible and it is irresponsible of the current administration and all the Republican candidates for not speaking about it and working toward it. Despite the trouble with some of the details of the Democratic candidates plans, at least the Dems are working toward this and you all should be very proud of that.

[Clovis Sangrail]

8. implementation I suppose...

I guess it really depends on how they went about requiring doctor visits.

Having the feds tell me to go to the doctor for my annual physical at 2pm on July 1 would seem a tad intrusive.
On the other hand, I really don't see any problem with the feds telling me, as a part of a national health care program, that I *have to have a physical once a year.

Seems like a reasonable request from anybody who insures you.

[Cameron27]

9. And what if they said twice a year? or quarterly?

[Clovis Sangrail]

64. I don't think I'd care

I'd chalk it up to "that's the price of free universal health care".

Sorta like I don't wanna stop at red lights all the time, but I do anyways.
... dem's da rules that make it so we can all drive.


I'm sure you could extrapolate it to a point that I'd no longer feel that way (like once a week) but that would make my reasoning for supporting it void anyways.
To me, it's all about maintenance care in order to lower the overall cost.
At some point the cost/frequency of visits exceeds the benefit gained by preventative care.
The frequency should be determined by actuaries and doctors, and I'm guessing it would scale with age.

[regnaD kciN]

10. It's a bullshit poll...

...because the answers are phrased in such a way as to make clear which is supposed to be the "correct" response.

Not all that different from the Bush/Rove "push polls" in South Carolina during the 2000 primaries, asking voters "would you be less likely to vote for John McCain if you knew he had fathered an illegitimate black baby?" :eyes:

[MADem]

12. I couldn't respond for precisely that reason. It's a funnel. NT

[ProudDad]

26. Exactly - a horrendous waste of bandwidth (n/t)

[Crunchy Frog]

13. Why is it that no other country with universal healthcare

has mandatory doctors appointments, and their health care systems aren't falling apart as a result? Are Americans somehow uniquely in need of having the government act as nanny?

In my opinion, this insistance on pushing for coercive health care is just going to scare people away, and undermine attempts to bring about meaningful reform. Coercion in health care is a very bad idea, and not necessary.

[Cameron27]

17. Well, he's calling for universal insurance coverage

and that's probably the reason he's pushing mandatory preventative care and making it unnecessarily authoritarian.

[CTyankee]

61. I don't know about that. There is something bothering me about all of these

posts instantly proclaiming JE's "authoritarian" tendency. It's as if JE grew another head. None of this makes any sense with someone in a major party in the top tier of candidates. There is no track record for us to suspect that JE is so authoritarian. We don't even have his clarification yet, and we've got folks calling him Joe Stalin. Something is fishy here...

[Kutjara]

54. Some are.

The UK National Health Service is in crisis, and has been for many years, with patients being refused treatments deemed "too expensive," or having to wait years for operations. Margaret Thatcher cut tax rates dramatically, and no government since has dared to raise them (except in "hidden" indirect ways), so the funding crisis has widened.

Other countries with universal healthcare fund it by extremely high income tax rates (Australia) or by a government-backed insurance scheme (Germany). The insurance schemes seem to work best.

[snot]

15. Yet the hey? COME BACK TO REAL LIFE.

I thnk there are bigger, more common problems with our current healthcare system.

[Prophet 451]

18. No, absolutely not

And I call "bullshit" on the way you've constructed the question and answers too.

The nature of socialised medicine means the cost is shared, regardless of when the illness is caught or for what reasons. Asking people to contribute a small sum, either through taxes or some other method (here, we pay about £7 per prescription as a contribution to the drug cost although the elderly and poor are exempt) is fair enough but to ask people to pay on this basis brings the whole system into the question. If we charge for this behaviour, why not charge for that one? And pretty soon, you're back to privatised healthcare again.

And as far as I'm aware, no nation with universal healthcare requires a doctor's appointment at any time. They may encourage periodic check-ups (here, you're encouraged to get a check up every six months) but nowehere requires them. Yes, Britain's healthcare is collapsing due to many things (such as a generally unhealthy culture and rampant underfunding for decades) but the health systems of, say, Holland or France seem to work fine without such coercive measures.

[MatrixEscape]

22. This is one of the most rediculous ...

biased polls I have ever seen on DU. I usually participate in polls, but this hypothetical is very obvious in its intent.

Why not just call it: Is Fascist Universal Health Care a Better Solution?

I think Libertarian is a dirty word, BTW.

[MatrixEscape]

25. Would somebody post a poll ...

about using polls to push and conflate ideas they are trying to promote?

I can understand a poll that is worded to fairly reflect several sides of an issue or allow for dissent, but this one pushes the bullshit over the top and that is annoying because the poster clearly had more of a point to make than a valid quesiton to poll.

You have to be a donor here and I have not been one for a while, but it would be nice to see how DU'ers feel about the abuse of polls.

[lvx35]

24. This question is bullshit.

"but your refusal to describe your symptoms to the doctor"

The doctor cannot assess whether you didn't report symptoms based on "libertarian freedoms" or not being that bothered by them. These threads are trying to spin universal healthcare into an invasive militaristic system where individuals are forced at gunpoint to visit doctors. Bullshit.

[Cronus Protagonist]

29. The word (precious) shows the bias in the poll

This is all so Rovian.

[1932]

39. I'm asking this on a personal level. I'm asking if you could live with yourself

if your choice had this ramification.

[MatrixEscape]

27. I am starting to really wonder ...

about who is behind this particular poll.

I wanted to add that I have done some careful study on Libertarianism, (since the word was used, in an odd fashion, in the poll) and this article sums up why I sincerely think it proves to be a very cleer ruse and a deceitful abomination of sorts that should be relegated to the logic and solutions poised by something like Scientology:

http://www.sensiblyeclectic.com/news/index.php?/archives/5757-Outing-the-L-Word,-Part-I.html

[1932]

41. Rather than raising questions about me, you should probably work on your argument

since a lot of people seem disagree with your interpretation of the implications of this question.

[aquart]

30. A straw man question?

This is simply destructively ridiculous. Go away.

[Mythsaje]

32. My dad hasn't been to a doctor in years...

I wish he would go, but he can't afford it. That's what it comes down to, now isn't it? He wouldn't be happy, but we could pressure him into doing it if he didn't have to worry about the cost. There aren't so many people who'd refuse to see a doctor if it didn't cost anything that we should even consider the possibility of forcing them.

The family could do that well enough without the government getting involved. Now I'm not sure what Edwards was getting at here. It left me scratching my head.

Oh, and this poll is just silly.

[jody]

33. If you don't want We the People aka government making decisions re health care, then pay your self.

[LWolf]

35. The cost of stubborness is paid in ill health.

It's a logical, natural, universal consequence and doesn't need our help with the perpetual bribe/punish methodology unfortunately supported by too many people.

[1932]

38. ...and is paid by people who are ill and want to be healthy and their families.

Do you think that's a good way to allocate limited resources?

[GreenArrow]

46. I think it's call life

and letting people live according to their abilities and inclinations.

[LWolf]

62. Your question isn't making sense to me.

Are you saying that John Smith, who is ill and wants to be healthy, can't get health care because he's paying for care for Bob Jones, who is ill and hasn't kept up with his checkups?

A universal, single-payer, not-for-profit health care system would not bill Mr. Smith more for Mr. Jones' care, or deny Mr. Smith care in order to pay for Mr. Jones'.

The system would get us more care, for less money, than we are paying now; that's the "not for profit" part. Those making the "profit" off the insurance industry are responsible for the high cost of our health care, not Mr. Jones.

If Mr. Jones chooses not to get the health care he is entitled to, and his health suffers, he is paying the price, which is not in dollars, but in health. We are still paying less for more.

[cobalt1999]

40. What's it going to cost to give annual checkups to 300 million people?

Compared to what will it cost when some people don't get checkups and need more treatment?

Somehow, I doubt the savings to the taxpayer will be that great if any at all.

[1932]

42. 1/16th the cost of treatment.

An ounce of prevention is worth a pound of cure.

:)

[cobalt1999]

43. LOL

If only economics were that simple.

[mohc]

47. The real issue here.

Setting aside for the moment the particulars of Edwards proposal, what in general do we want from our government in regards to health care. I certainly think everyone should be able to make their own choices, along with their doctor(s), about when they have checkups, what treatments and medications they receive, etc. If anyone is advocating forced medical treatment, even checkups, I do not think it is going to fly very well. The real issue though, is not what care you will be forced to take, but what funding for that care the government, in proxy for the people, are forced to provide for it. The whole concept of government sponsored health care is spreading the costs of health care among everyone, so that everyone has access to the best care when it is needed. But what is or is not covered, and in turn how it gets funded, obviously has to be in the hands of the people as well. This can not function as a collective agreement to allow the individual to do whatever they want. Many here have said that if choices about checkups are a factor in coverage, what would prevent any behavior from being a factor. Well the slippery slope goes both ways. If anyone can choose as they see fit toward checkups, can I get luxury recliner for my bad back on the government's dime? Can I get checkups every week? Every day? How about my pain medication, can I have a limitless supply of percocet just because I want one? This is exactly what democracy is for. If the people collectively believe that those things should be covered, then they should be covered. If the people believe that some things should be paid for individually, then they should not be covered. And that includes not having regular checkups. I know it may confuse some to think of not doing something having a cost, but in this case it obviously does. On average those who do not have checkups end up costing the system more, just as some hypochondriac having a checkup every week would, though probably to a lesser degree, and they should be treated the same way. Together we must decide if we will choose to fund coverage for those that choose to cost the system more, or require that those who do pay some portion toward their treatment. Its not about forcing people to make choices for their treatment, but whether the people are forced to pay for whatever treatment an individual may want.

As to Edwards proposal, if he is actually saying that someone is going to drag you to the doctor, or that you could be arrested for not going, then I have a problem with it, and I think just about anyone would. If he is saying it will cost you more not to get regular checkups, then it is up for the people to decide if they think it is a reasonable consideration.

[slackmaster]

48. There is no such thing as "free" health care anywhere in the world

I have a fundamental objection to the language of this entire discussion.

[ljm2002]

49. Totally ridiculous

Sorry but making coverage contingent upon everyone having an annual checkup would cost more than just having universal coverage, period. Why? Because of the complications that will ensue when trying to enforce the annual checkups. Who, for example, will be keeping track of your and my compliance? And how much leeway do we have -- is there a 1-month window during which I need to make that visit? 2 months? 3 months? And are they staggered -- you have to go in January, I have to go in February, etc? And for how long do they lose coverage? And, if I missed getting my checkup, lost coverage, and then got sick, what happens? We're right back where we started.

Mandated yearly checkups is just another control freak proposal. It is another way for the "authorities" to withhold from us what is our due. So finally the idea of universal health care is gaining some traction, and yet another politician can't wait to attach strings because of his own personal experience.

You can talk all you want about the occasional person who will discover something earlier rather than later, because they went for their checkup. But no one talks about the massive inconvenience for the population as a whole, as they struggle to keep everything together, and have yet another absolute requirement to meet, lest they lose their benefits. We'll end up right back where we are now, with millions who are not covered because they did not go for their mandated checkups. And then there will be the massive bureaucratic nightmare as people try to prove they really did go, or they weren't a day late as the records show, or whatever.

Bah humbug. Give us what we need: universal single payer health care, no strings attached.

[Cameron27]

53. Edwards plan is based on universal insurance coverage, right?

That may be the reason he wants to mandate preventative care. We need to get the insurance companies out before calculating costs.

[ljm2002]

56. We have plenty of statistics right now...

...for the amount of medical care that people need. And we better be calculating costs before we implement any program -- IOW, mandated checkups would be after the fact anyway, so I don't think that can be the reason he wants to mandate the preventive care.

It's a bad idea. Americans love their "freedoms" or at least we think we do. And things like this quickly become hot button issues that are pointed to as yet another "nanny state" idea. Which in fact it is.

It's BS. We need universal single payer health care, period. We American workers get less vacation than Europeans, we have higher productivity, and we get less for our efforts -- unless you think that a mighty military, dedicated to imperialism in the service of Big Business, is getting something. Quit with the carrot and stick routine, Mr. Edwards. Health care in a wealthy nation such as ours should be a basic right, no strings attached.

[Cameron27]

59. Thanks,

I think it's BS too. Universal single-payer is the only way to go IMO.

[rinsd]

55. What is the love affair with some socialists and authoritarianism?

I see this alot in Chavez threads but you see it again here.

WTF is wrong with simply having universal single payer healthcare with education and encouragement for annual checkups vs. making them mandatory?

[rinsd]

57. What about the homeless? What about the home bound?

[Milo_Bloom]

58. Screw those welfare people...

If someone has a child when they can't afford it, why should I pay for it?

If someone gets fired from their job because they weren't as good at it as they thought they would be, why should I pay unemployment for them?

If someone chose to go to school for the wrong thing and now can't find employment, why the hell should I help pick up the bill?

It is time to make society MISTAKE FREE.