The perfect health care system for the U.S. (3 simple principles):

[Ron Green]

1. Single payer, everyone in the pool. Funding based on ability to pay, delivery based on need and medical decisions.

2. Preventive care and lifestyle education paramount, including incentives for exercise and good eating, disincentives against industrial food and unhealthy addictions.

3. A national conversation about death and what reasonable expectations ought to surround it.


It sounds simple because it is simple. Only a nation in the grip of the Free Market could reject such a plan.

Your thoughts?

[Dogmudgeon]

1. One and Two, certainly

Number three opens a big can of worms -- "raised on country-grown Whoop-Ass" -- and would be like inviting every crackpot preacher in the USA to a seat at the table.

Granted, we need to come to grips with death, but a system instituted under law with a bunch of wackos at the gavel is a bad idea.

But as I said, #1 and #2, they're winners.

:thumbsup:

--d!

[Oregone]

2. 4. Single-Tier

Just because you're poor, it doesn't mean the chair next to you in the waiting room must be occupied by a cockroach

[NoNothing]

3. Devil always in the details

Everything sounds easy when you break it down in to broad, extremely *vague* platitudes. Take your #3: clearly you have some notion of just what the reasonable expectations should be, but you can't bring yourself to say anything more than that a "conversation" should happen. Well, we can already imagine how that conversation is going to go and the one thing you can be sure of is that consensus is not likely.

Or your number 1 point: what constitutes "need," exactly? A treatment that prolongs life 1 year? 1 month? 1 day? A treatment that has a 90% success rate? 50%? 10%? .001%? What is the line and more importantly, *who decides*?

You are right that these principles are obvious, but wrong that they are *simple*.

[Ron Green]

4. We haven't even had the conversation (about death), so I can't imagine how it's going to go.

I suggest, though, that reasonableness will flourish in the light of official scrutiny much better than it has in the darkness of superstition and fear-mongering.

Medical need should be determined by doctors and patients, without economic incentives. "Heroic measures" are decried and rejected by almost everyone until the actual end is near, and then often 90% of the medical expenses of a person's life are incurred in the final, and futile, efforts to forestall the inevitable.




edit for tpyo

[NoNothing]

5. "Death panels" *was* the conversation

How you expect it to become more reasonable is not clear to me. You can't force people not to fear-monger.

Second, determining "need" is a separate issue than the presence or absence of economic incentives. If "need" simply means "medically beneficial" then need is practically infinite, because up to the point that everyone has a personal physician around them 24/7 there is always an incremental benefit to more medical attention. Someone, somehow, has to draw lines if you remove the price factor.

[Ron Green]

7. "Death panels" was no more a conversation than "birth certificate"

is a conversation. And medical need is something that can't be considered in a vacuum, either; it has to do with the end of life, with overall human viability, and, yes, with economics. My point is that our current "health care" model acts as if all these factors exist separately, to be fought over in an effort to deny aging and death, as well as lifestyle risk factors. The U.S. deserves to have a holistic program that treats all people as having basic medical needs, some as having extraordinary needs, and none as having infinite needs.

[anonymous171]

8. Now you are talking about the government perpetuating moral values

Life is the goal of medicine, not comfort.

[Ron Green]

10. Yes, I'm talking about the government perpetuating moral values,

just as it did in 1964 with the Civil Rights Act. To allow pharmaceutical companies, churches and insurance companies to set the tone in broadly defining what American life is and should be is to miss an opportunity to bring needed balance to the process.

I believe the goal of medicine is health.

[anonymous171]

6. #3 is stupid. The rest is cool. nt

[spin]

9. The for profit healthcare industry has Congress in its pocket...

whatever plan comes out, they will continue to be bloodsuckers.