It's easy to look at a life flight helicopter program and say it's too expensive to fund.
Few will look at this as overt rationing. But it is. And look at the drama created by one simple act of trying to control a state budget when you choose to ground one of two air ambulance helicopters because the state is millions of dollars in debt
How can they possibly put a value on a life? I can answer her question. When you put no value on life, then paying for all care without consideration for cost will eventually make no care the only feasible outcome for all. Unless restrictions are placed (rationing) FREE=MORE health care will always implode on itself when given enough time.
Folks, this is overt rationing. And it's just the beginning. If you want the government to pay for your health care, you had better start donating to the lobby arm of the Match Made For Heaven Committee, a congregation of humans entrusted with the role of playing your God with your tax money). Or start saving all your money for your future health care expenditures. Look at this fight over a couple million dollars. This is peanuts compared to the tens of trillions of federal tax dollars mandated without funding in the next several decades.
If one state can't even decide on how to cut a couple million dollars in health care spending, I have no doubt that our country is not ready to make the difficult choices. One more reason to stay healthy. Eat right, exercise and don't smoke. Because one day the Match Made For Heaven Committee will decide it's your time.
This reminded me of the Natasha Richardson case. Some American medical bloggers seemed to blame her death on the fact that the area of Canada she was skiing in, did not have med helicopter access. Maybe all Canadians have medical coverage because they limit access to expensive interventions like med flights. Curious.
ReplyDeleteFrom airlift to basic health coverage, the whole national and individual health plan have been diverged to feed two morbidly obese cats named Insurance and Pharma.
ReplyDeleteAmids a worsening economy, for some Americans it's only one diagnosis away (or rather, one "pre-existing condition" away) from medical and financial ruin.
And US is supposed to be one of the most financially well-off Super Powers; such contradiction in term.
"Or start saving all your money for future healthcare expenditures."
ReplyDeleteYou're just going to have to trust me on this one, but when we all get FREE=MORE healthcare in this country, it's not going to be legal to go outside of the system to buy your own. That's not fair, and it creates a two-tiered system and that's not what these people want. They want equal access to equal care, and paying for your own care does not fit into that equation anywhere. The only people who will have different healthcare will be those who force this socialist system upon the rest of us.
I wonder if dentists are worried about ending up in the same system...they will. And what about chiropractors? They will, too.
Considering chiropractors are not real medical professionals, I'm sure they will be happy to get their piece of the pie.
ReplyDeleteOR consider working oversea when the system makes much more sense.
ReplyDeleteLou, that is simply not true at all, what you describe is socialized medicine, not universal healthcare...
ReplyDeleteNow, I know that it strains the minds of the Rush Limbaugh listeners to think of two systems that can be talked about together, but are actually different.
Zeke Emanuel's plan actually is government funded, but ENCOURAGES people to buy additional insurance if desired.
So much misinformation regarding delivery system reform.
Wouldn't you mind enlightening us the difference beyond the obvious rhetoric?
ReplyDeleteHow are socialized medicine and universal healthcare different, Physasst? Appreciate it.
That's easy.
ReplyDeleteUniversal Healthcare implies only that all patients are covered by insurance. Could be catastrophic. It does not differentiate between employer based, and single payor. Although, MOST of the time, it is used in the context of a single payor system.
Single Payor is another term used frequently in health reform discussions, and this implies a single payor (government) of all healthcare costs. Zeke Emanuel's plan, which I support wholeheartedly is this type of plan. The government pays the bills, but has NO control over healthcare decisions.
Socialized Medicine on the other hand, refers to a single payor system that is not only PAID for by the government, but MANAGED by the government as well, and this is an important distinction. I do not support socialized medicine here.
The terms are often misused, misconstrued, and twisted by talk radio into meaning something that they do not.
For more info on Zeke's plan, see my blog, although it MIGHT be a slightly older post.
"Coverage" does not guarantee access. We have a gazillion Medicaid patients who can't get in to see an Orthopedist or a Gastroenterologist, and plenty of Medicare patients who can't even find a PCP to see them.
ReplyDeleteAnd if they print more dollars, we can all be rich! Yay!
Agreed, coverage and access are two different things entirely. I have a meeting next week in DC on policy matters, and as my focus is primary care access, this will be definitely brought up.
ReplyDeleteIf the key difference between the two is whether the gov would have control over healthcare policies, i think to some degree it should. For instance, if gov wouldn't step in to set a standardized price for drugs, pharma could easily jack up the price (already have) without challenge. If gov wouldn't step in to enact specific policies to protect patients and providers, the insurance companies could (again, they already have) force us to jump through all these hoops/redtapes until we either give up, come to a dead end or reach a compromise that favors special interest groups.
ReplyDeletei don't particularly like Big Gov, but it's the only opposing power we have to counterbalance the big pharma and insurance cos and lay down a new system in place of the one we have today that's set up by and to benefit the two industries.
From a patient's perspective, the insurance term "pre-existing condition" is probably the most distasted of all. Acute illnesses aside, doesn't most disease process take time to manifest?
ReplyDeleteBottom line is, NO ONE, if they were desgning a health system from scratch would design the system we have. HELL, we DIDN'T even design the system we have. It evolved slowly with patches here, and designs over there, and at the end, you have what we have. A completely garbled, disjointed, malfunctioning mess.
ReplyDeleteOne of the bigger talking points now for the Mayo Clinic Health Policy Center is CE, or Comparative Effectiveness. Which compares not only medications, and procedures, but even the delivery of care. Our CEO at Mayo, Denis Cortese, who is also a board certified pulmonologist who practiced up until he became CEO, agrees with evaluating this. His saying is the right provider for the right condition at the right place in the right time. Note, he didn't say MD. He actually thinks PA's and NP's should do more. And will provide far more of the care in this country in the future.
The ACP is currently predicting a 35,000 to 45,000 shortage of internists by the year 2025.....that's only 16 years away. Who's going to give that care? The answer will come in greater utilization and deployment of PA/NP providers. It simply has to.
There's shortages in almost every physician field, especially in primary care and EM.
Comparative Effectiveness. It's coming to a theater near you.
If we don't want to ration by limiting services, we will ration by who comes first. When we run out of money taking care of them, the next in line will simply die of the natural history of their illness.
ReplyDeleteCall me naive but where have all the US medical school graduates gone to? US has 130+ medical schools which should account for at least 800 graduates a year. Counting the number of foreign medical graduates in the US for residency programs which should at least compensate the supposed attrition rate, we should still have at least 750 newly minted doctors entering the system.
ReplyDeleteWhere have these US residency graduates gone to? Subspecialties? Private practice? Academic? Laboratory? Health-related industries? Oversea?
Anonymous 12:33, that's the silliest thing i've heard. We might as well prescribe a pistol with 4 rounds of bullets to those that are terminally ill.
ReplyDeleteWait, why do we bother to have "healthcare" system in the first place if all we want is profit and a modern equivalent of Old Wild West?
Healthcare in US has been intentionally kept unaffordable so that we must rely on insurance companies for "coverage."
ReplyDeleteThe cost of treatment for Stage 3 testicular cancer, for instance, can rack up close to $2 million. Worse still, there are some who would suggest that let those who are terminally ill "simply die of the natural history of their illness." It's amazing how barbaric we have become over the years.
The term “from cradle to grave” in Europe highlights their pride in European social welfare programs: that the government will be there for you through different stages of life, from cradle to grave.
ReplyDeleteThe term “from cradle to grave” in US highlights commercial opportunities for those who know how to exploit the unsuspected at unavoidable junctions of life, from baby shower to funeral home.
"the government will be there for you...Cradle to grave".
ReplyDeleteSigh. Rugged individualism is dead. Look at the mentality in some of these posts. It's the government's responsibility to fix our problems for us. If there's a problem that doesn't get fixed, well then it must be the government's fault.
Want to know why the difficult choices don't get made? It's because our government is wholly incapable of telling us "No," just like we're incapable of accepting No for an answer. We were the most successful country in the world because each and every citizen took it upon themselves to roll up their sleeves and deal with their problems. Not so much anymore. You'll never today's politicians say, "Ask not what your country can do for you..." as JFK did during his inaugural address.
This is America!! Stop making it everyone else's responsibility to baby you and hand-hold you through life. And stop acting like bad things shouldn't happen. They do. Life isn't fair, and **** happens.
Re: Fend for Yourself
ReplyDeleteHAD any individual been able to tackle insurance industry and alike alone, it would have been done already. Don't hold your breath.
OR shall i suggest that the American "individualism" by today's definition is no more than a self-defeating illusion?
"Life isn't fair, sh*t happens." Very well. Try to teach that to your kids along with your vision of 21st Century America, Cowboy.
What Pink said is true for myself as well. My wife an I were set to pay 600/month for coverage through an employer, and after some shopping around and setting aside savings for the deductible, we pay under 150/month.
ReplyDeleteAnd yes Anon 12:36, my kids will be learning that life isn't fair, you don't get everything you want, and that your actions have consequences. Its quite obvious this generation never learned it.
"...American "individualism" by today's definition is no more than a self-defeating illusion"
I'm not sure exactly what that means, but I like it. Heh heh. By the by, my vision of 21st century America is lookin' pretty bleak. Beauty of pessimism is, I'm either pleasantly surprised or prepared.
don't have much to add but have a little concern about fingerpointing betwen the generations...whether thru a sense of entitlement to medicare, bad lifestyle choices or not understanding who pays for what, pretty much we all bear this burden no matter what age.
ReplyDelete"I have a meeting next week in DC on policy matters, and as my focus is primary care access"
ReplyDeleteSnort
Let's see a PA who works in the ER not as primary care "provider" (I wonder why) is going to make his major focus "primary care access" at a big DC meeting. Am I the only one to see irony here?
No, you aren't the only one, Anonymous 10:09, but your cynicism is as appalling as is counterproductive.
ReplyDeleteAhh,
ReplyDeleteSo, because I have serious concerns about patients having access to primary care, that I cannot discuss it because I work in EM? That's the craziest thing I've heard. The patients who don't have access to primary care show up IN the ER. I have job security because of them, but considering it is about 5 times MORE expensive to see me in the ER, than it is to see one of our primary care docs, economically, I have to be concerned. Especially when I see patients like I have recently who have lost their jobs, subsequently their insurance, and have foregone ANY medical care for their chronic conditions. The last several I have seen have been quite sick, and it could have, and SHOULD have been prevented. Policy occupies about 40% of my time any more, and I am one of the people involved in the policy making discussions.
BTW- EM is in more ways than many people ever realize, primary care.
If we had a primary care base wide enough to cover most communities (say in 20:1 patient-provider ratio) and a compensation system not so exclusively dictated by insurance companies, perhaps things could start to change for the better, with or without the elusive universal health care system in place.
ReplyDeleteDoes anyone know any pilot program that's designed to take community "subscribers" off insurance or managed care systems?
ReplyDelete