From: yar@cs.su.oz.au (Ray Loyzaga)
Subject: Re: Medicare == manslaughter?
Reply-To: yar@cluster.cs.su.oz (Ray Loyzaga)
Organization: Basser Dept of Computer Science, University of Sydney, Australia
Distribution: aus
Date: Thu, 10 Dec 1992 21:25:16 GMT

In article <chris.723878971@suite.sw.oz.au> chris@suite.sw.oz.au (Chris Maltby) writes:
>In <1992Dec9.034423.28404@cs.su.oz.au> yar@cs.su.oz.au (Ray Loyzaga) writes:
>>In a recent report it was stated that delays to admissions for public
>>patients for cardiac operations were typically delayed by months
>>whereas it was typically only 2-3 weeks for private patients.
>>The number of unnecessary deaths was reported to be 60-80.
>
>I wonder how you define an "unnecessary death"? If it was your death
>and you could have afforded private cover you'd be kicking yourself
>I'd bet. But perhaps if we (society that is) had paid an extra $100G
>to medicos, insurers and hospitals then no-one would die? Or perhaps
>we would have just added a week or two to some sick people's lives?

Oh, we can rationalise it now, rich people survive cardiac problems,
but poor people can die since we are only adding 2-3 weeks to their lives
via medical intervention. An "unnecessary death" is one that occurs
to a patient with a treatable disorder through neglect. In our system
this neglect occurs due to the lack of facilities available to these
public patients because resources are being used to treat people who
can afford to pay for their own health care.

>>Could this be because universality means that the govt has to dole
>>out money so that people like me can get 75% of my medical bills paid
>>even though I would be willing and able to pay for it myself??
>
>Or is it because someone has made a (perhaps cynical) judgement about
>the proportion of national income to devote to health, and we are just
>paying the price for that? There is no doubt that Medicare has been

It is not the system that I advocate, I have no problem with the
medicare levy (though I would prefer that the pretense of it not
being a tax be removed), jut use the money (and the current additional
funds) to pay for EXCELLENT health care for the needy, rather than
spreading it across the wider community.

>quite effective in restraining balooning national health costs. It's
>problem is that it doesn't quite have enough price incentive for
>people to consider the marginal value of health services. 

There are other ways to contain costs without using the lives of
public patients as a variable in the economics of medicine.

>>Isn't it about time that you trendy psuedo-socialists stop and think
>>that these policies are actually hurting (and in this case killing)
>>the people that should be protected?????
>
>It would be nice to be able to afford infinite resources for health.
>But how do you propose that we fund this. Don't tell me that cutting
>the insurance companies in on the act is going to reduce the costs of
>providing health services.

It is perfectly funded now, just cancel the free/subsidised health 
for those that can afford their own.

>>Get rid of universal health care, make free medicine available to
>>those in need, and make the rest pay according to their means. That
>>way the government can focus on supporting the needy, not a bunch of
>>middle class bozos who think that medicine is free in this country,
>>it isn't it costs lives.
>
>Actually, I agree very strongly with the last part of this paragraph.
>I just don't see how the alternative (as proposed) is going to do it.
>After all, we have had Ray's system before, and Medicare was introduced
>to fix it. Perhaps if we could work out a way to make doctors' fees
>behave according to a free market model...

I haven't proposed anything, are you assuming that I am talking about the
Liberal health policy? I prefer it to the governments on the basis that
it would allow a resumption of the debate on health, right now the
system is perceived by the public as providing free health care,
without consideration of the costs of this system in terms of suffering
and death for those that do not receive adequate or timely care.
At least with the Liberals policy, we will be able once again to
have the health system as an active topic for discussion in terms
of its provision of services to the needy, rather than its unecessary
subsidy to the middle and upper classes.

A system that I would be happier with would be something of the order
of people with taxable incomes below $X (I would say 15k) pay 0.
From that point on everyone has an excess i.e. you pay the first
$N where N is a proportion of their income above X, lets say $1 for
every $20 that they exceed X, or a higher figure with the average taken
over a few years. To contain the medical costs spiral, public hospitals
provide services to the entire community profitably, private hospitals
may charge more for the hotel side of health care but the market
can even it up. In effect this is a government sponsored health insurance
system, but the user pays for normal use, i.e. the 2 or three visits
to the doctor during flus etc. Once a major problem occurs the user
pays a portion of the fees, depending on his ability and then
the rest is picked up by the community. A person should be able to
obtain private insurance for this excess.