From: tcox@ssrl01.slac.stanford.edu (Tony Cox - (415)926-3105)
Newsgroups: talk.politics.medicine
Subject: Re: HIAA and Reform
Date: 14 Dec 92 14:22:38 -0800
Organization: SSRL, Stanford Synchrotron Radiation Lab
NNTP-Posting-Host: ssrl01.slac.stanford.edu

In article <50390@shamash.cdc.com>, rjv@a2.cim.cdc.com (Rene Valdes) writes:
> In article <1992Dec8.171033.1@ssrl01.slac.stanford.edu>, 
> tcox@ssrl01.slac.stanford.edu (Tony Cox - (415)926-3105) writes:
> |> In article <50269@shamash.cdc.com>, rjv@a2.cim.cdc.com (Rene Valdes) writes:
> |> > The only practical way to do this is implementing a single-payer national
> |> > health plan.  I think Consumers Reports did a good job at showing this.
> 
> |>    I get it now. You think that your concept of universal care is
> |>    fair and equitable, but then you go on to say that _I_ should
> |>    be forced to join your plan. Well, everyone is different you
> |>    know - we _are_ apples, oranges and, no doubt, lemons
> |>    too...
> 
> I guess you are suggesting that the "lemons" should be left alone to
> die in a corner once they have found themselves ill and with no medical
> care.  Correct? 
>  

   `Lemons' was meant as a reference to you. It was stronger in the
   original post, but I quietly reposted. Guess I shouldn't have
   bothered.


> |>    Here are some of those fruits which don't fit neatly into your
> |>    fruitcake:-
> |> 
> |>    o - those who do not wish for any medical care because of
> |>    religious or philosophical reasons. Why make them pay for
> |>    nothing?
> 
> Will these people have some label on them that tells the emergency
> crews who would pick them up after an accident that they should be
> left to die on the side of the road?  If they are taken to a hospital
> "by mistake", who would pay for that?

   I asked first.

>  
> |>    o - those who take great care of themselves so as to minimize
> |>    the diseases of old age. Why should they subsidize those who
> |>    smoke 40 a day?
> 
> There are many cases of people who take very good care of themselves
> and suddenly find themselves in a catastrophic health situation.  As
> there are people who smoke and drink and get to live to be 100 years
> old.  As you said, things are not so simple.  Anybody can end up
> requiring expensive medical treatment.

   Presumably you would say `yes' then eh?

>  
> |>    o - those who play dangerous sports. Why should they be
> |>    allowed a free-ride at the expense of the couch potatoes?
> 
> Do you really believe that a couch potato is a good health risk?
> How much intrusion of privacy are you proposing so that insurance
> companies can classify people into thousands of different health 
> risk levels?

   In my scheme, that is between the company and the participant.

   And in yours, what exactly? We have already seen state funding of
   medical aid used as an excuse for compulsory crash-hat laws.
   You can use the same justification to outlaw all sports, smoking,
   homosexual behaviour, unnecessary driving. Be creative here.
   Remember, you now have the monopoly.

> 
> |>    o - those who are so scared of death that they want a policy
> |>    with almost unlimited benefits, and are prepared to pay for
> |>    it. Should _everyone_ have unlimited benefits?
> 
> This is possible under the Canadian system and in any other country
> that enjoys a national health care plan.  You get you basic coverage
> taken care through the national plan, and then you can buy any 
> additional frills and benefits from private insurers as has been
> explained once and again by Canadians.

   So _who_ exactly decides what the base level of care should be?
   What if I don't _want_ that base protection? See how arbitrary and
   difficult this all is? This is an area where the _market_ makes
   decisions far better than you and your friends jawing in the back room.

>  
> |>    o - those who currently live in the US, but intend to retire
> |>    somewhere else. Will they have to fly half way round the world
> |>    to get the medical treatment they paid for in their youth, or
> |>    will they have to pay twice?
> 
> Again, as you probably have read by now, national health plans, such
> as Canada's, often cover treatment in other countries.  On the other 
> hand, you may retire to a country where they have a national health 
> care system that may cover you.  In any case, if the Canadian system
> can cover Canadians in Florida and Arizona, we sure could devise an
> American health care system that would cover you in Katmandu.

   I'm sceptical.
   In the US, "World" (as in World series) means the US and Canada.
   Do you really think that the national payer plan will dole out cash
   to _all_ health care providers? Surely it will be limited to
   _licensed_ providers? And what if I happen to live in some country
   which is on the embargo list? Would they pay Cuban doctors for my
   health care?

   In the final analysis, I just don't trust _you_ to look out for _my_
   interests in Katmandu or anywhere else. Who asked you in any case?

Tony Cox, Stanford, CA