How SHOULD Health Care Work?

[vern_humphrey]

If a single women with kids needs gov’t assistance with food, shelter, or medical care, she should get it. Whether she is a single mom because she is a widow, or because she made a mistake and married then divorced the wrong guy, or because she made a mistake and had a child out of marriage when she couldn’t afford one shouldn’t matter. She still has a family to care for. And our gov’t should care.

Even if it encourages her to have more children out of wedlock? Even if welfare has become an economic strategy in her family and sector of society?

That makes us enablers – and the child in question has become a hostage to force us to continue in this role.

 

[boppaid]

Even if it encourages her to have more children out of wedlock? Even if welfare has become an economic strategy in her family and sector of society?

That makes us enablers – and the child in question has become a hostage to force us to continue in this role.

Our first concern must be for her family’s welfare. And I hardly think the small amount of government money or health care she receives would entice her to have more children. Of course, there are objections to every rule, but it certainly wouldn’t be the norm. Welfare is a small amount…and the expense of a new child out of her own pocket would certainly outweigh what she gets in food stamps. Besides, technically we should be talking about the topic of this thread…health care. So, **especially **in that respect, I don’t think government health care would entice her to continue having children she couldn’t support.

 

[emily47017]

this is a really interesting paper – people are always saying (including me!) that non-emergency ER visits are one of the major problems with our health care system… according to this study, it just ain’t so. hmm.

US emergency department costs: no emergency

and yeah, actually, the uninsured do live sicker and die younger.

Scientific Research Linking the Lack of Health Coverage to Poor Health

Uninsured Americans Experience Poorer Medical Outcomes

* Uninsured Americans experience a generally higher mortality and a specifically higher in-hospital mortality.
* Uninsured Americans may be up to three times more likely than privately insured individuals to experience adverse health outcomes.
* Uninsured patients have been found to be up to four times as likely as insured patients to require both avoidable hospitalizations and emergency hospital care.

 

[boppaid]

this is a really interesting paper – people are always saying (including me!) that non-emergency ER visits are one of the major problems with our health care system… according to this study, it just ain’t so. hmm.

US emergency department costs: no emergency

and yeah, actually, the uninsured do live sicker and die younger.

Scientific Research Linking the Lack of Health Coverage to Poor Health

Very interesting article, Emily. Thank you for posting that.

 

[vern_humphrey]

Our first concern must be for her family’s welfare. And I hardly think the small amount of government money or health care she receives would entice her to have more children.

Wrong. There are sectors in our society where having a baby out of wedlock is a rite of passage. A 16-year old girl becomes all grown up, with her own welfare check and her own apartment in the project when she has a baby.

Of course, there are objections to every rule, but it certainly wouldn’t be the norm. Welfare is a small amount…and the expense of a new child out of her own pocket would certainly outweigh what she gets in food stamps.

Welfare is huge!

Every single department of government, from the Defense Department to the Treasury Department has “poverty programs.” The cost is enormous.

And by perpetuating the poverty cycle we double the cost – people who should be gainfully employed and contributing to society are instead consuming much of what other members of society produce.

Besides, technically we should be talking about the topic of this thread…health care. So, **especially **in that respect, I don’t think government health care would entice her to continue having children she couldn’t support.

And government housing wouldn’t entice her to continue having children she couldn’t support.

 

[boppaid]

Wrong. There are sectors in our society where having a baby out of wedlock is a rite of passage. A 16-year old girl becomes all grown up, with her own welfare check and her own apartment in the project when she has a baby.

I’ve never heard about this “rite of passage” (and I know people on welfare). What parts of the country have you seen this/heard about this happening? Do you, personally, know people like this? Or is this statistical information?

Welfare is huge!

Add up the costs of another baby. Add up what a person gets in food stamps for that extra baby. Add up how much their welfare check goes up for that extra baby. Let me know what you come up with. My sister in law gets welfare (mentally handicapped, she would fit into your category of ‘deserving’). Her food stamps are $187 per month. It just doesn’t add up for me the way it’s adding up for you. Can you show me your numbers? Because I’m confused.

Again, Vern, after you get those numbers to me, can we get back to the topic at hand? (health care) How does free health care to each member of a poor person’s family = enticing them to continue the cycle and keep having children?

also, could you please answer my question that I posed earlier? (I’m guessing you missed it, because there are a lot of posts here to muddle through! )

Okay, then. Based on my examples of real people, specifically, how do we help them?

 

[vern_humphrey]

I’ve never heard about this “rite of passage” (and I know people on welfare). What parts of the country have you seen this/heard about this happening? Do you, personally, know people like this? Or is this statistical information?

I know or knew people in Georgia, Virginia and Arkansas. And yes, there are studies backing it up.

Add up the costs of another baby. Add up what a person gets in food stamps for that extra baby. Add up how much their welfare check goes up for that extra baby. Let me know what you come up with. My sister in law gets welfare (mentally handicapped, she would fit into your category of ‘deserving’). Her food stamps are $187 per month. It just doesn’t add up for me the way it’s adding up for you. Can you show me your numbers? Because I’m confused.

You seem to assume that people always spend all their money caring for the extra child. They don’t.

Again, Vern, after you get those numbers to me, can we get back to the topic at hand? (health care) How does free health care to each member of a poor person’s family = enticing them to continue the cycle and keep having children?

How does providing money, foodstamps, housing, health care, and many other things entice people to have children out of wedlock? By adding up to a way to make a living, of course!

also, could you please answer my question that I posed earlier? (I’m guessing you missed it, because there are a lot of posts here to muddle through! )

Then why not re-state it?

 

[Trader]

How about another difficult case I had to think about last year. A seriously overweight and active alcoholic is suffering from kidney failure. His brother is a excellent match and willing to donate a kidney. The operation will cost more than a half million dollars and the patient has insurance that will pay no more than $200,000 for the procedure. Should the government–that is, the taxpayer–pay for the operation and follow-up care above the $200,000 in private insurance?

I am really unhappy that no one took a shot at this one. Would it help if I told you to be careful because it was a trick question?

 

[Man]

Ah, but her circumstances do matter. Government is not giving away its own money. It is giving away money taken from the people who earned it. Government may have the duty to be a good steward, but the track record on that score is miserable.

As I tried to say before, if there is a living father for her children she has an obligation to demand just support from the father, even if she does not want to deal with him. That support is the absolute right of the children and even best for the father to be called to do his duty.

There is a big difference between being judgemental and exercising prudent judgement. A lot of people are deliberately blurring that line to avoid their own responsibility. Prudent judgement is not a vice, it is a virtue.

Deciding who is deserving of sympathy and who is deserving of our tax dollars are two different considerations.

“But also now concerning this, it has been said, Let your alms sweat in your hands, until you know to whom you should give.” Didache 1:6

 

[Man]

Even if it encourages her to have more children out of wedlock? Even if welfare has become an economic strategy in her family and sector of society?

That makes us enablers – and the child in question has become a hostage to force us to continue in this role.

The target of the welfare needs to more specific. It is difficult, however, to divide the prosperity of a child from that of a parent. School grade based incentives?

 

[Man]

We should do what we can to help the poor – but bear in mind Saint Paul’s cautions about excessive charity and its negative effect on the recipients.

When you look at the poor, you find they fall into several categories:

1. The chronically poor – the third or fourth generation on welfare.
2. The metally ill.
3. The drug and alcohol abusers.
4. The unfortunate ones who simply cannot make a living, try as they might.

There are others, but this list will do for illustrative purposes. The first three categories defy our best efforts. The fourth category is the group that with help can become self-supporting.

Criminals also use welfare to subsidize their ill gotten income.

 

[Man]

I’ve never heard about this “rite of passage” (and I know people on welfare). What parts of the country have you seen this/heard about this happening? Do you, personally, know people like this? Or is this statistical information?

I had a friend who taught at a certain school in the inner city. Yes, 16 year olds have babies and enter the system willingly. Raise their babies and continue the cycle. Yes, it does happen. They often find employment somewhere or other that pays tax free…

 

[Man]

I am really unhappy that no one took a shot at this one. Would it help if I told you to be careful because it was a trick question?

Usually, some doctor and hospital will find some way to deal with such a pittance.

They will sue the person for their money, unless a deal is settled with them, and likely end up with whatever equity they have in personal property or something like that. Or they can garner 10-20% or more of their wages…

And the government does already does all dialysis…

 

[DrPiano]

Okay, then. Based on my examples of real people, specifically, how do we help them?

I’d just like to point out in defense of Vern that I believe he does advocate government help (in the form of contributions to health care) for those who truly cannot afford to contribute the maximum to their MSAs. He can elaborate, but it seems to me that for many of your cases, he would probably say (or at least, using his system I would say) that they should contribute X amount (based on their tax returns no doubt) and the government would pay Y% of the bills that come in, up to a certain amount.

Vern - correct me if I’m wrong.

Any way - the point is that people are making their own medical decisions about their own care. They would also be expected to contribute something. The tax burden to the rest of us would be significantly less than it even is now since we’d be much less responsible for other’s decisions. Theoretically, I believe there would be catastrophic insurance for the really big claims (paid for by premiums of those who bought the catastrophic insurance).

Anyway - It sounded like you might have forgotten Vern’s stated plan.

 

[emily47017]

How about another difficult case I had to think about last year. A seriously overweight and active alcoholic is suffering from kidney failure. His brother is a excellent match and willing to donate a kidney. The operation will cost more than a half million dollars and the patient has insurance that will pay no more than $200,000 for the procedure. Should the government–that is, the taxpayer–pay for the operation and follow-up care above the $200,000 in private insurance?

the insurance pays for less than half of the procedure? hasn’t he been paying his fair share to be part of the company’s risk pool? they should know that covering so little of the cost is equivalent to not covering it at all. he probably got that insurance thinking he was going to be okay in case of disaster.

did you know that about 37% of bankruptcies in the US are caused by medical bills for people who already had insurance when they got sick? pnhp.org/PDF_files/MedicalBankruptcy.pdf

anyway, back to your trick question. my first thought is to wonder if this guy is really a good candidate for organ transplant. i’m reminded of the woman in france who immediately started smoking again after she got her new face… that’s a question for a medical ethicist, methinks.

but if all systems are go, the donor is willing, the doctor is comfortable with it, the hospital’s board of ethics is comfortable with it, and you’re not withholding any further details, then i don’t see why not.

what’s the trick? lay it on me!

 

[emily47017]

Theoretically, I believe there would be catastrophic insurance for the really big claims (paid for by premiums of those who bought the catastrophic insurance).

that is, in an ideal world where insurance companies actually paid those big claims… sigh

 

[whatevergirl]

there is usually a $1 million threshold on most medical policies, fyi. In many incidents, the costs of hospital stays, chemo, etc…can go beyond that.

 

[Trader]

the insurance pays for less than half of the procedure? hasn’t he been paying his fair share to be part of the company’s risk pool? they should know that covering so little of the cost is equivalent to not covering it at all. he probably got that insurance thinking he was going to be okay in case of disaster.

did you know that about 37% of bankruptcies in the US are caused by medical bills for people who already had insurance when they got sick? pnhp.org/PDF_files/MedicalBankruptcy.pdf

anyway, back to your trick question. my first thought is to wonder if this guy is really a good candidate for organ transplant. i’m reminded of the woman in france who immediately started smoking again after she got her new face… that’s a question for a medical ethicist, methinks.

but if all systems are go, the donor is willing, the doctor is comfortable with it, the hospital’s board of ethics is comfortable with it, and you’re not withholding any further details, then i don’t see why not.

what’s the trick? lay it on me!

A gold star to Emily. All that stuff about the cost, and insurance, and the willing donor is meaningless because the operation will not happen. A transplant to an active alcoholic has no chance for sucess and the ethical standard, “First do no harm” will not permit major surgery on two people when there is no chance of sucess.

By the way, to donate a kidney you are required to be in excellent health, less than 60 years old, and have to meet with a psychologist and an ethicist to make sure you know what you are doing and there is no outside pressure on you. They don’t take your word on the good health part. You get a more thorough physical than most people ever get. They even promise to give you a good excuse,(lie for you) if you decide not to be a donor. I am not sure if it is the psychologist or ethicist who will lie for you, or if they hire a lawyer for that.

When my sister goes back to see her nephrologist for checkups she gets some nasty comments from people who were on the transplant list before her and are still waiting. “It’s not fair.”
The standards for who get which kidney are very complex. They factor in your current health, your age, whether you have children, and how good the match is with the available organ.
You have to be sick enough, under 20% kidney function, but healthy enough to tolerate the surgery. You can get a relative to donate, but cannot pay a stranger. My sister was 54 when she received her kidney, but new proposed standards would drop the maximum age to 50.

I met a woman at church who had a brother at the same hospital who was in much worse shape. He was also diabetic and had both legs amputated. He was taken off the transplant list because he was no longer healthy enough to survive the surgery at 37. She was complaining that high blood pressure ran in her family. Apparently she had not noticed that she weighed nearly 300 lbs.

It all goes back to where I started on this thread. Health care is not all about insurance, money, or whether you are sympathetic enough. A lot of it is about the choices you make and medical science cannot fix all the problems we cause for ourselves.

 

[emily47017]

It all goes back to where I started on this thread. Health care is not all about insurance, money, or whether you are sympathetic enough. A lot of it is about the choices you make and medical science cannot fix all the problems we cause for ourselves.

of course. that’s no excuse for the enormous number of people in this country that are a) foregoing basic care, and b) unable to get care for more advanced problems merely because they can’t pay for it. what’s happened to us? when did we get so self-righteous that we can think this is okay?

 

[boppaid]

I know or knew people in Georgia, Virginia and Arkansas. And yes, there are studies backing it up.{/quote]

I’ve been searching for these studies, and I can’t find them. Can you provide them for me?
vern humphrey;2492874:

You seem to assume that people always spend all their money caring for the extra child. They don’t.

Those I know on welfare do. Again, I understand that some people abuse the system, and I am 100% against that. My problem is, though, that if we stop providing basics that people need to live a semi-decent life from people who cannot afford them, just because some bad apples muddy the system, then we hurt innocent people who need government help. People who DONT have family to help.

How does providing money, foodstamps, housing, health care, and many other things entice people to have children out of wedlock? By adding up to a way to make a living, of course!

Well, since the “extra” health insurance one would receive for having another baby would only further benefit that other baby (as the other family members are already covered with or without that extra baby), I can’t see how health benefits provided by the gov’t would entice someone to have another child.

Then why not re-state it?

It just keeps evading you, doesn’t it? I did restate the question! (It was in the quote box at the bottom of my last post.) I’ll do it again:

Okay, then. Based on my examples of real people, specifically, how do we help them?