Re:Health Insurance-

[Guest guest]

Ralph Giarnella wrote:

> As a physician treating these people I have had the

> opportunity to peer into their lives and hear the tragedies

> that the are reasons why many are in the predicament they

> are in.

I've had that opportunity as well--not as a doctor, but as a family member. You

are not

the only person who has met people who have been through such tragedies, and if

you

have not had more than one member of your nuclear family go through it, as I

have, then

perhaps the things I've written in this thread will have a somewhat different

meaning for

you.

> As I stated in one of my posts " many times

> through no fault of their own " they have come down on

> hard times and need the help of others. And sometimes the

> only helping hand might be our government.

Agreed. As I stated in my post indexed at no. 48140, " So when somebody who is

not

physically or mentally disabled and earns $40k per year tells me he 'can't

afford' health

insurance, I need to know more before I'm willing to accept that as a legitimate

claim.

Sometimes, through unlucky coincidences, it will be, and that is always a

tragedy. For

those people, we are willing to pitch in for their basic medical care, food and

shelter. "

> Some are born with lower than normal intelligence and can

> only hold down low paying jobs [snip]

> Some where born into dysfunctional families and suffer

> severe anxiety resulting in their turning to drugs and

> alcohol to treat their symptoms[snip]

> Some had a decent income and insurance until their company

> went bust and laid them off along with hundreds of their

> fellow workers [snip]

> The husband/wife who is forced into a divorce because of a

> cheating or abusive spouse and is left with 1/2 their income

> and assets[snip].

Through the nuclear family into which I was born, I have lived through three of

those four

scenarios. Trust me, I understand these things in a very personal way. Again,

as I stated

in my post indexed at no. 48140, " So when somebody who is not physically or

mentally

disabled and earns $40k per year tells me he 'can't afford' health insurance, I

need to

know more before I'm willing to accept that as a legitimate claim. Sometimes,

through

unlucky coincidences, it will be, and that is always a tragedy. For those

people, we are

willing to pitch in for their basic medical care, food and shelter. " The

circumstances in

your examples above may excuse the individuals who cannot pay for their own

medical

care, but it does not excuse us from our civic duty of trying to make judgments

about

legislative policies regarding health care.

> While we all hate taxes [snip]

If you're referring to me, please don't put words in my mouth. I do not " hate "

taxes. I

don't even disapprove of them per se. A tax is as good or as bad as the

governmental

action it funds. Government intervention in private transactions, even when it

results in

the transfer of wealth from one family to another, is not per se wrong, IMO.

The value of

the intervention depends on how, and by how much, it distorts the demand for

various

goods or services, or creates or mitigates positive or negative externalities.

It depends on

how well the program achieves distributive justice (for example, whether the

intervention

has a " Pareto optimal " result, or is reasonably close). It depends on the

administrative

costs. It depends on whether the intervention creates a " moral hazard, " as that

term is

used by economists. All these things must be measured against alternative

solutions to

the problem that the government intervention is supposed to mitigate. When

comparing

alternatives, we must look at efficiency, efficacy, and fairness......and the

manner in which

those criteria are defined and measured.

So taxes and government intervention in private transactions per se don't bother

me.

What makes my blood boil is poorly conceived tax policy, especially where it

creates a

moral hazard by creating a disincentive for people to make prudent decisions

about their

own welfare. It is sadly ironic when a government welfare program is

destructive to the

people it was intended to help. It is also grossly unfair to those who have

acted

responsibly, but whose ability to provide for themselves is sapped by the taxes

levied to

support such a program.

> There but for the grace of God, go I. - Judge not lest you too be judged.

> These are words that impressed me in my youth and I try to live by.

Let's not judge people, but legislative policies. Or to the extent we judge

people, let's at

least judge their actions on a continuum of prudence and responsibility. We can

do so

without imparting a moral judgment, if that offends you. But please, let's not

underestimate the number of people who abuse the generosity of others, nor

understate

the problem that the more generous the governmental safety net, the greater the

disincentive for people to take care of themselves.

> It is easy to sit in our Ivory towers and look out

> and judge all those poor slobs who are obese, unfit, poor,

> uneducated, drug addicted, unemployed and say it is just

> their fault and if they would just do as I have they would

> not have these problems.

Surely you're not referring to anything I wrote. I know that in my post indexed

at no.

48140 I went on at length about how my wife and I have tried to be financially

responsible

citizens, and not only in terms of health insurance. But if you thought that

the purpose of

that example was so I could seize the moral high ground and heap scorn on the

uninsured, you really missed the point. The point was to explain why, " when

somebody

who is not physically or mentally disabled and earns $40k per year tells me he

'can't

afford' health insurance, I need to know more before I'm willing to accept that

as a

legitimate claim. " My next two sentences were, " Sometimes, through unlucky

coincidences, it will be, and that is always a tragedy. For those people, we are

willing to

pitch in for their basic medical care, food and shelter. " Are those the words

of someone

who is " judging all those poor slobs " and saying " if they would just do as I

have they

would not have these problems " ?

> Next time you go to an Emergency room and have to wait 4-6

> or more hours because

> it is crowded with uninsured people, who waited until they

> were extremely sick

> to seek medical care, just think how much better medical

> care would be if they

> treated their severe asthma when is just a minor wheeze.

And be sure to ask if the reason they didn't treat the asthma before was because

they

didn't have the ability to pay for the treatment, and if not, why not. And then

make sure to

ask why we have laws that require hospital emergency rooms to treat people who

cannot

pay, and whether there might not be a better way to treat them. Let's look at

the big

picture.

> In the 60s there was an uproar against Medicare by many

> including physicians

> yet, with all its flaws, where would our senior citizens be

> without Medicare.

We should also ask where they would be if they'd saved enough for retirement, or

if our

government had not allowed inflation to run rampant throughout the 1970s,

devaluing the

savings they had made. I am not trying to " snipe " at you--I'm using your

example to

show how big the " big picture " is.

> Even the prescription Medicare part D with all its flaws

> has been a tremendous

> help for many of our seniors who can now get medications

> they could not

> previously afford.

See above. Many Americans complain because our government does not

(yet) offer the same socialized medical programs as European governments, yet it

is so

typical of this American generation that they do not also complain that we as

*individuals*

do not save like Europeans. Despite the fact that the Europeans and Japanese

pay higher

taxes than Americans, they save much more than we do. Heck, by European or

Japanese

standards, my wife and I are spendthrifts. Perhaps we should look at Medicare,

Medicare

Part D, and socialized medicine in America as a " forced savings program, " except

that

instead of us earining interest on our money, the government takes about a 30%

cut for

administrative costs, something that would put an insurance company or a charity

right

out of business.

Moreover, it funds the benefits in a manner that would be illegal (those who pay

today are

paying for those who collect today) if done by an insurance company. Although

the

government has created a double standard, one for insurance companies and one

for

itself, the hazard is the same for both. There is one thing we know for

certain: those of

us who will not become eligible to collect Medicare benefits for another ten or

fifteen

years will not be collecting the same benefits that we have been paying for for

all these

years, and the money that was taken from us to support the previous generation

is not

available to us to save for our own future needs.

Regards,

s

Ardmore, PA

[Guest guest]

, I'm very curious about how you justify your statement (see below

after my diatribe<g>). Could you please explain to me what moral code

allows someone to steal the results of a person's production and give

it to somebody else. Who is omnipotent enough to decide what's fair

(how much to steal). Please give an example of somewhere your pie in

the sky system has created more wealth for more people than even the

meager token capitalism that exists in the USA.

I also have noticed that no one has taken it upon themselves to

challenge my previous post on this subject although Nick has agreed

that capitalism does not exist in the Western world. There seems to be

many that are crying for a socialist health care system even though

the free market has long been abandoned but is still blamed for the

failures. On the other hand, many if not most government sponsored

health care systems provide poor service and/or going broke or

continually have to raise taxes. I'm afraid the law of supply and

demand and the associated costs of excess demand has yet to be

overturned anywhere.

Since everyone is giving examples of why health care is such a

problem, I'll give my own. Several years ago while running I kept

noticing that my left calf was getting very tight. It kept getting

worse. I had been having problems with peroneal tendonitis and when I

went to my GP he assumed that was the reason. I had made an

appointment with an orthopedist who had previously prescribed

orthotics (probably another over-prescribed device) for the peroneal

problem that I had off an on for 3 years. The orthopedist looked at my

leg and suggested that I might want to have a Doppler scan ASAP. So I

went and had one and it was determined that I had a blood clot that

extended from my ankle to above my knee. Despite my potestations that

I could walk, they put me in a wheelchair and sent me to the ER. There

I waited for 6 hours while family after family with children with

colds were seem before me. I saw no one with an apparently serious

problem. If there were, they came in through the ambulance entrance.

Regarding the blood clot, I had just returned from a trip from Ca. I

hadn't realize the high potential of getting a blood clot on a long

plane trip. Added to that, being an endurance athlete I may have been

a bit dehydrated and it was later learned that I have a narrowing of

one of the main veins near my knee that makes me more susceptible to

the problem.

Now you can say that the reason is that those in the emergency room

with children with coughs don't have health insurance because it is

too expensive so they had to go to the emergency room. There are

several problems with that line of reasoning.

First of all in this age of car seats, seatbelts, bicycle helmets,

playgrounds with ultra self surfaces and the rest of the protections

forced on us by the nanny state, many parents have no idea of how to

handle the slightest problem with their children. They also have no

idea of why they are fat, out of shape, have diabetes, etc. but have

plenty of time to sit on their ass and watch TV or go out to eat at

fast food joints. Yes there are many people, especially working moms,

who are stressed for time, sleep, etc.. But have they ever considered

what they were getting into when they bought that high cost house in

the burbs? Or had an additional kid(s)? Or when they had that child

out of wedlock?

Secondly, since the government has forced ERs to treat everyone for

whatever reason, whether they have insurance or are legally in this

country, the only disincentive to using the ER for all medical care is

the wait time. I grew up in a lower middle class household and we

seldom went to the Dr. unless there was a serious problem. I realize

that people live longer now because of improved medical care and some

of the drugs developed by the greedy drug companies. On the other hand

I no more believe that everyone has a right to the best and most

expensive medical care in the world than I believe everyone has a

right to a million dollar house or a Lamborghini. To assert otherwise

is to favor socialism " from each according to his ability, to each

according to his means " .

It's the same deal with Medicare, Medicaid and employer sponsored

insurance. There is no incentive not to use whatever is available for

the least little problem. If you do have a problem such as those

suffered by an athlete, or at least someone who works out and develops

an injury, you know that you probably need to go a physical therapist.

But for many insurance plans and for Medicare you have to go to a

physician, most of whom know little about such things to get a

referral to—a physical therapist!

Bob Dannegger

Raleigh, NC