--- [EMAIL PROTECTED] wrote: > >Debbie asked- [actually, it was Ronn] > >OTOH, where *does* one� hold the line on health > costs? > > This is a doozie to work through, maybe we can start > this one bit at a time > and try an international flair. So far to date > (after some schooling and > thinking) I like the Australian System best. > Philisophically I figure that > "first world" countries should be advanced enough > that basic healthcare > should be a starting point- IIRC in Australia, every > individual has a basic > plan and individuals can "buy up" to other levels.
Does this mean a National Health Care System (what we would call a single payor plan), paid for by taxes? > I am not a huge fan of "heroic" life prolonging > measures, Me neither, in the case of terminal conditions or massive multisystem failure: while an 80 year-old with a mild-moderate heart attack - but no other significant problems - can go back to independent living and activities with proper treatment and rehab, a 65 year-old with the same heart attack - but on top of longstanding uncontrolled diabetes, renal failure, and emphysema - is going to do very poorly, no matter how well-treated. > so I guess part of > my answer is "what should everyone have" and the > other boundary is "what is a > realistic accepted level of care". Some > millionaires (and actors in > Christopher Reeves case frex) will always be able to > "buy up" or get into experimental plans. My real objections here are in the case of severely limited resources, frex organs for transplant, going to people who caused their own problems (Mickey Mantle and David Crosby getting livers, after years of alcohol and alc/drug abuse). No one has been deprived of something because of Reeves' treatment. > To some degree I see people do this every day, some > people pick the HMO version with limited options for > physician care in > comparison to a PPO/fee for service plan (or higher > coverage/lower deductible > plans) because they do not have the money to pay the > childcare, etc (How > many of us would choose to put a family member in an > experimental program > that could be of no benefit/placebo/damaging when we > are not under the > emotional strain of coping with a family member that > may die? (How many > people think about the level of care they want for > themselves if they get > sick- although it might be a bit less intimidating > than setting up your own funeral plans). Facing your own mortality is quite frightening - although for me it is not *death* but _loss of control before/while dying_ that terrifies. If I'm terminal - turn off the ventilator. If it's been 2 weeks of coma - same (or cease fluids/meds). > For lack of a better starting point, there is > routine care, and respect of life... Respect of > life is easiest to perceive when it comes to > hospice, but there are everyday > patient rights that also play in here (I am not > talking about people > demanding the "best/most extreme" care, but respect > and rights to basic "quality of care"/treatment). > > My other concern is that "holding the costs" ends to > be a reactive > philosophy. Some posters have already noted that > preventive measures can > have good return on investment. Could you expand on this? > There is no simple answer. For example, I hear > people complain about > skyrocketing costs of malpractice insurance and > general insurance rates- the > common sound bite is the lawyers are ruining the > system but I heard a great > article on NPR about how several studies have shown > that these rates increase > when the interest rates/etc are diminished and the > insurance companies really > have to make money off premiums and not the > interest/investments they have. > The fallacy of managed care has been over for more > than 5 years- the worst > cases of HMO type bankruptcies on the east coast > were not this year- yet we > are just hearing about the insurance company > suffering to provide care now. There is certainly no simple prescription; any 'quick fix' would be like surgery without anesthesia - painful and difficult to perform as the patient writhes on the table. :( Debbi Beads And Rattles Maru __________________________________________________ Do you Yahoo!? Yahoo! Mail Plus - Powerful. Affordable. Sign up now. http://mailplus.yahoo.com _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
