----- Original Message ----- 
From: "Erik Reuter" <[EMAIL PROTECTED]>
To: "Killer Bs Discussion" <[email protected]>
Sent: Sunday, February 20, 2005 4:31 AM
Subject: Re: Real cost of living (was Social Security reform)



> We might be able to figure it out, but we won't be able to pay for it.
> Many people seem to think that medical care should just be given to
> those who need it. Perhaps we should assign a full-time personal doctor
> and full-time nurse to take care of everyone in the world!

My brother-in-law (who's a physician) and I had an interesting discussion
on the subject of medical costs.  Using car metaphors from our youth, we
compared what we thought would be a reasonable plan for medical insurance
with what we have now.

What we have now is this: the requirement to give medical care to people
without insurance is soft.  If a hospital, for example, decides to not have
an emergency room, they can restrict input fairly effectively.  But, once
someone is admitted, no procedure can be excluded because that patient
cannot pay for it.

A more reasonable way of doing this is to include the cost of procedures in
the mix.  Everyone can get basic solid care.  But, the high cost care that
pushes the envelope has to be paid for, one way or another.  Hospitals are
not required to give it.

The car metaphor is that the present system is that the hospital can refuse
to let people have a Chevy.  But, if they give them a car, they must be
willing to give a Caddy.  Jeff and I agree, a system in which everyone gets
a Chevy but has to pay for an upgrade to a Caddy is far better.  It would
cost less and provide better care.



Dan M.



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