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  • SAULBKNYC_904

    Member
    May 5, 2009 at 3:24 pm

    Nothing would stop creating policies that are more expensive for people who engage in risky lifestyles. No one is complaining that a life insurance policy is more expensive for smokers than non-smokers. If you are asking in a world with mandatory health coverage how to cover those people, that needs to be worked out. I’m asking what of people who do not engage is a risky lifestyle who have no coverage. I’m asking how to address the problem of medical costs being a leading cause of bankruptcy or lack of coverage being a major factor in higher morality.

    You make a blanket conclusion that except for people with hormonal problems, most all other health problems are ‘self-inflicted’ and their personal costs should be higher. That assumes they can get coverage at all and that is a might large assumption that their health problems are their own due to their irresponsibility. While I agree that some are their own worst enemy I also think your assumption is a convenient cop-out. First, what of those with hormonal problems, are they getting adequate care or should they get a normal rate because it’s not their fault? What of children, including teenagers? What of mental health? Too many holes in your argument, too many left out. Not all sick people are themselves at fault.

    As for utopia, no one is seeking utopia. I’m told that Paradise will come in the next life. That’s good enough for me, in the meantime I’d like to leave this world a better place than found. Utopia never was the destination.

     
    I was not really talking about life insurance…we are talking pimarily about health coverage which is acutally a larger cost.  I work this year in a hospital where essentailly everyone comes in for free because it is a teaching hospital and they can see the residents.  Everyone is seen.  We would have at least (and I am being generous here as it is likely more) 60-70% of the patients that are being seen as a direct or inderect result of their own unwillingness to make the right choices concerning their own health care.   If you took away  DM, obesity and smoking related diseases not to mention various infectious diseases (hepatitis, STDs for examples), the hospital census would be cut in half if not less.  My wife does family practice and it is no different in her practice.  So it is not like we are talking about 5-10%.  Look at epidemiology statistics and usually the smallest segment of causes for most pathology is due to a genetic cause.  The rest, are aquired, often through activites that are avoidible and known to most of the population.
     
    Here is what I dislike about socialism in general and is behind most of my part of this (admitting that no system is likely to be all on thing or another), it either requires intrusive government that has to control for all these varibles so it can afford to pay the costs or it depends on a complete altruistic population.  You will never have the latter so you end up with the former…which is a society that I don’t wish to be apart of….You say “it is something that will have to be worked out”…well that will be more laws outlawing this and that because it costs the gov. too much money.   Look what Canada has had to do…outlaw private healthcare of anytype. Is that what you really want? Not to mention the gov usually does a crapy job at most things.  During the off seasons before I started back to school, I worked for the EPA…10 people doing 2 people’s job (is why I worked there I had could take time off for travel and racing), impossible to fire lazy often incompetent workers, people often promoted to jobs they were not qualified for to get them out of departments where they were not liked, ‘cost cutting’ almost never got rid of real problem people but just ones that did not have enough political capital to stay…I can’t imagine my healthcare being decided by a similar group of people.  
     
    I am fine with a health care system that picks up kids and people not insurable….or, how about a competiting private system that mandates coverage for all adults (dispersing the cost more broadly) based on a lottery system to assign the higher risk/poor pts to the insurance companies and subsidized by the gov to reduce cost.  Similar systems work pretty well for car insurance in some states. 
     
     
     

    As for Reinhardt’s mother, who in her family is bumping her out of the way? That makes no sense. I never said Germans were superior, that’s your misinterpretation, deliberate? Maybe Germans do have a different sense of social responsibility? Maybe David Brooks can illustrate in today’s opinion.

     
    Reinhardt had the idea to use the system to get his mother in front of others instead of waiting.  From the story, the ONLY reason this did not happen is because she objected.  Therefore, in the absence of her objection (had she said, lets do it), he would have done it.  The fact he sugested it shows that people over there thing just as someone here would, it also suggests he thought he could pull it off.  Therefore, intent and opportunity in the mind of Rienhardt demonstrates that 1 of the 2 people in your story do not share Rienhardt’s mother’s point of view.  This is pretty consistent with most humans I have met on this planet so it is likely that there are more of him around….even in Germany.  That is the point I have been making. You told the story in an attempt to demonstrate the system could work, it would just take a little work to get Americans to change their attitudes.  I don’t think they will change.  I have traveled around quite a bit and have worked with people from many different countries.  There are some differences but basic ones are not that much different.  It is like being a successful coach…..you have to use the players you have, you don’t try to force them to do things they can’t, you use what they do well and form a system around that.  MOST (you and Reinhardt’s mother might be different) people act out of self interest or self perservation.  You just have to align the goals you want with those that conicide with the individuals in the population.
     
    BTW, i don’t blame Reinthardt, if it were my daughter, wife, mother I would do what I had to do to get them the medical care they needed.