Author:
tzz, all-knowing moderator
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Date Posted: 11/ 7/04 8:28:00pm
>i just can't resist proving how rIght i am [in more
>ways than one]
>
>http://www.techcentralstation.com/110404D.html
still reading your other posts - but I had to put my 2 cents in on this one. I actually do think we have a national responsibility to provide a minimum of health care for all Americans - a good role of the government. It will benefit our country to have people healthy - Medicare and Medicaid should remain, reformed but remain. Assuring a minimum provides a work force able to work, a mind ready to learn, and keeps very bad diseases out of the country (think polio) where the personally responsible are equally as likely to face infection as those who aren't. I also have no problem paying taxes to support this system, although again - I would prefer some changes.
Here's one change that scares me: CMS (Centers for Medicare and Medicaid Services) last week started debating whether it was more fiscally sound to pay for bariatric procedures (the stomach stapling stuff)than to pay for the medical consequences of obesity in our country. The CMS has compared this to smoking, where the cost to the taxpayer has been astronomical. Since most of the problems with smoking appear later in life (typically after Medicare eligibility), there is a sense of what this life choice has cost the public. CMS sees obesity dwarfing the costs of smoking. Scares me to death.... and as a knee jerk reaction I'm wholly against it.
The question is how you build personal responsibility into health care in a system where costs are virtually unknown to the recipient in advance of care provision, when it really takes someone with training to be an 'informed' consumer (where's the health care equivalent of Consumer Reports'?), and when care is never reimbursed based on outcome? Put it this way, if you went to an automechanic who failed to fix your tire, do you pay him a second, third or 4th time until he gets the fix correct(or until you do it yourself)? The profit model for health care is based on units of care delivered, not whether said care was necessary or even caused change. How frustrating that a therapist who can't distinguish and arm from a leg is reimbursed the same as I would be.
Nice start of a post t. I think there's much to discuss in the balance between personal responsibility and the role of government. A whole range of issues from what do we do with the Danny's of the world (especially the ones born into families who cannot afford them - unlike Geo and I), to what we do with those who can make meaningful change and choose not to.
Great thread!
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