**

You reach the same impasse every time: who do you trust with the power to decide when care stops and the patient is allowed to just die naturally? The doctors? Next of kin? The patient himself? The insurance companies (or whoever is paying the bill)? The lawmakers? No matter who you pick a case can be made that wrongdoing is a distinct possibility.

We can't treat humans the way we treat our pets, so we can't be as humane toward each other as we are to Fluffy and Fido when talking about euthanasia. And that is mostly because our motives are likely not always as noble as they are when dealing with animals.

Damn shame, that.

Edited by Wayde Murray on 25 March 2010 at 10:00am

When the funds run out (for a specific time period), even universal government health care "rations" care.

But it's according to a system of medical triage, where young people with curable ailments get priority, highly experimental treatment with low chances of success gets denied (mainly because in a limited system spending a lot of money on long-shots will deny highly succesful, easily affordable care to a lot of people.) The guiding principle is to get as much healthcare for every dollar as possible. To eliminate "waste".

But the way it gets presented in the health care debate, one gets the impression that some people think that private health insurance doesn't ration care.

The problem is that insurance companies ration care according to profit principles and financial models, based on a balance between profitability and competitiveness on price.  Getting the most healthcare out of every dollar is not a concern. They have no incentive for eliminating waste, just for eliminating expenses.

Indeed that's been an important point in the debate, that some doctors order unnecessary tests under this private system because the system is set up to make it profitable.

No matter what the profit margin is, that's money taken out of the system and "wasted".  And certain administrative costs are a "waste", too. 

Some people seem to "believe" that if something is public, it's automatically less efficient than something that is privately owned.  They don't even need proof. It just is.  Yet if a public option is EXACTLY as efficient as a private option that also has a 5% profit margin, they are in economic terms 5% more efficient in terms of health care per dollar.

A private enterprise where "the common good" is one of the goals  starts off with a handicap equal to its profit margin. It has to be proportionately better just to be equally good in terms of "value for money".

So, I guess Medicare must be really crappy, right?  Otherwise you guys would have to be insane to prefer such a widespread and costly private option. Better with what the rest of us have in terms of private insurance, a limited Cadillac plan that lets rich people cut in line.

QUOTE: but do you often work for no money? I sure as hell don't

I should have explained myself better.

Insurance companies employ actuaries and,  of course, doctors.  One of the functions of the doctors is to keep up with medical trends, and decide what is considered normal medical procedure and what is experimental or research oriented.  The actuaries collect hundreds of thousands of number from case data, and can come up with what is known as a reasonable and customary amount that should be paid. As anyone from the midwest, who has flown to NY and purchased a burger, the cost for things of course vary by what region of the country you are in.  Patient A goes to the doctor and procedure X is prescribed.  Procedure X is still in the experimental stage, and costs $50,000.  Insurance says, since we don't fund research, we will pay the reasonable and customary amount that usually apllies to procedure B, which is $35,000.

They aren't working for free, they just aren't getting what they asked for, since there are not accepted gaurantees that procedure X is any better than procedure B.  It very well might turn out to be, but experimental case studies need to be privately funded, not thru insurance.

Insurance plans will pay for what they were designed to cover, the problem a lot of people have is they don't know what is in their plan.  How many people read their house or car insurance plan?

Wow.  "I'm talking to a brick wall" and "stick it where the sun don't shine."  How civil.  I'm not going to resort to name calling or nastiness.  It's unnecessary and solves nothing.  William, I'm sorry your wife experienced whatever it was that has made you so angry.  And I truly hope she is better now.  Don't assume that no one in my family has been through any sort of medical crisis that involved a struggle with an insurance company.  You'd be attempting mind reading and you'd be wrong. 

Insurance companies cannot pay for every single medical expense of their members, period.  It's simple math.  You can't subtract 3 from 2 and come up with a positive number no matter how hard you try.  If insured people were allowed to run amok, there would be no insurance companies because the claims would simply outpace the premiums.  Look at the cases where patients (and thus hospitals) do have a blank check, like the heavily unionized auto industry.  Those plans are broke.  And not only are they broke, they nearly dragged down the entire industry with them.  This isn't due to a diabolical insurance company lording over the masses.  This is the direct result of waste and fraud on the part of patients and the medical system.

At no time did I say that insurance companies were perfect.  They are not.  And they are for-profit businesses.  They make no secret of that.  But to vilify them while giving doctors and patients a completely free pass demonstrates a lack of a thorough understanding of the situation. 

Placing blame is easy.  Taking responsibility is hard.