This issue is crucial for every American and requires a great deal more explication than I can do here, but because this is for the file cabinet - it will serve, if I ever choose, as one of many such commentaries on the subject.
I will digress before I return to health care.
When we are little, say 2-7, from where do our monsters come? What were our monsters? Unlikely we can remember them when we hit 20 or 30, but what could they have been? Something big in the closet? Something furry under the bed? Something with big teeth? And where did the origin or genesis of those fears come? Whatever the source, the manifestation was something we created based upon something we were told or saw - from an older sibling, parents, friend, a book or comic, or a movie. We then used the manifestation and fed it our fear to create our very personalized monster. We could not, at age 3, conceive of a pink monster that floated and smoked Cuban cigars - in part because we had no idea at 3, what a Cuban cigar was.
In order for the fear to be real to us, we had to understand the form the fear took. We could not imagine an evil such as the robotic monster from War of the Worlds when we were 4. Our monsters tended to fit the model of things we could comprehend, imagine, had read about, been told or seen.
This same form applies to our responses to events. When we are hurt or get hit, when we receive bad news or we are told of a death ... we respond according to a model we have created based upon manifestations created or directed by others early on in our life.
There are of course variations on our behavior that deviate from the original manifestation of fear, but generally they will follow them quite closely. We rarely if ever can operate outside a paradigm we understand.
For example - no one could conceive of the idea that all doctors work for free and do not charge patients. That paradigm does not exist and we cannot operate within a paradigm that has not existed for we need models.
We need models.
Models for political systems: the Greeks, Democracy, Communism, Socialism ...
Models for heath care: France and Germany, Britain and Canada, Sweden, Norway, and Finland...
So which models will Obama choose to follow for health care?
He cannot operate in a world that has never existed. It simply does not work like that.
He can look at Sweden, but it is easier and simpler to look at Canada and England.
England has a population of 65 million.
The US has a population of 305 million.
A factor of about 5, or 350,000 in the US.
Is this acceptable to you?
What if it is your mother or father, uncle or grandparent.
Heart bypass surgery costs between $50,000 and $250,000 in the US, and in Canada and the UK or some equivalent sum. Yet the patient does not get burdened by that cost nor does insurance cover or permit the charging of that much. Yet the fact is it is quite expensive. At the moment, we have private care - we pay the insurance and they will do the surgery whenever we would like because we pay and the insurance company pays. The insurance company can afford to pay as a result of the premiums it collects that are not expended on $250,000 surgeries.
Now - assume it is the government that handles all the costs and payments. It will need to save money - 300 million people getting older each day and being afflicted with old people's issues. If it was a private policy you simply make the payment and the doctor does whatever he needs to do. If it is the government, someone else cares whether or not the process is done - the government. Should the government spend $250,000 on a 66 year old?
The answer under our private care system is YES, hell yes, right now, anytime.
But if the government has to decide - to spend the $250,000 on a 66 year old male with heart problems or use it for 5 twenty year olds with less serious afflictions. Which choice?
The 5 twenty year olds have 40 years of paying taxes and being productive citizens. The 66 year old is almost out of time and should not, based upon criteria, receive the surgery.
We do not have the resources now or ever to provide payments for surgeries that will not provide some benefit in return. Providing surgery for twenty year olds to walk again would benefit society - they will spend 40 years repaying taxes. A cost / benefit analysis would be very simple - the 66 year old should be given meds to take home to make him more comfortable, but no surgery would be provided.
This would apply to any 68 year old or 70 year old with a tumor or cancer - cancer surgeries are expensive and very intrusive. It would be much easier, and more beneficial to send the patient home with medications to remain pain-free than do a surgery that might cost tens of thousands of dollars that are never recouped.
Socialism does not value the individual, socialism values what the individual produces for society.
Patients who can afford to come to the US for medical care abandon Canada and Britain if they want to live - and that is not over stating the issue too greatly.
No system that is 'free' or paid for by the government, can do all the surgeries and provide all the medical care - cost / benefit analysis - just not worth it in many cases. Too expensive and why spend it on people who may not live, are too old, and will never survive. You don't. Instead, rather than trying to save the lives of hundreds of thousands of people, you give them meds to feel better, and send them to a hospice to die.
In Canada, England, and any country where they have socialized health care this is exactly what they do.
People with MS or some other condition - if you are over 40 - way too old to be spending so much money. Better to make you feel better and let you sit at home.
In a system where the government pays for it all - it cannot afford to pay for every surgery that just might save your life. Rather, only those that will benefit society and be repaid in taxes, in time.
You are not important as an individual any more - your only importance is as a tax payer.
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