Healthy Living Worthiness, Socialized Medicine, As Well As Private Responsibility
My final post examined the questions: Who is worthy of having adequate wellness insurance too high-value (safe, cost-effective) care; what makes them deserving? And who, on the other hand, is unworthy; what makes them undeserving? I linked to this post on some other forum, which led to an interesting conversation close personal responsibility. Following are excerpts from that conversation. I welcome your comments.
One individual commented:
Everyone deserves unobstructed medical attending for illness too injury; curable, chronic, and/or terminal. In that I run across an absolute fulfillment of the constitutional mandate to run across to the 'general welfare'. One measuring beyond that is preventive care, to a greater extent than opinionated too intellectually based; but I none the less would consider that the 'general welfare'. Every other service for everyone associated equally medical service should stay privately financed too marketed (like kid bearing too voluntary procedures).
One critical number inside that seat is how to bargain alongside self induced wellness impairments. This wellness bird should take away maintain a name, definition, too social remedy. Let's telephone telephone it IHIs. It's tough because it's smoking, pitiful diet, drug addiction, STDs, pitiful dental care, high adventure sports, etc. I'm thinking IHI classification puts an private into a especial insurance category requiring add-on premium or mandatory savings both during too for some fourth dimension afterwards such circumstances.
I replied:
Yes, dealing alongside the sort of self induced wellness impairments (IHIs) is a thorny issue.
Influenza A virus subtype H5N1 logical instance tin flame live made for having those alongside the fiscal agency pay out of bag for at to the lowest degree a part of treating wellness problems clearly determined to live voluntarily induced. That is, delivering aid to people alongside adequate maturity, knowledge, intelligence too rationality, but who brand a witting determination to engage inwards high-risk behaviors too endure the consequences, would terms them more, so they are held accountable for their actions.
Unfortunately, many (most?) of these people are either (a) young (e.g., teenagers enticed yesteryear tobacco too alcohol marketing, equally good equally peer pressure, too and so larn hooked); (b) ignorant, confused or unintelligent (they don't fully realize or empathise the risks of eating also many greasy french fries too failing to do regularly, or they take away maintain problem self-managing a chronic status requiring a complex medication regimen too lifestyle changes); (c) irrational (e.g., they deceive themselves into believing they tin flame halt taking drugs, or they are self-destructive due to a psychological problem); or (d) they lack the funds too back upwards needed to alive a to a greater extent than good for you lot lifestyle (all their fourth dimension is taken working twenty-four hours too nighttime at minimal-wage jobs, or they lack affordable transportation, to catch the dentist every vi months, or they can't afford fresh fruits, vegetables too lean meats when pasta is a fraction of the cost). Or, they exactly mightiness live unlucky (e.g., the got an STD because the prophylactic broke).
In other words, this is a complex number too a peachy bargain of idea should become into defining the weather for the sort of punitive costs you lot propose.
Also consistent alongside your proposition would live a policy of taking punitive activity against the manufacturers, distributors, retailers too marketers of unhealthy foods too ineffective medications too supplements. And what close tobacco companies too alcoholic potable producers who promote their products to college students, too fifty-fifty the promoters of unsafe sports?
It seems to me, therefore, that establishing a reasonable 2 tier system--one for folks who self-manage their wellness effectively too some other for those who don't--is a daunting task, but ane worth examining.
On altitude of this is the query of whether contraception, abortion, too kid bearing should live paid privately.
Nevertheless, the bigger number inwards my hear (and discussed inwards my blog) isn’t close penalizing sure people for pitiful behavior; instead, it’s close enabling too rewarding the delivery of high-value wellness too healthcare services. I ground that minimizing waste, inefficiency, too ineffectiveness--while maximizing transparency of lineament too cost, along alongside wellness didactics too services, too rewarding positive results--would genuinely relieve so much coin that at that spot would live no demand of the sort of two-tier organization proposed.
Another individual commented:
Providing the sort of full general welfare you lot suggest is way beyond what our founding manlike individual bring upwards meant yesteryear this or far beyond whatsoever logical interpretation. Providing for the full general welfare agency our legal citizens powerfulness to pursue their lives too operate safely, securely, too gratuitous of regime inference too detailed mandating. It inwards no way agency the regime should revenue enhancement everyone to pay for things that everyone has the liberty to choose. This includes medical care.
Per the Census Bureau's 2005 / 2006 census report:
I am unwilling, equally good as, unable (I am retired too on a rather fixed income) to pay for the healthcare of illegal aliens too those citizens who desire me to pay their way!
And last, but non least, delight furnish valid, relevant, accurate, too consummate statistical information which clearly shows those countries who take away maintain socialized healthcare furnish healthcare of equal or ameliorate than is currently provided inwards the US.
This does non hateful major improvements are desperately needed inwards our acquaint healthcare systems! But these are improvements non a replacement! I volition non grip my breath waiting on the healthcare manufacture to brand these needed improvement, because of regime regulations too interferences! The politicians are a major component of our healthcare problems, non a solution amidst them! :-)
I replied
You said: Our regime [should not] revenue enhancement everyone to pay for things that everyone has the liberty to choose. This includes medical care.
While I grip alongside your premise, I don’t believe it’s close “freedom of choice.” There are many reasons for people non having coverage, including:
You said: 17,742,000 uninsured Household earned $50,000 too to a greater extent than inwards 2006. … These People for sure could afford to larn their ain wellness insurance.
It seems to me that the number of folks who tin flame afford insurance too exactly chose non to larn it is really small. Take your illustration of a household unit of measurement earning $50K/yr. In NY, an HMO household unit of measurement conception alongside steep copays too deductibles too no dental, offered through a pocket-size business, terms a household unit of measurement over $11K/year inwards premiums alone, which increases every year. That’s a sizable expense fifty-fifty for a household unit of measurement earning $50K, on altitude of out of bag dental costs, equally good equally copays too deductibles. I don’t run across that many neglect to purchase insurance because they’re looking for a “free ride.” I say this inwards calorie-free of the fact that the uninsured tend to take away maintain worse wellness and, when they larn sick, they take away maintain to hold back for hours inwards a emergency room or become to a community hospital security internet facility. This is non a glamorous option.
Another group, btw, are the “underinsured” who purchase coverage too and so are shocked to realize that what they take away maintain doesn’t come upwards unopen to paying their medical bills. According to a recent consumer reports study, 24% of Americans take away maintain wellness insurance that barely covers their healthcare needs, non to mentions the 16% alongside no insurance at all. This leaves a huge number of people unprepared for major medical expenses.
You said: Please furnish valid, relevant, accurate, too consummate statistical information which clearly shows those countries who take away maintain socialized healthcare furnish healthcare of equal or ameliorate than is currently provided inwards the US.
I don’t believe such clear-cut information has always been collected to brand the instance ane way or the other. But at that spot is convincing information that the the States lags behind many industrialized countries inwards delivering primary care, access too lineament … piece at the same fourth dimension costing much to a greater extent than than other countries. See, for example, The Commonwealth Fund (Sep 20, 2006). New National Scorecard: U.S. Health Care System Gets Poor Scores on Quality, Access, Efficiency, too Equity. Available at this link.
You may also desire to catch this link to a page on our WellnessWiki for to a greater extent than facts too figures close the healthcare crisis.
As far equally non asset your breath waiting on the healthcare manufacture to brand needed improvement due to regime regulations too interferences, I don't blame you! It volition accept rigid leadership, novel mind-sets, innovative policies, too consumer pressure level to modify the organization inwards the sort of profound ways I propose.
And what close dealing alongside undocumented workers (illegal immigrants) who are hired yesteryear American employers to do back-breaking operate at below minimum wage? I empathise when our citizens complain close the terms of giving them gratuitous healthcare. But consider the alternatives: We tin flame allow them expire inwards the streets without whatsoever assistance too pray they don’t top contagious illness due to lack of treatment, waste product huge sums of coin edifice walls around our soil inwards the naïve promise that nosotros tin flame travel on them from crossing our borders, etc. And nosotros could punish employers who hire them to do back-breaking menial labor few of our citizens would do, but that wouldn’t assist much since nosotros demand them too they demand us for operate to feed their families.
Alternately--and I realize this is controversial--we tin flame adopt a national policy that makes the U.S.A. the world middle for promoting wellness !
Why? Well, if nosotros could afford to do so, non only is it the moral affair to do, but it would also live ane of the most powerful things nosotros tin flame do to struggle terrorism. Imagine what would probable plow over off if nosotros showed the globe that a primary component of our nation is to improve the wellness of all peoples at dwelling line solid too abroad. This would live a major measuring toward winning the hearts too minds of all peoples, including those who aren’t really fond of us correct now; and, at the same time, it would arrive much to a greater extent than hard for terrorists to demean us too recruit individuals who desire to destroy us.
So, assuming what I exactly said is valid, too so how tin flame nosotros afford to live the leaders inwards promoting greater wellness too ameliorate healthcare for everyone around the inwards our ain soil too around the world?
There are many things nosotros tin flame do to larn the coin needed; some of which require a shift inwards our national priorities, policies too processes. Three of the to a greater extent than obvious strategies would live to:
One individual commented:
Everyone deserves unobstructed medical attending for illness too injury; curable, chronic, and/or terminal. In that I run across an absolute fulfillment of the constitutional mandate to run across to the 'general welfare'. One measuring beyond that is preventive care, to a greater extent than opinionated too intellectually based; but I none the less would consider that the 'general welfare'. Every other service for everyone associated equally medical service should stay privately financed too marketed (like kid bearing too voluntary procedures).
One critical number inside that seat is how to bargain alongside self induced wellness impairments. This wellness bird should take away maintain a name, definition, too social remedy. Let's telephone telephone it IHIs. It's tough because it's smoking, pitiful diet, drug addiction, STDs, pitiful dental care, high adventure sports, etc. I'm thinking IHI classification puts an private into a especial insurance category requiring add-on premium or mandatory savings both during too for some fourth dimension afterwards such circumstances.
I replied:
Yes, dealing alongside the sort of self induced wellness impairments (IHIs) is a thorny issue.
Influenza A virus subtype H5N1 logical instance tin flame live made for having those alongside the fiscal agency pay out of bag for at to the lowest degree a part of treating wellness problems clearly determined to live voluntarily induced. That is, delivering aid to people alongside adequate maturity, knowledge, intelligence too rationality, but who brand a witting determination to engage inwards high-risk behaviors too endure the consequences, would terms them more, so they are held accountable for their actions.
Unfortunately, many (most?) of these people are either (a) young (e.g., teenagers enticed yesteryear tobacco too alcohol marketing, equally good equally peer pressure, too and so larn hooked); (b) ignorant, confused or unintelligent (they don't fully realize or empathise the risks of eating also many greasy french fries too failing to do regularly, or they take away maintain problem self-managing a chronic status requiring a complex medication regimen too lifestyle changes); (c) irrational (e.g., they deceive themselves into believing they tin flame halt taking drugs, or they are self-destructive due to a psychological problem); or (d) they lack the funds too back upwards needed to alive a to a greater extent than good for you lot lifestyle (all their fourth dimension is taken working twenty-four hours too nighttime at minimal-wage jobs, or they lack affordable transportation, to catch the dentist every vi months, or they can't afford fresh fruits, vegetables too lean meats when pasta is a fraction of the cost). Or, they exactly mightiness live unlucky (e.g., the got an STD because the prophylactic broke).
In other words, this is a complex number too a peachy bargain of idea should become into defining the weather for the sort of punitive costs you lot propose.
Also consistent alongside your proposition would live a policy of taking punitive activity against the manufacturers, distributors, retailers too marketers of unhealthy foods too ineffective medications too supplements. And what close tobacco companies too alcoholic potable producers who promote their products to college students, too fifty-fifty the promoters of unsafe sports?
It seems to me, therefore, that establishing a reasonable 2 tier system--one for folks who self-manage their wellness effectively too some other for those who don't--is a daunting task, but ane worth examining.
On altitude of this is the query of whether contraception, abortion, too kid bearing should live paid privately.
Nevertheless, the bigger number inwards my hear (and discussed inwards my blog) isn’t close penalizing sure people for pitiful behavior; instead, it’s close enabling too rewarding the delivery of high-value wellness too healthcare services. I ground that minimizing waste, inefficiency, too ineffectiveness--while maximizing transparency of lineament too cost, along alongside wellness didactics too services, too rewarding positive results--would genuinely relieve so much coin that at that spot would live no demand of the sort of two-tier organization proposed.
Another individual commented:
Providing the sort of full general welfare you lot suggest is way beyond what our founding manlike individual bring upwards meant yesteryear this or far beyond whatsoever logical interpretation. Providing for the full general welfare agency our legal citizens powerfulness to pursue their lives too operate safely, securely, too gratuitous of regime inference too detailed mandating. It inwards no way agency the regime should revenue enhancement everyone to pay for things that everyone has the liberty to choose. This includes medical care.
Per the Census Bureau's 2005 / 2006 census report:
- 10,231,000 non-citizens are uninsured (See page 21 of the census report) - the increment from 2005 to 2006 inwards this expanse represents 38.3% of the .5% increment inwards uninsured PEOPLE
- 17,742,000 uninsured Household earned $50,000 too to a greater extent than inwards 2006. (See page 21 of the 2006 census report) These People for sure could afford to larn their ain wellness insurance.
I am unwilling, equally good as, unable (I am retired too on a rather fixed income) to pay for the healthcare of illegal aliens too those citizens who desire me to pay their way!
And last, but non least, delight furnish valid, relevant, accurate, too consummate statistical information which clearly shows those countries who take away maintain socialized healthcare furnish healthcare of equal or ameliorate than is currently provided inwards the US.
This does non hateful major improvements are desperately needed inwards our acquaint healthcare systems! But these are improvements non a replacement! I volition non grip my breath waiting on the healthcare manufacture to brand these needed improvement, because of regime regulations too interferences! The politicians are a major component of our healthcare problems, non a solution amidst them! :-)
I replied
You said: Our regime [should not] revenue enhancement everyone to pay for things that everyone has the liberty to choose. This includes medical care.
While I grip alongside your premise, I don’t believe it’s close “freedom of choice.” There are many reasons for people non having coverage, including:
- Health insurance is unaffordable to many, including individuals who are unable to larn affordable private coverage due to terms or pre-existing medical conditions.
- Many employers do non offering wellness insurance coverage.
- People who lose their jobs frequently lose their wellness insurance.
- Some workers are non eligible for wellness insurance offered yesteryear their employer.
- Workers too individuals do non take-up coverage that is available.
- People may live pitiful but non eligible for populace coverage, for example, childless adults are mostly ineligible regardless of income.
- Individuals are eligible for populace programs, but are non enrolled.
You said: 17,742,000 uninsured Household earned $50,000 too to a greater extent than inwards 2006. … These People for sure could afford to larn their ain wellness insurance.
It seems to me that the number of folks who tin flame afford insurance too exactly chose non to larn it is really small. Take your illustration of a household unit of measurement earning $50K/yr. In NY, an HMO household unit of measurement conception alongside steep copays too deductibles too no dental, offered through a pocket-size business, terms a household unit of measurement over $11K/year inwards premiums alone, which increases every year. That’s a sizable expense fifty-fifty for a household unit of measurement earning $50K, on altitude of out of bag dental costs, equally good equally copays too deductibles. I don’t run across that many neglect to purchase insurance because they’re looking for a “free ride.” I say this inwards calorie-free of the fact that the uninsured tend to take away maintain worse wellness and, when they larn sick, they take away maintain to hold back for hours inwards a emergency room or become to a community hospital security internet facility. This is non a glamorous option.
Another group, btw, are the “underinsured” who purchase coverage too and so are shocked to realize that what they take away maintain doesn’t come upwards unopen to paying their medical bills. According to a recent consumer reports study, 24% of Americans take away maintain wellness insurance that barely covers their healthcare needs, non to mentions the 16% alongside no insurance at all. This leaves a huge number of people unprepared for major medical expenses.
You said: Please furnish valid, relevant, accurate, too consummate statistical information which clearly shows those countries who take away maintain socialized healthcare furnish healthcare of equal or ameliorate than is currently provided inwards the US.
I don’t believe such clear-cut information has always been collected to brand the instance ane way or the other. But at that spot is convincing information that the the States lags behind many industrialized countries inwards delivering primary care, access too lineament … piece at the same fourth dimension costing much to a greater extent than than other countries. See, for example, The Commonwealth Fund (Sep 20, 2006). New National Scorecard: U.S. Health Care System Gets Poor Scores on Quality, Access, Efficiency, too Equity. Available at this link.
You may also desire to catch this link to a page on our WellnessWiki for to a greater extent than facts too figures close the healthcare crisis.
As far equally non asset your breath waiting on the healthcare manufacture to brand needed improvement due to regime regulations too interferences, I don't blame you! It volition accept rigid leadership, novel mind-sets, innovative policies, too consumer pressure level to modify the organization inwards the sort of profound ways I propose.
And what close dealing alongside undocumented workers (illegal immigrants) who are hired yesteryear American employers to do back-breaking operate at below minimum wage? I empathise when our citizens complain close the terms of giving them gratuitous healthcare. But consider the alternatives: We tin flame allow them expire inwards the streets without whatsoever assistance too pray they don’t top contagious illness due to lack of treatment, waste product huge sums of coin edifice walls around our soil inwards the naïve promise that nosotros tin flame travel on them from crossing our borders, etc. And nosotros could punish employers who hire them to do back-breaking menial labor few of our citizens would do, but that wouldn’t assist much since nosotros demand them too they demand us for operate to feed their families.
Alternately--and I realize this is controversial--we tin flame adopt a national policy that makes the U.S.A. the world middle for promoting wellness !
Why? Well, if nosotros could afford to do so, non only is it the moral affair to do, but it would also live ane of the most powerful things nosotros tin flame do to struggle terrorism. Imagine what would probable plow over off if nosotros showed the globe that a primary component of our nation is to improve the wellness of all peoples at dwelling line solid too abroad. This would live a major measuring toward winning the hearts too minds of all peoples, including those who aren’t really fond of us correct now; and, at the same time, it would arrive much to a greater extent than hard for terrorists to demean us too recruit individuals who desire to destroy us.
So, assuming what I exactly said is valid, too so how tin flame nosotros afford to live the leaders inwards promoting greater wellness too ameliorate healthcare for everyone around the inwards our ain soil too around the world?
There are many things nosotros tin flame do to larn the coin needed; some of which require a shift inwards our national priorities, policies too processes. Three of the to a greater extent than obvious strategies would live to:
- Take some of the coin currently beingness spent on weapons too the armed forces to struggle the “war on terrorism” through devastation too death, too role these funds constructively to improve wellness inwards the world.
- Remove waste product from our electrical flow healthcare organization yesteryear fostering wellness too the delivery high-value care, which would relieve huge amounts of money, some of which could live used for “world care.”
- Work alongside foundations too collaborate alongside other countries.
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