The moral, financial dilemma at the heart of health care
If such a thing were possible, it would be useful to set aside partisan sentiments for a few minutes to discuss profound questions about life and death, the obligations that we have to each other as human beings and the morally difficult choices that technology increasingly forces upon us.
Let’s begin with a new report from the nonprofit National Institute for Health Care Management Foundation. It reports that Americans “spent nearly $2.5 trillion on health care in 2009, reaching an all-time high of $8,086 per person. This per-capita spending represents an almost two-fold increase since 1997.”
Those numbers, while startling in one sense, pretty much confirm what most of us already knew. But here’s where things get more sticky:
“Spending is highly concentrated among a relatively small portion of high-cost users, with just 5 percent of the population responsible for almost 50 percent of all (health care)spending. At the other end, half of the population accounts for just 3 percent of spending.”
The tricky part, of course, is how quickly and unexpectedly any one of us can jump from one category to another. You can go for decades as part of the 50 percent that consumes just 3 percent of spending, and with one diagnosis or accident suddenly become part of that 5 percent that consumes almost 50 percent of the health care dollar.
In fact, absent sudden death by accident or heart attack, most of us will at some point make that transition from the 50 percent to the 5 percent, as will our loved ones. It is the human condition.
I feel a chart coming on.
The healthiest 50 percent of Americans account for just 3 pennies of every health-care dollar spent, while the sickest 5 percent account for 50 cents of every dollar spent on health care.
———————————
Now let’s move from the statistical to the actual. The New York Times reports today on three new drugs developed to treat late-stage prostate cancer. The drugs do not cure the cancer, but they do prolong the lives of those afflicted.
Without the drugs, men with late-stage prostate cancer have a median life expectancy of a year and a half. With the new drugs, that can be extended by roughly six months, with a decent quality of life.
However, as the Times reports:
” … the price of these drugs has already stirred concerns about the costs of care among patients, providers and insurers. For example, Provenge costs $93,000 for a course of treatment, while Zytiga costs about $5,000 a month. Another of the new drugs, Sanofi’s Jevtana, costs about $8,000 every three weeks.
With other pricey drugs on the way, said Joel Sendek, an analyst at Lazard, “We could be talking easily $500,000 per patient or more over the course of therapy, which I don’t think the system can afford, especially since 80 percent of the patients are on Medicare.”
Medicare has been conducting a year-long review of Provenge, and is expected to announce on Thursday that it will cover the drug. Private insurers are expected to follow that lead. But as the Times reports, the fact that Medicare even decided to study the question became a point of controversy. “Medicare officials denied that price was the reason for the review,” the story reports. “But some patient advocates and politicians portrayed the review as a step toward rationing.”
So there’s the situation. Those men with sufficient financial resources can of course make their own decision about whether to spend $500,000 for another six months of life. But what about the rest of us? Is that an acceptable use of taxpayer money and health-insurance premiums?
And if it isn’t acceptable, what mechanism should we create to make such difficult decisions on our behalf?
I’m not looking for partisan rhetoric or bumper-sticker responses here. These are decisions that we as a society and a nation have to confront. At what point, if any, do we decide that the marginal gain in lifespan is no longer worth the investment?
Who makes that decision? And on what basis?
– Jay Bookman
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486 comments Add your comment
mm
June 28th, 2011
1:14 pm
We need to start a grassroots push to force the congress critters to give up their public healthcare it they are not willing to allow all of us to have it. Let them pay out of their pockets the way we do.
I just looked into my employer provided healthcare. After retirement, the cost triples.
So, all of you free market crazies, how in the world does my risk increase one day after retirement that my premiums should triple?
getalife
June 28th, 2011
1:14 pm
Jed is here to call us liars.
WhateverMan
June 28th, 2011
1:15 pm
I hate to break it to all of you who think the drug company is evil for wanting to make money, but the only reason they have the drug is because they spent a lot of money figuring out how to make the drug. The guy who developed the AIDS drugs used by around 90 percent of the AIDS population is not hurting for money. Eventually, the cost because small for those drugs, but he was definitely able to recoup the investment and more so. He works at Emory by the way.
But for some reason people view healthcare as this product that is supposed to be given away to people because it seems to be the moral thing to do. What other aspect of life is this the thought? Do we give away big homes to people because they have a large family but no place to live? Do we give people cars because they need to work at a job that requires them to drive? Why do we make healthcare something different? Ahh…because of the great liberal equalizer – FEELINGS. It FEELS wrong to not give another human being the best shot at healthcare. Ironically, we let these same people starve and go homeless everyday, but when it comes to $500,000 drugs then somehow the drug company is evil for not taking care of these folks.
I hate to break it to you, but we don’t live in an equal world. And no matter how much someone like Jay or Obama say the word “fair”, reality isn’t. And instead of motivating people to get out and help each other – like setting up a non-profit organization that can accept donations to then provide care or drugs for free – we have articles like this one that hint at (and sometimes just blatantly say) the idea that wealthy people owe it to poor people to help. And they demonize the wealthy person and make it seem like wealthy people or companies are trying to kill poor people. Such arguments just create a totally different problem instead of provide the solution.
The most ironic thing, in my opinion, is that liberals have done all they can to kill Christianity in this country. And it is the Christian mindset they wish everyone would have. Help those in need. Give to the poor. If a man needs a coat, give him your own. But liberals are not into motivating people to do anything. They are all about forcing them through taxation and regulation. I admire their goals, but their methodology is all wrong.
Telling my sister she was a horrible sister because she didn’t give me a part of her candy bar never worked. Coming up with a way to coax her into believing it was a good idea or I would give her a benefit in return for a piece of the candy did. This is how life works. Nobody gives you money for nothing (typically). You work (the benefit), they pay you (the candy bar). Again, because we FEEL bad about it, we think healthcare is different. But it is not.
Moderate Line
June 28th, 2011
1:17 pm
Left wing management
June 28th, 2011
9:53 am
Moderate line: “It doesn’t appear to me that either the left or right is willing to address the problems of our current system.”
Not true. If you count Obama and the Democratic-led congress at the time the Affordable Healthcare Act passed to be “left” (highly debatable, but can be assumed for this discussion), then that bill most certainly does represent a serious attempt to address the problems of the current system, however problematically
++++
It does not address cost which is the problem.
Left wing management
June 28th, 2011
1:18 pm
Is it 2012: “Anyone notice the riots in Greece? This will be us in 2013 if we don’t face the situation now and stop our spending and start making our own cuts ..”
The riots in Greece are precisely BECAUSE of said cuts, dude! Are you really that misinformed? Or are you just willfully so?
Here’s a plan: allow ALL of the Bush tax cuts to expire (not just those on the top brackets) and that will MORE than get us on the way back to manageable debt-to-GDP ratios in the middle term
But why is such a reasonable suggestion as that not even light years from being thinkable, let alone doable, in the current climate? Because we have a POLITICAL crisis, that’s why. And that’s why you’ll reject the very suggestion. Because that’s what you’ve been told to think.
mm
June 28th, 2011
1:18 pm
” hate to break it to all of you who think the drug company is evil for wanting to make money, but the only reason they have the drug is because they spent a lot of money figuring out how to make the drug.”
That’s what they want you to believe. It is pure profit for 7 years after a small pitance to pay for R&D.
WhateverMan
June 28th, 2011
1:18 pm
Your cost triples in retirement because you are not benefiting the company anymore. Why do you think your company should pay for your healthcare after you are not working there? You should have planned years ago to assume this cost on your own.
What do you do for others for free? Do you give away all of your own personal “profit” to those who need it? I doubt it, so quit making that the expectation for others. Work with your OWN money, quit telling others what they should do with theirs, including your company.
And by the way – government regulation makes it illegal for an insurance company to operate across state lines, hence the huge overhead costs since they have to basically have a “company” in every state. Want lower costs? Get rid of that regulation!
WOODSTOCK MIKE
June 28th, 2011
1:19 pm
@getalife
Here you go… I’m wondering what your excuse will be…
“The health sector dramatically shifted their contributions from Republicans to Democrats in the 2008 election cycle. Democrats received 54% of all health sector contributions, the highest percentage they have received since the Center for Responsive Politics began tracking campaign contributions. Leading the way was presidential candidate Barack Obama. Obama, perhaps the largest recipient of health sector contributions in history, brought in over $19 million from the sector in the 2008 election cycle.”
getalife
June 28th, 2011
1:20 pm
The President’s health care bill was the best bill that could pass corrupt congress.
It is more corporate welfare with a mandate for more corporate welfare.
Pure and simple.
Normal
June 28th, 2011
1:21 pm
All y’all are good people and I thank you.
——-
Josef,
From St. Elsewhere. You are right, of course. I’ll talk to you later there. Thank you too, Sir.
WhateverMan
June 28th, 2011
1:24 pm
mm –
Exactly how many drugs have you brought to market? Do you have any idea how much it costs? Because of the FDA, do you have any idea how LONG it takes??
Quit with your conspiracy theories about drug companies lying to people. I work in the healthcare industry. It’s not free nor is it easy thanks to organizations like the FDA to come up with a new treatment or drug. And to say that an organization or group of people need to go through all of that and then not benefit from it is stupid. Do you show up at your job and turn down the paycheck? Do you tell them they pay you too much? Didn’t think so. The reason people are willing to work hard to discover anything (the car, train, etc.) is not just because they want to make your life better.
Thulsa Doom
June 28th, 2011
1:25 pm
Disgusted
June 28th, 2011
11:59 am
“Who was the poster that said they worked for a health care insurance company?”
That’d be Thulsa Doom, who by sheer coincidence is unalterably opposed to the health care law. See, there’s not as much profit in it if everybody can afford health insurance.
Disgusted,
Actually I don’t work directly for an insurance company. I have an independent agency and I have contracts with several insurance plans. I’m opposed to the health insurance law because it will ultimately raise premiums for everyone. You cannot mandate a myriad number of new coverages like in group health insurance and expect costs to decrease. Its mathematically impossible.
Likewise you cannot mandate coverage for people that refuse to purchase coverage for themselves, add millions of them to the medicaid rolls, and once again expect overall costs to decrease. Again, its a mathematical impossibility.
See, there’s not as much profit in it if everybody can afford health insurance.- Disgusted
Disgusted, that is a truly bizarre statement. If everyone could afford health insurance then obviously I would make even more money. Why would I not want health insurance to be more affordable?
Left wing management
June 28th, 2011
1:26 pm
Moderate Line: “It does not address cost which is the problem.”
At the risk of getting overly legalistic here, you said “neither side addresses it”, which is what I’m taking exception to. However tentatively the Affordable Care Act attempts to move us towards effective cost control in health care, it nonetheless at least represents an attempt to address it, which is more than can be said of the right which only ever proposes doubling down on the disastrous private system we now have and which has gotten us to the current impasse.
Joe Mama
June 28th, 2011
1:27 pm
WhateverMan — “Your cost triples in retirement because you are not benefiting the company anymore. Why do you think your company should pay for your healthcare after you are not working there?”
How about this — because retiree medical insurance was part of the retirement benefits package the company used to induce me to work there in the first place?
“You should have planned years ago to assume this cost on your own.”
Excellent. Glad to hear you are on board. Let’s expand and liberalize the Flexible Spending Plans; let’s increase the amount of money a contributor can put away each year. Let’s allow unspent amounts to roll over from year to year. And to get our Republican friends on board, let’s let depository banks (NOT investment banks) to hold and manage these accounts, and maybe even pay a little interest on them (again, tax-sheltered to encourage saving). If Jack and Jill Average manage to save a couple thousand each year over their working lives, then they can have a nice medical account in retirement to pay for copays, deductibles or catastrophic care that’s not otherwise covered.
Glad to have your support.
“What do you do for others for free? Do you give away all of your own personal “profit” to those who need it? I doubt it, so quit making that the expectation for others. Work with your OWN money, quit telling others what they should do with theirs, including your company.”
It seems to be quite upsetting to you that others whose opinion differs from yours are exercising their free speech rights. Why is that, exactly?
“And by the way – government regulation makes it illegal for an insurance company to operate across state lines, hence the huge overhead costs since they have to basically have a “company” in every state. Want lower costs? Get rid of that regulation!”
You appear not to understand that insurance is regulated at the *state* level. In order to “(g)et rid of that regulation, the 50 states would ALL have to “(g)et rid of that regulation.” Good luck convincing them to do it.
Paulo977
June 28th, 2011
1:28 pm
JKL2
“If you want to make it affordable, get the government out of it.”
As the saying goes …….” Fools rush in where angels fear to tread”
Brush up on your knowledge of Govt HC systems!!!
getalife
June 28th, 2011
1:28 pm
Ah, it was Doom.
Sorry about that grumpy Dave.
Doom is our resident health insurance rep.
Doom,
How much is pro life worth?
Message from Matti
June 28th, 2011
1:29 pm
To ALL of you, aching for your Mommas today:
http://www.youtube.com/watch?v=KB1-1zuDGJ0
J. Wellington Wimpy
June 28th, 2011
1:30 pm
mm: We need to start a grassroots push to force the congress critters to give up their public healthcare it they are not willing to allow all of us to have it. Let them pay out of their pockets the way we do.
Where can I sign up?
Thulsa Doom
June 28th, 2011
1:32 pm
josef
June 28th, 2011
12:08 pm
Yeah, Thulsa is all against government subsidized health care, but all for government subsidized insurance…that same mentality is what’s at work in this health care reform fiasco…nationalize the lot of them and be done with it…you can’t have it both ways…jmo…
Josef,
You’re an educated guy. But you’re not a mind reader.
I’m not opposed to all govt subsidized health care- you would be surprised what I’m in favor of such as govt funding of small health clinics or mini clinics in poor neighborhoods that could treat patients for very nominal or zero co-pays as opposed to treating them in an ER room.
Secondly I’m not all for govt subsidizing health insurance plans. That just happens to be the model right now in Medicare and it works with some effectiveness because the health plans themselves do a good job of delivering the health care and because they are incentivized to keep the individual healthy. Is it perfect? No. But it certainly beats a single payer, fully funded govt system where cancer survival rates are substantially lower than in the U.S.
Lynn
June 28th, 2011
1:33 pm
@Joe Mama – I never said these drugs should be limited to RA treatment only. And I am sure you will find those suffering from RA disagreeing that this disease is just “arthritis”. I agree that this drug should be used to treat autoimmune diseases that are debilitating. My point which you keep overlooking is that psoriasis is not a debilitating disease and to pay for the treatment of this condition at $5,000 a month is not what health care should be paying for whether it is the government or an insurance company.
And again, you misunderstand what will happen with the real life example Jay has given us of a drug that does cost this much. Insurance companies will exclude drugs and treatments deemed experimental. There will be insurance companies who will cover this drug and employers who will be forced to provide the coverage as well due to the current restrictions on plan design changes under the current regulations with PPACA (Obamacare).
You seem to want to argue about your condition and treating this condition. Without revealing the condition, can you tell us what the monthly cost to you and to the insurance company/Medicare is to treat this condition? Does the treatment cure your condition or does it alleviate symptoms?Again, I an not saying your condition should not be treated. Treatment and alleviation of symptoms are the reason to take these drugs. My argument concerned $5,000 a month to treat psoriasis.
Thulsa Doom
June 28th, 2011
1:37 pm
Adam
June 28th, 2011
1:05 pm
“Death Panels” have another name: “Health Insurance Companies.”
Repeal and Replace should be: Repeal ACA and replace with Single Payer, abolishing health insurance companies.
Adam,
Just another statement of profound ignorance not to mention baseless, emotional rhetoric. Unfortunately I’ve come to expect only that from you.
And I suppose we could go to a national health system if enough folks voted for it. But you can’t simply abolish health insurance companies. They have as much a right to exist and sell a product as McDonalds does. If you don’t like them then don’t purchase their product. Problem solved.
WhateverMan
June 28th, 2011
1:38 pm
Joe Mama
– I have no problem with free speech nor someone else’s opinion. I do have a problem when their free speech and their opinion ends up taking from my pocket and yours.
And I agree, if your original agreement with a company said the retirement benefits were to be a certain way, then you have an argument to be upset with your company. However, if those benefits were dependent upon the success of the company being at a certain level and the company doesn’t achieve that or economic reasons cause it to be different, it is unrealistic to think they can live up to everything as promised. It is actually remarkable that companies provide healthcare at all. In fact, it might be that the overall price would be lower just by having it up to individuals versus large company contracts.
I love your idea – allow people to not pay into SS and have their own accounts. Good deal – done! Good luck getting Obama to go along. And Jay will tell you that you don’t care about poor people.
And your argument about insurance regulation doesn’t make sense. I don’t care what government regulation it is (federal, state, local), it doesn’t change the fact that it is regulation that causes this increased expense.
USinUK
June 28th, 2011
1:39 pm
“And I suppose we could go to a national health system if enough folks voted for it. But you can’t simply abolish health insurance companies. ”
exactly so –
the different, of course, is that then health insurance companies are a NICE to have, not a NEED to have.
Joel
June 28th, 2011
1:39 pm
No, we as a society do not have to confront this issue. People live, people die. This will never change. Robbing Peter to pay Paul’s hospital bills only ensures that Peter won’t have anything left when his hospital bill comes due. Putting the government in charge only ensures that eventually Paul will be left to die and they will be blamed, instead of Paul’s smoking habit. Then the question will arise as to whether Paul was allowed to die because he was black, or white, or gay, or not. Perhaps he was cut off because he was a Democrat, or Republican, or Independent. Then all faith in government is lost, and we descend into anarchy–which is good for no one.
Disgusted
June 28th, 2011
1:42 pm
We need to start a grassroots push to force the congress critters to give up their public healthcare it they are not willing to allow all of us to have it. Let them pay out of their pockets the way we do.
It may surprise you to learn, Wimpy, that there isn’t a “public healthcare,” unless you’re talking about Medicare. All federal employees, including members of Congress and the President, must choose from among some 25 health insurance plans or HMOs. These health plans include Blue Cross/Blue Shield, United Healthcare, Aetna, etc. They must pay a share of the premium, just as employees of businesses do.
But don’t let the facts get in the way of your anti-government rant. Keep on believing that there’s a public healthcare plan that doesn’t charge covered employees anything and certainly never requires co-pays or deductibles. If that’s what you want to believe, go for it.
Thulsa Doom
June 28th, 2011
1:42 pm
getalife
June 28th, 2011
1:28 pm
Ah, it was Doom.
Sorry about that grumpy Dave.
Doom is our resident health insurance rep.- getalife
getalife,
Not really. I don’t sell much regular health insurance. Since the new health care law the commissions were cut in half so its just not worth my time. Law of unintended consequences at work. Less agents actively soliciting and selling health insurance means less of it being sold. Hence more uninsured people out there not paying into the system but costing the system if they end up in the ER room.
Doggone/GA
June 28th, 2011
1:45 pm
“Robbing Peter to pay Paul’s hospital bills only ensures that Peter won’t have anything left when his hospital bill comes due”
But that is a false comparison. We aren’t “robbing Peter to pay Paul” – we’re “robbing” (not) maybe 100,000 Peters to help Paul overcome his health issues. And when any other of those 100,000 Peter’s beccomes a “Paul” – there will be 100,000 Peters helping to pay for HIS health issues as well.
It is not, and never will be, a one-to-one issue.
1811/1801 - 0311/0317
June 28th, 2011
1:45 pm
Headline: “Obama won’t say if he wants ATF director to resign…”
Headline: “Obama on Libya: I don’t need Congressional approval — but give it to me anyway…”
Now THAT is leadership !
Left wing management
June 28th, 2011
1:45 pm
Thulsa, USinUK: “And I suppose we could go to a national health system if enough folks voted for it. But you can’t simply abolish health insurance companies. ”
Precisely. Which is why I — in agreement with Marx — believe that democracy is overrated. Private interests first have to be neutralized before you can have true democracy.
1811/1801 - 0311/0317
June 28th, 2011
1:51 pm
“Private interests first have to be neutralized before you can have true democracy.”
………… and that takes the murder of millions of “resisters” !
Adam
June 28th, 2011
1:51 pm
Anyone notice the riots in Greece?
This will be us in 2013 if we don’t face the situation now and stop our spending and start making our own cuts….
And with that, you obviously missed the reason the riots are taking place. Hint: It’s because of the CUTS.
Adam
June 28th, 2011
1:53 pm
WhateverMan: …think the drug company is evil for wanting to make money…
Now, where did any of us say that?
Doggone/GA
June 28th, 2011
1:53 pm
“you can have true democracy”
You can never have “true democracy” because true democracy = mob rule – anarchy. There is no “pure” political system that is perfect, which is why they ALL have some form of checks and balances. And why those checks and balances are needed.
Left wing management
June 28th, 2011
1:53 pm
Joel: “Robbing Peter to pay Paul’s hospital bills”
Building on what Doggone said, it’s not “robbing” Peter to pay Paul, it’s helping Peter to understand that his and Paul’s interests overlap, despite attempts to confuse the issue by those who would profit from they’re being prevented from realizing their solidarity and mutual interests.
Adam
June 28th, 2011
1:54 pm
WhateverMan: But for some reason people view healthcare as this product that is supposed to be given away to people because it seems to be the moral thing to do. What other aspect of life is this the thought?
Police, fire, roads, infrastructure….
Basically anything that uses taxes, instead of private interests, to get the job done.
Oh, I’m sorry, were you trying to say that we wanted it without paying for it AT ALL? Please do indicate where any of us said that.
AmVet
June 28th, 2011
1:55 pm
Evil = My vocabulary is so pitiful, this is the only word I could come up with…
Joe Mama
June 28th, 2011
1:56 pm
@Joe Mama – I never said these drugs should be limited to RA treatment only.”
And I didn’t say that you did. But you keep referring to “the serious condition of rheumatoid arthritis” and pointing out that the drugs you’re talking about were developed to treat it, as if those drugs shouldn’t be used on *other* autoimmune diseases. Your rhetoric makes it look like you’re saying ‘other diseases shouldn’t be treated with the drugs that were specifically developed to treat RA.’ I don’t think that’s what you mean, which is why I’ve been asking you questions and asking you to clarify your position.
“And I am sure you will find those suffering from RA disagreeing that this disease is just “arthritis”.
Just as I’m sure those suffering from various forms of psioriasis would disagree that it’s just a ’skin condition.’ I try not to diss others’ health problems. FWIW, I’ve got several relatives with RA, and I am sympathetic to those suffering from it.
“I agree that this drug should be used to treat autoimmune diseases that are debilitating.”
Good. I’m pleased to hear that. Seriously.
“My point which you keep overlooking is that psoriasis is not a debilitating disease and to pay for the treatment of this condition at $5,000 a month is not what health care should be paying for whether it is the government or an insurance company.”
I’m not overlooking that at all. My point — which you keep overlooking — is that as autoimmune diseases go (which is what many RA drugs were developed for), RA is *far* from the worst. There are plenty that are way, way worse.
“And again, you misunderstand what will happen with the real life example Jay has given us of a drug that does cost this much. Insurance companies will exclude drugs and treatments deemed experimental.”
Don’t they already do that?
“There will be insurance companies who will cover this drug and employers who will be forced to provide the coverage as well due to the current restrictions on plan design changes under the current regulations with PPACA (Obamacare).”
Okay. And your issue with that is what, precisely?
“You seem to want to argue about your condition and treating this condition.”
Not at all. I’m more concerned with you labeling psioriasis a mere ’skin condition’ when RA isn’t a life-threatening disease itself.
“Without revealing the condition, can you tell us what the monthly cost to you and to the insurance company/Medicare is to treat this condition?”
Actually, I’ll come right out and tell you. It’s called Ulcerative Pancolitis. And I’m not taking the immunosuppressant meds any more, as I underwent a proctocolectomy last fall. For those of you keeping score, this is what Tony Snow had — but he didn’t get it treated, so it led to colon cancer and eventually killed him. I had it for about two years from onset of symptoms to major abdominal surgery.
At this point, the monthly cost is a few hundred dollars, as I’ve had an ileostomy and now crap in a bag. I’m no longer on medication for the condition (as my colon is gone), but insurance does pay 100% for the ostomy supplies (bags, adhesives, skin protectant, cleaning items).
“Does the treatment cure your condition or does it alleviate symptoms?”
When I was taking Humira, it gave me *some* relief from symptoms, but not a lot. Remicade made me horrendously sick.
“Again, I an not saying your condition should not be treated. Treatment and alleviation of symptoms are the reason to take these drugs. My argument concerned $5,000 a month to treat psoriasis.”
If you’re taking a dose of Humira each week, that’s about $5K a month. And Humira treats lots of different autoimmune diseases — but most of them have no cure. There was a surgical option available to me that would have significant, lasting results and would relieve my pain. There was a pharmaceutical option available to me that would probably last a few years at most, and which may or may not give me symptomatic relief. I gave the meds the best part of a year; they offered a marginal improvement in my symptoms.
So last fall, I had the d**n thing taken out. Now it doesn’t hurt any more.
The moral, financial dilemma at the heart of health care – Atlanta Journal Constitution (blog) | International Health Tribune
June 28th, 2011
1:56 pm
[...] more: The moral, financial dilemma at the heart of health care – Atlanta Journal Constitution (blog) Posted in: Uncategorized Tags: atlanta-journal, control-costs, hillsboro-times, journal, [...]
Joe Mama
June 28th, 2011
1:58 pm
WhateverMan — “I love your idea – allow people to not pay into SS and have their own accounts. Good deal – done!”
I didn’t say anything whatsoever about SS. I specifically indicated that I was referring to Flexible Spending Plans. Are you familiar with them?
JDW
June 28th, 2011
1:59 pm
The issue here is reasonableness. Is it reasonable, in the current environment, for society at large to pay $500,000 to extend anyone’s life 6 months….I say no. Society should provide a base of coverage for all citizens. If someone desires treatment above and beyond that base then they must pay the cost. As for how we decide what is covered and what is not, simple, take the amount of money we are willing to spend and authorize the most effective treatments until that money is exhausted. No deficits, no rationing, just simple budgeting.
Adam
June 28th, 2011
1:59 pm
USinUK: the different, of course, is that then health insurance companies are a NICE to have, not a NEED to have.
I would prefer completely unnecessary. Or rules placed on them that they would have to cover anyone no matter what.
Health Care should not be a for profit venture. It is the reason we spend more on it than any other country, and get less out of it per person.
Thulsa Doom
June 28th, 2011
2:01 pm
Jay,
Oddly enough I find myself agreeing with you on this point. There is no way around it. We have an aging population and I myself and others routinely see this where an elderly person in the last days, weeks, or months of life puts an extraordinary strain on the system.
And I can see from your position that you are pushing a not so thinly veiled idea of death panel. As much as I hate it it may well be an idea whose time has come- especially in light of the situation you post above. Should the rest of the public pay $500,000 to enhance one’s life an extra 6 months? Its a difficult decision. We would all like to say yes but the simple fact of life is that as a nation we can’t afford it. We just can’t.
Whether its the govt or an insurance plan that has to make the decision based upon govt guidelines the fact is that new technologies, new drugs, new techniques raise the cost of health care as opposed to lowering it. That’s the odd thing about medical advances and I’ve tried several times on here to start a rational discussion on this subject but to no avail. We can either add these advances and drugs and pay out the nose for them for everybody or we can say no and or ration them. But who decides? And what if a wealthy person can afford to pay the $500,000 to extend his life another 6 months while a middle class person is denied? Is it fair? Of course not but life isn’t fair. Are we going to deny that wealthy person out of envy? And if we do have a rationing system can you tell me that certain people- politicians, celebrities, connected people, wealthy people, that they will be under the same rationing fairness as everyday joe and jane sixpack?
Lot of tough questions on this issue and contrary to the typical partisan bickering today this really isn’t a liberal- vs conservative issue. We have to make a tough decision as a society as to whether or not we are going to pay for this kind of care which could well bankrupt us or whether or not we will ration the care via the govt or insurance plans. One thing is for sure. There is no free lunch.
PGS
June 28th, 2011
2:01 pm
The key here is do we expect health-care companies, providers,etc… to be profitable? If we do, then we have to expect them to do all they can to make money. They are owned by shareholders who expect a lot in return for their investment. Those of us lucky to have 401Ks probably have some type of investment in health insurance companies, health care etc…
thomas
June 28th, 2011
2:02 pm
Aquagirl
June 28th, 2011
10:13 am
what did he do to show a lack of class?
-Take less money for a chance at glory with aq group instead of as an individual?
Wow that is aweful!
-Maybe it was that he donated all of the proceeds from “The Decision” to the Boys and Girls club?
That is a shady group those boys and girls clubs?
What did he do to show a lack of class as you explained it, other than being extreamly wealthy and successful?
Now go after his mother she is a wh*re if you wish atleast then u would be attacking someone for a lack of class. Otherwise you just come off as another of the many who hate him because he is rich and successful!
Seems as if there is alot of that going around though! Maybe its catching?
Dave R.
June 28th, 2011
2:02 pm
“Here’s a plan: allow ALL of the Bush tax cuts to expire (not just those on the top brackets) and that will MORE than get us on the way back to manageable debt-to-GDP ratios in the middle term”
Proof positive that government education in mathematics has failed miserably.
MarkV
June 28th, 2011
2:02 pm
Jay, I do not have an answer to your very profound questions. But I have two comments:
1. It is rather disheartening how few people in this discussion have taken the questions seriously.
2. My immediate reaction is the following question: Has someone looked closely at the prices of those driugs you have mentioned. to see whether the high price is defensible?
1811/1801 - 0311/0317
June 28th, 2011
2:02 pm
Doggone/GA :
Did you know that our Republic is a “States Rights” Republic ?
And it has nothing to do with the 10th Amendment !
AmVet
June 28th, 2011
2:03 pm
Scout, you are perplexing.
You want all radical Muslims killed.
BHO is apparently assisting in doing that, yet you complain bitterly and incessantly.
What exactly do you want? (LOL)
Adam
June 28th, 2011
2:03 pm
PGS: If we do, then we have to expect them to do all they can to make money.
Including their own death panels that determine when to cut off recipients one the basis of nothing more than monetary greed.
Old and still kicking
June 28th, 2011
2:03 pm
Boil it way down..how much is spent keeping people alive in last six months to one year of their lives? We face more difficult decisions (and feel everyone must pay for it with Medicare) because doctors can people alive longer and longer. Should they?
joe suggs
June 28th, 2011
2:03 pm
We need more money for healthcare for the illegals. You know they are a burden on taxpayers but they do have a right to invade our country. Just ask the Federal Judges !!!
Adam
June 28th, 2011
2:03 pm
Dave R: Proof positive that government education in mathematics has failed miserably.
Not Intended to Be a Factual Statement.
Disgusted
June 28th, 2011
2:04 pm
I would prefer completely unnecessary. Or rules placed on them that they would have to cover anyone no matter what.
Health Care should not be a for profit venture. It is the reason we spend more on it than any other country, and get less out of it per person.
Amen! Until my wife had her stroke, I had no idea about the sheer number of leeches who lurk in the healthcare industry, ready to pounce on your misfortune to make a buck. Nationalize the entire industry and get rid of the health insurance companies.
josef
June 28th, 2011
2:05 pm
Thulsa
Thanks for that clarification. I backtrack and will refrain in the future from that characterization. You should, though, imo, make clear that point of where you support government subsidized health care. While I am not in total agreement with you in all aspects of what you say, I am in what you say in reference to health maintenance and non critical care and access thereto for all…and while I’m not out for compromise insofar as self is concerned, what you say should be a point of compromise at present and would go a long way toward lowering the costs of health care:
“…such as govt funding of small health clinics or mini clinics in poor neighborhoods that could treat patients for very nominal or zero co-pays as opposed to treating them in an ER room…”
Though I would go for making this universal and not just for poor neighborhoods, and there is still the problem of perscriptions…but what you say is a starting point…
Left wing management
June 28th, 2011
2:06 pm
Scout: “………… and that takes the murder of millions of “resisters” !”
No it doesn’t. It takes awakening the majority to the fact that they needn’t perpetuate a system that is unsustainable and unjust. Then we’ll see just how small the numbers are of those who are the true resistors — those who benefit most from that system and refuse to part with those benefits.
Doggone: “You can never have “true democracy” because true democracy = mob rule – anarchy. There is no “pure” political system that is perfect, which is why they ALL have some form of checks and balances. And why those checks and balances are needed.”
Ah ye of little faith!
Careful, Doggone, that you don’t get too caught up in the belief in the ‘purity’ of your vigilance against an overhasty attempt to usher in ‘pure’ democracy.
Adam
June 28th, 2011
2:07 pm
MarkV: I think I answered with “preventative care helps avoid this problem.”
Thulsa Doom
June 28th, 2011
2:10 pm
Adam
June 28th, 2011
1:59 pm
USinUK: the different, of course, is that then health insurance companies are a NICE to have, not a NEED to have.
I would prefer completely unnecessary. Or rules placed on them that they would have to cover anyone no matter what.- Adam
Adam,
Obamacare does away with pre-existing conditions and so therefore a health plan has to take just about everyone. Of course you’re going to pay obscenely sky high rates as a result. It would be like buying car insurance after you had the accident. Don’t you understand that the cost would therefore be substantially higher for everyone?
Health Care should not be a for profit venture. It is the reason we spend more on it than any other country, and get less out of it per person.- Adam
Says who? You? So now you have a right to a doctor and nurses and hospitals services at other taxpayers expense because you decide it should be a right?
Also we spend more than other countries not because of the profit incentive but because of a myriad number of reasons- an aging population, the cost of new drugs and technologies being born by Americans while the rest of the world piggybacks off of us, increased costs due to our litigation culture and defensive medicine.
josef
June 28th, 2011
2:11 pm
out for a while…back soon…
Adam
June 28th, 2011
2:12 pm
I thought I heard a buzzing fly and I swatted for a while. I’m not sure I got him but he seems to have gone away. I think he just wanted some attention.
Dave R.
June 28th, 2011
2:15 pm
Actually, Adam, do your research.
You could tax the top 25% of earners at 100% of profit and still not eliminate our deficit, which means you couldn’t even begin to address our debt.
independent thinker
June 28th, 2011
2:16 pm
Y’all forget that according to Herman Cain who is a conservative “know nothing” we are guaranteed the right to “the pursuit of happiness” Does that right not include unlimited drugs and medical care regardless of who pays????? A true consevative would know why it is in the Declaration of Independence and not in the Constitution.
Of course any one versed in the Constitution knows there is no right guaranteed there for unlimited happiness. That is why this country is so messed up- everyone thinks they have the right to unlimited profits, greed, health care, housing, food, farm subsidies etc
.But hey if you believe that you have a constitutional right to pursue unlimited happiness -no amount of health care and drugs will make you or your family happy and no one can limit that god given right. That’s why we are no. 37 in quality of health care.
thomas
June 28th, 2011
2:16 pm
If the call is to shutdown the insurance companies ability to make a profit, fine.
Then why should we not do away with the ability of McDonalds, Burger King, IHOP, ALL Tanning Bed Salons, any alcohol prodcuing coorporation, and all cell phone companies to make any profit at all?
These companies and the products they make are one of the main reasons that our countries Health Care cost is so high. We pay alot for our Health Care, but it seems there would be way less of a need for the Health Care if we simply elimnated these companies from being able to make a profit, thuis eliminating or reducing our use or consumption of their products.
Why should they be allowed to make a profit?
Thulsa Doom
June 28th, 2011
2:18 pm
josef,
Well we certainly don’t and won’t agree on everything. We are a compassionate society- even us cons, that wants to see all people treated with the most basic of care. Personally I don’t mind paying a little extra tax to make sure that the poor among us as well as all children have access to routine care. I suspect where we differ is in how that care is delivered in the most efficient manner.
And I do believe Jay has touched on what I think is the crux of the debate. We as a society do in fact spend an inordinate amount of money on end of life care and on costly drugs, new techniques and medical devices, etc. And while this makes our health care system the best in the world it also means we have the most expensive system in the world. There is no way around it. If we want all this we are going to either have to ante up and pay for it or start rationing care in one form or another on end of life expenses.
thomas
June 28th, 2011
2:19 pm
Adam,
Are you Ok with Food Companies making a profit?
Or is all of your hate directed at only Insurance companies?
Doggone/GA
June 28th, 2011
2:19 pm
“everyone thinks they have the right to unlimited profits, greed, health care, housing, food, farm subsidies etc”
I guess you’ll have to stop using that “everyone” because I, for one, do not believe that. That means NOT EVERYONE believes it.
Adam
June 28th, 2011
2:19 pm
Dave R: I see you are preferring to argue a point that wasn’t made. You assume:
1) The argument was we should reset the taxes to Clinton levels and that will solve everything by itself, and
2) That no other changes, such as spending cuts, are being considered by the person or people making that argument.
You also seem to have missed the point of this part:
that will MORE than get us on the way back to manageable debt-to-GDP ratios in the middle term
Referring to the fact that if we allow the tax cuts to expire, the debt-to-GDP will not skyrocket. It will still slowly increase, but MUCH more slowly, also assuming no changes in other areas. However, changes in areas like spending and other tax revenue increases are being proposed by the Democrat side.
Do I really have to take a page from Ryan’s book and go “What YOUR plan?”
Doggone/GA
June 28th, 2011
2:21 pm
“Or is all of your hate directed at only Insurance companies?”
There’s nothing wrong with insurance companies making a profit. But HOW they make that profit can be, and is, open for criticism. Just as it is for any other company.
Message from Matti
June 28th, 2011
2:22 pm
The high prices of the drugs are necessary to support the drug companies’ television advertising budget. After all, we might not know we NEED expensive toxic chemicals if we don’t see the ads. Heck, we might go months or years without asking our doctor if it’s right for us. Doctors might go out of business without the drug pushers drumming up business for them!
Thulsa Doom
June 28th, 2011
2:22 pm
thomas,
Don’t forget tobacco companies, auto manufacturers, candy makers, pool makers, bicycle makers, motorcycle makers, jetski and skiboat makers, football, b-ball equipment mfgers, any sporting good company mfging anything such as skiboards, etc. basically any company that produces a product which can injure or kill people shouldn’t be allowed to make a profit since they all add to the cost of health care.
Left wing management
June 28th, 2011
2:22 pm
Thulsa: “Obamacare does away with pre-existing conditions and so therefore a health plan has to take just about everyone.”
That of course being the point, i.e. to cover everyone.
“Of course you’re going to pay obscenely sky high rates as a result.”
The exact opposite is of course the case, Thulsa.
Do you understand the concept of a risk pool, Thulsa? The nature of the problem in any risk pool is ensuring that there are always far more people paying into the pool (because each has an interest in coverage in the unlikely event of need) than have need for a payout, which in the case of health care of course closely correlated to age and health condition (which itself is closely tied to age). The reason employer-based insurance worked for a good while was that it brought together large numbers of people of widely different ages and did so on a random basis, meaning the likelihood of any given worker having a health claim remained fairly constant and controllable. That system has now broken down and so the challenge now is to reproduce that in a general system. The only way, many of us feel, is go ahead and have a universal system, which instantly solves the problem of the risk pool.
eddie
June 28th, 2011
2:22 pm
Love all of the Monday morning QBs about what should be done with those diagnosed with cancer or some other disease where the treatment costs are in the tens of thousands per month. I’m sure that all of you brave souls will just go out in the backyard, grab some dirt and rub it on your sore place. Not likely…..you’ll be queued up at the infusion room just like all of the rest no matter the costs.
“The statement that the drug only extends life for up to 6 months” may be true but then again it may not and the doctors cannot predict what type of response you’ll have. Statistics are for groups….in the cancer world, ignore stats ’cause they are depressing and sometimes grossly wrong. I know many Stage IV patients who have been Stage IV for several years…was the cost of their treatment worth it…you betcha!!
When you time comes, in the cancer world, you’ll know. You don’t need an insurance company, gov’t death panel to tell you that further treatment is hopeless. I know someone who has chosen hospice and stopped all treatments. They knew when they didn’t respond and the tumors continued to grow and spread in spite of costly and painful treatments.
Do yourself a favor and go visit a chemo room and talk with some patients. Ask your questions and listen carefully to their responses. You’ll find most are just ordinary people trying their best to stay alive and beat an unrelenting foe, cancer. They are not the “money grubbing…stay alive at all costs” folks that many of you seem to think occupy the chemo rooms. I am one of these folks. I am a cancer patient with melanoma Stage III; kidney cancer…left kidney removed; and lung cancer, non-smoker, with upper left lobe of lung removed. My battle has been for 10 years but thankfully I am still here. Don’t make us to be the evil ones who’ll cling to life at any cost. Some of you will probably find out when you enter the cancer world. Jay’s chart doesn’t tell the true story but only the statistical story. Be sure to send Jay the facts and decisions made in your specific case when your time comes…..the human side of the story.
Adam
June 28th, 2011
2:23 pm
thomas: Through taxes, we already have programs to help people who are unable to pay for food. Much of the types of food people eat is a choice. Obtaining health care is a necessity. But, now that you bring it up, I think certain basic food SHOULD be provided to people. As of right now, though, starvation is this country isn’t as big of an issue as the amount of people unable to get proper health care.
J. Wellington Wimpy
June 28th, 2011
2:26 pm
From Disgusted: It may surprise you to learn, Wimpy, that there isn’t a “public healthcare,” unless you’re talking about Medicare………………… They must pay a share of the premium, just as employees of businesses do. But don’t let the facts get in the way of your anti-government rant. Keep on believing that there’s a public healthcare plan that doesn’t charge covered employees anything and certainly never requires co-pays or deductibles. If that’s what you want to believe, go for it.
I’m confused. Why are you mad at me? I just wanted a hamburger.
Jm
June 28th, 2011
2:27 pm
Government created healthcare bubble we r in the middle of. U read it here first….
1811/1801 - 0311/0317
June 28th, 2011
2:27 pm
AmVet:
No ……… I want all radical Islamists killed.
Radical Muslims (many which are here in the U.S. preaching their jihad) I would be happy to just have locked up !
……………………………….
Adam
June 28th, 2011
2:29 pm
Scout: Radical Muslims (many which are here in the U.S. preaching their jihad) I would be happy to just have locked up !
So, lock them up for what they say?
AmVet
June 28th, 2011
2:31 pm
Matti, to your point,
The Pharmaceutical Research and Manufacturers of America (PhRMA) uses data from IMS, a firm specializing in pharmaceutical market intelligence, to conclude that pharmaceutical companies spend $29.6 billion on R&D and $27.7 billion for all promotional activities (data from 2004).
Why are pharmaceuticals so expensive? This question has been asked for many years. In fact this was the question asked by Senator Estes Kefauver (D) in the late 1950s. Senator Kefauver was the first to put together an indictment against the business practices of the pharmaceutical industry. In fact he lobbed three charges at the pharmaceutical industry at the time.
They were the following:
1) Patents sustained predatory prices and excessive margins
2) Costs and prices were extravagantly increased by large expenditures in marketing
3) Most of the industry’s new products were no more effective than established drugs on the market.
Throw in GARGANTUAN salaries for the fat cats who run the show and some serious swindling of Uncle Sam, and voila!
The perfect storm of BIG business malfeasance…
getalife
June 28th, 2011
2:31 pm
Doom,
A VP from a health care company wrote the bill.
The corrupt senators praised her on the senate floor after it passed.
Thulsa Doom
June 28th, 2011
2:32 pm
Left wing management,
Absolutely I understand the idea of a risk pool and the law of large numbers. But here is where you are wrong with Obamacare. Obamacare mandates certain coverages such as coverage for pregnancy, mental health, alcohol and drug abuse treatment, etc. It is similar to the difference between individual health insurance and group health insurance. If I do a quote for a group of 5 people vs 5 individuals the individuals are going to pay roughly 60-70% as individuals as what they would pay as a group plan. Why? Because they can pick and choose what they want in their plan whereas the group plan doesn’t give them a choice. The group plan covers more but consequently the costs are going to be higher for everyone.Same as with Obamacare. More people will be covered and more conditions covered but it will be at a substantially higher cost to everyone.
Dave R.
June 28th, 2011
2:33 pm
“However, changes in areas like spending and other tax revenue increases are being proposed by the Democrat side.”
More like the Democrats wouldn’t even be talking spending cuts if the GOP hadn’t whipped their butts in November of 2010.
See: Hope & Follow’s ™ original proposed budget for 2011.
Left wing management
June 28th, 2011
2:33 pm
thomas: “Are you Ok with Food Companies making a profit? / Or is all of your hate directed at only Insurance companies?”
As we’ve pointed out on here ad nauseam, there is no comparison between food and health care as insurable products/services. As Krugman et al. have pointed out — and as we know, Krugman is a perfectly honest broker here, and if you try to dispute his view on this then you are deluded and in need of re-education — health care is the quintessential example of an INEFFICIENT market, primarily because information sharing for the average consumer is impossible (”hey I hear Emory Hospital’s got a great deal on stints right now”), therefore there’s no ability for the market to function as a free market.
Thulsa Doom
June 28th, 2011
2:34 pm
getalife,
Yes. That’s the funny thing about Obamacare. The health insurance companies had a large hand in writing Obamacare and one of the biggest hands was AARP which stands to make a lot of money selling Medicare supplements. I just sold one for them the other day.
RedEye
June 28th, 2011
2:35 pm
“therefore there’s no ability for the market to function as a free market.”
yup, as long as it is the most regulated industry by government any talk about using free market forces to lower prices in healthcare is just a waste of time
Adam
June 28th, 2011
2:36 pm
Dave R: So what? Is that a reason not to go forward with reasonable cuts AND revenue increases?
1811/1801 - 0311/0317
June 28th, 2011
2:36 pm
Adam:
Yep …………. it’s called “terroristic threats”.
You can get locked up for yelling “I’m gonna punch you in the nose” to your neighbor right here in
Georgia ……………. happens everyday ……….. welcome to the real world !
Dave R.
June 28th, 2011
2:36 pm
“and as we know, Krugman is a perfectly honest broker here, and if you try to dispute his view on this then you are deluded and in need of re-education”
There’s your sign . . .
AmVet
June 28th, 2011
2:37 pm
NATO is killing them by the droves yet you try to undermine our troops in time of war, Scout?
Don’t you think they read about how you peaceniks are hurting our boys’ morale?
Tsk, tsk. Billy “Loofah” O’Reilly would say that is un-American.
According to him, once the bombs start falling, you need to shut up. (LOL)
Dave R.
June 28th, 2011
2:37 pm
Adam, what you would consider “reasonable” and what I would consider needed are two very different things.
Adam
June 28th, 2011
2:37 pm
RedEye: yup, as long as it is the most regulated industry by government any talk about using free market forces to lower prices in healthcare is just a waste of time
Agreed. It should be a national system paid for through taxes instead.
getalife
June 28th, 2011
2:37 pm
Doom,
The drug companies are well represented too.
They say the process is ugly but it is corrupt.
I am sure there is a way for you to make money with this bill.
jt
June 28th, 2011
2:38 pm
eddie -
Remember this eddie.
No government parasite EVER helped you ONE bit.In fact …government bureaucrats hampered your effort of survival EVERY STEP OF THE WAY.
.
Doctors, family, businessmen, and you ,yourself , are responsible for your heroic struggle.
.
Good luck Sir. …and for your heir’s sake(if any)….vote freedom..vote Ron Paul.
Adam
June 28th, 2011
2:38 pm
Scout: You can get locked up for yelling “I’m gonna punch you in the nose” to your neighbor right here in
Georgia ……………. happens everyday ……….. welcome to the real world !
That’s absurd. If true, it’s also Authoritarian Government.
JKL2
June 28th, 2011
2:38 pm
Left wing- join those of us who argue that health care is as much a right as a basic education.
Wow, another department the federal government is totally inept at controlling and needs to get out of. Can we talk about how the Dept of Energy has eliminated our dependance on foreign oil next?
Adam
June 28th, 2011
2:39 pm
Dave R: That’s a debate worth having. What is not a reasonable discussion is “Tax revenues are off the table.”
RedEye
June 28th, 2011
2:40 pm
Adam,
As long as it can get funded without raising taxes..I’m all for that
Adam
June 28th, 2011
2:40 pm
JKL2: Wow, another department the federal government is totally inept at controlling and needs to get out of.
See Leg Lamp’s previous posts on the subject of public education.
Thulsa Doom
June 28th, 2011
2:41 pm
health care is the quintessential example of an INEFFICIENT market, primarily because information sharing for the average consumer is impossible (”hey I hear Emory Hospital’s got a great deal on stints right now”), therefore there’s no ability for the market to function as a free market.- Leftwingmanagement
Completely untrue. You can shop for docs and services all day long and get substantially lower rates by paying private pay. I have a client who works at a docs office. She does her own shopping and needed an MRI. Rather than paying $2500 at a hospital she found mri of georgia and paid 300 or 500 I don’t remember which. Lot of docs will take $50 cash co-pays to see you and several are now going to plans where you pay a flat monthly fee such as $50/month for a family and have unlimited copay visits of $15-20 per visit. In other words they are getting rid of the middle man- the insurance plan which is a good thing. And if you call around you will also get varying costs on what what you pay for a mammogram- anywhere from $200- $800 to free screenings. Health insurance should be just like car insurance where it covers the catastrophic and unexpected events such as cancer, etc but where the patient pays for routine care such as doc visits,etc. You don’t expect your car insurance to pay for new tires or oil changes do you?
Mighty Righty
June 28th, 2011
2:41 pm
Jay, I am having a little trouble with your math. $93,000 for a “course” of treatment or $5,000 per month will extend life 18 months somehow equals $500,000?
All treatment brings in questions od cost and of societies moral responsibilities. So let’s examine a few.
Is it fair for someone who has paid into the system for many years to be disallowed treatmtnt because of high cost while giving free care to someone who has never paid into the syatem?
Is it fair to not treat a person because that person is old and may not have long to live while treating a younger person who is here illegally?
Would it be proper for society to treat a person who is both old and not expected to live much longer who has scientific skills that may lead to cures of desease or even extend the life of our planet?
Should a Donald Trump be given priority treatmtnt because he is a major contributor to the health of our economy? Should he have priority over a Barack Obama who is merely a politician and is easily replaced.
Who will decide who lives and who dies and what will be the criteria?
These quetions are best left to GOD. We mere mortals have no business inserting ourselves in this dilema. H-ll we can’t even do something simple like stop spending money we don’t have.
Adam
June 28th, 2011
2:41 pm
RedEye: Of course taxes will have to go up. But is that go up from the current levels, or up from the Clinton rates, or up in the form of loophole closing… etc etc. We already spend more than we take in, and until we take in more than we spend we won’t be able to implement a new program.
RedEye
June 28th, 2011
2:42 pm
Adam,
With respect to your and Daves convo…spending as a % of GDP is at 24%, and has been at roughly 17% the past few decades. Additionally tax revenues are just below 15% of GDP, and has been at roughly 16.5% the past few decades. It seems spending cuts must be made before any discussion on tax revenue increases take place.