I hear your point as well. Nobody, including me, accused the gov't of being efficient. But I sure won't accuse private insurance of being without fraud or deciet. The percieved "inefficiency" of private insurance is a carefully calculated bunch of hoops they make patients jump through to get covered, and make docs jump through to get paid. If either one gives up, they happily pocket the dough. We've seen coverage decrease, denials of claims increase, payment to physicians decrease, be bundled, and denied outright under private for-profit health insurance executives. Bill Frist made BILLIONS of such practices. US Healthcare awarded their CEO one billion in stocks when I was a med student in 94.
Originally Posted by Eric Johnson
Please don't think i'm in favor of all public option. I'll get screwed. I wish we had a simple pay-for-service, like every other aspect of American capitalism enjoys. I would gladly provide service to those who couldn't afford to pay, as I do already. But at least those who could afford to pay, would.
Yes, I read the Advance Planning Services section where it provides that under Medicare patients may receive counseling with respect to actions they may take with respect to living wills and durable powers of attorney to halp ensure that their wishes with respect to the care are being carried out even if they are no longer able to direct their care. Do you believe that such information should be withheld? Did you actually read the section or simply believe propaganda pieces stating that the purpose of these services was to advise patients on euthanasia.
Originally Posted by Eric Johnson
Most of the people I know who are facing old age and frailty are much more fearful about what things may be done to keep their bodies alive long after their minds have left the room than they are about receiving services to prolong their lives longer. My father went in the ICU for 10 days after aspirating vomit following minor hernia surgery. The doctors convinced me that if he survived at all he would make a complete recovery. He did and lived another 18 months. The cost for the ten days, paid principally by Medicare, was $250,000. From a personal perspective, I'm glad we got the additional time. From a societal perspective there may be some questions about the wisdom of spending money in that way. I suspect that if he had not had Medicare (a government medical program) he might not have survived the process.
18 months later my father's cancer had advanced much further. During the last six months of his life, he was in greater amounts of pain. The medications to counter the pain -- Fentanyl and Oxycontin -- left him in a zombie-like state for all but a few hours each day. When my Dad lapsed into a state where he ranged from semi-conscious to unconscious, I fulfilled his wishes as he had sworn me to do. We moved him to a residential hospice (coincidentally operated by a Catholic order) where my sister and I could spend his last days with him without having to spend all of our time trying simply to keep him clean. We withheld all drugs except pain killers, all IV nutrients, and all IV fluids. He received food and drink when he was conscious enough to take them. He died peacefully a few days later having had a single 15 minute period where he was semi lucid. He ate scrambled eggs, drank orange juice, and said goodbye to us both. My father had sought out advice on advance planning directives. He thought through his choices carefully. When he made his decisions, he committed them in writing and made my sure my sister and I knew exactly what he wanted and that we had the written documents needed to act on his behalf. I certainly hope that any health plan would make such counseling services available to every adult, not simply those over the age of 65. Our medical system has become too good at preserving our bodies long after our souls have fled.
BTW, the bill reads just like most health insurance policies, with explicit descriptions of what is covered. The biggest difference is not in the services it limits, but in the services that it doesn't limit.