Three false health care claims by Congressman Brian Baird

By John in Oregon

Rep Brian Baird has been one of the more level headed of the North West members of Congress. That said. Last Tuesday Rep Brian Baird appeared for a radio town hall on the Lars Larson show. During that appearance Rep. Baird made three incorrect claims. The claims seem sound on the surface, but only on the surface. While not the only claims made, these three claims must be challenged.

False Claim number 1.
– Insurance Companies ration health care.

This is utterly and absolutely false. Beyond denying payment, insurance companies have no other power to deny you care. Assume for argument that insurance has declined to cover your child’s illness. You still have options. Here are nine of them;

– You may appeal your adjusters decision using the companies appeal process.
– You can seek coverage by other insurance companies.
– You can ask your state insurance commissioner to intercede on your behalf.
– You may file a law suit and ask the courts for relief.
– You can mortgage your house to pay for the care.
– You may solicit donations to pay for your child’s care.
– You can seek admission to St. Jude Children’s Research Hospital or the Shriners hospital for treatment at no cost.
– You can ask the drug company for assistance with medications.
– You may seek your child’s inclusion in a research study.

In short you have many options to obtain care. Insurance companies can not and do not ration your health care. Period.

False Claim number 2.
– When government rations health care it will be under the control of the people, will be fair, and people will have choices.

It is true that congress may choose to speak for the people and instruct bureaucracy to ration care. Beyond that, the claim is false. Once in place the bureaucracy will make the rules and decide what treatments will be allowed and which treatments are prohibited.

The rules will apply to all. You, the individual, will not get to plead your case or your circumstances. The rule is about the treatment, not about you or your needs. When the rationing board has prohibited the treatment for your child’s illness you have no choice:

– You were excluded by rule and have no decision to appeal.
– If you seek other coverage, the treatment remains prohibited.
– You may file a law suit but you will have no standing.
– You can mortgage your house to pay for care however the treatment remains prohibited.
– You may solicit donations to pay for your child’s care however the treatment remains prohibited.

This solution simply substitutes the will of Congress in place of your decisions. You will have exactly two choices. Ask congress to pass a law to give you relief. Or, alternatively, you may smuggle your child to another country that does permit treatment.

False Claim number 3.
– Health care is limited and must be rationed.

Money to spend on health care is limited. The health care we can buy with that money is not.

In 1796 Dr. Edward Jenner discovered the inoculation to prevent smallpox. With that discovery Jenner created thousands of empty infirmary beds. Beds no longer need for smallpox patients.

The idea that health care is limited is false — and it is destructive. The idea is falsified by every innovation in health care.

Rationing creates shortages, rationing does not prevent them.

In the 1970s two US Presidents rationed petroleum. The result was more shortages and even less petroleum. In the 80s Ronald Reagan scrapped rationing. The result was a rapid increase in petroleum supplies and falling gas prices. Health care resources are no different.

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  • Joe

    This Baird guy is a complete fool. He is ill-informed. He would not last a minute in the private sector in any performance-based job.
    It is so sad to see the Peter Principle in full blown glory with this guy and others like him.
    Time to head back to the farm, Brian. Please. Do it for the people.

    I don’t think these wacked out politicians know that anything they vote for is going to be bad and going to carry consequences for them in the next election. In this case status quo is better than anything being disucssed right now in Washington. Anything.

    Clueless is too kind for these dingbats.

  • Anonymous

    Just as bad and misrepresenting are his many progressives out here in the blogosphere posting their absurd characterizations of not only the universal health care but how the oppostion just doesn’t get it.

    As so often is the case with leftists the rhetoric and techniques Baird and company use makes it impossible to have a normal conversation where actual and specific points raised are the ones they respond to.
    Their continual responses to what they concoct and mischaracterize stiffles forward movement which would normally establish some incremental recognitions of basic facts.

    Every time the simplest of factors is injected into the process it gets ambushed and morphed into
    something more easily rejected.
    Then as the debate evolves it arrives right back where it started.
    This leftist circular motion is the single most obstructing detriment to honest debate and progress.

  • Rupert in Springfield

    Progressives always want to frame things in terms of a zero sum game. No matter what you are discussing there is a finite amount and it is up to the government to distribute it.

    Except of course the amount of taxes that can be extracted from smokers and the rich. Then of course things are limitless.

  • vp

    “This is utterly and absolutely false. Beyond denying payment, insurance companies have no other power to deny you care.”

    A distinction without merit John. Denial to pay for a procedure, or any procedure once they drop you, is the same effect as so called rationing. Unless you think that in a democracy once could not appeal a decision by say, a government helath board to ration certain procedures, or choose to pay out of pocket, which is perfectly legal in most or all nations that have single payer systems.

    “When government rations health care …”

    Who is proposing rationing in the first place? Limits on how much the public chooses to spend, and on what procedures, is not rationing. It is sensible budgeting. At what point did conservatives come to the conclusion that budgeting = rationing?

    “Health care is limited and must be rationed…”

    The ability to pay for health care is limited. This is true today, true tomorrow, true always. The ability for medical science to innovate is not limited today, tomorrow, and forever.

    “Progressives always want to frame things in terms of a zero sum game. ”

    Funny. I thought it was the other way around. Isn’t it conservatives making the argument that there is only so much money available and therefore 50 million Americans just have to go without care? And that Medicare and SSI funding is also limited, so sooner or later geezers will lose their coverage? If that is not zero sum, then what is it?

    • Rupert in Springfield

      >Isn’t it conservatives making the argument that there is only so much money available and therefore 50 million Americans just have to go without care?

      Nope – I’ve never heard a conservative make that argument. Can quote a conservative who has said something like that?

      If not, should we just put this down as a statement made to fulfill this need you have to make up arguments the other side never made but which you think you can defeat?

      >And that Medicare and SSI funding is also limited, so sooner or later geezers will lose their coverage? If that is not zero sum, then what is it?

      You are confirming my argument. If you feel Medicare and SSI funding is not limited, it would be nice to know from where you expect to get the funds. Let me guess – smokers and “the rich” ( of which you once were a member I guess, since you said you would pay more under Obama, but now you aren’t, since you say you got a tax refund ).

      This is one you should have thought about a little more I think.

      • vp

        You are obtuse Rupert. I did not say SSI and Medicare funds are not limited. Of course they are limited by how much we are able or willing to pay into the kitty. I’m saying that since this is so, and since conservatives constantly point this out, that in so doing conservatives are making a zero sum argument. Therefore your contention above that attributes zero sum arguments to “progressives” is pure hogwash.

        Beyond that, you seem to have pulled out your favorite dead horse to beat once again. Isn’t its flesh getting a bit rotten by now….even for you?

        • Rupert in Springfield

          >Of course they are limited by how much we are able or willing to pay into the kitty. I’m saying that since this is so, and since conservatives constantly point this out, that in so doing conservatives are making a zero sum argument.

          I know I have pointed this out in the past, but I don’t think you understand what a zero sum argument is. Here you are confusing it with something that is obviously a limited supply.

          The funds available for Medicare and SSI are limited, the amount people are willing to pay in taxes is not infinite. That is not the same as zero sum.

          If you want to look up what a zero sum argument is, fine with me. However its a little ridiculous that I have to continually explain to you what zero sum is and you continue to pop off with mistaken ideas about the very nature of the term.

          I think we would probably sit here all day waiting for you to grasp the concept that the commodities market is zero sum and that the stock market is not.

          >Beyond that, you seem to have pulled out your favorite dead horse to beat once again. Isn’t its flesh getting a bit rotten by now….even for you?

          No, I just am fascinated that you will incessantly make arguments that indicate, in this case, a complete lack of grasp of the term you are using rather than educate yourself on what the term actually means.

          The case of mistaking a situation of finite funds as being interchangeable with a zero sum situation, especially after I know I have explained zero sum to you in the past is an example of that.

  • John in Oregon

    VP. You have confused Rationing and Market Price Allocation.

    Rationing is the centralized control of resource distribution in which the rationing authority controls the size of the ration and chooses those groups eligible to receive the ration.

    Market Price Allocation is buyers making individual purchasing decisions based on the value or utility of the product at the current asking price.

    Those two things are very different and nearly the exact opposite of each other. To assume as you have done that they are the same is in error.

    VP you raised the limited money to spend. > *Isn’t it conservatives making the argument that there is only so much money available and therefore…*

    In my original piece I stated explicitly *”Money to spend on health care is limited.”* In fact that’s true for the money to buy *any* product. Food, cell phone time, consumer toys, or any other product. No purchaser has unlimited funds.

    The error you made is the same as Rep Biard. You assume that a limited pot of money is the same thing as limited resources. In fact one can have both limited health care money to spend and an abundance of cost effective health care. We do it now for cell phone time, consumer toys and thousands of other products. We can have the same for health care as well.

    > *Who is proposing rationing in the first place?*

    Rep. Baird did on Tuesday. More importantly the Congress and the President have implemented rationing.

    On Saturday, August 15th, the Department of Health and Human Services announced the members of the “Federal Coordinating Council for Comparative Effectiveness Research” (“CER”).

    The legislation which created the CER was H.R. 1. The responsibility of the CER is to select the “effective” treatments which will be allowed and the “ineffective” treatments which will be prohibited. The councils decisions will apply to Federal programs such as Medicare, Medicaid, and Schip.

    The members of the CER are;
    Anne C. Haddix, Ph.D.
    Thomas B. Valuck, MD, MHSA, JD
    Peter Delany, PhD, LCSW-C
    Carolyn M. Clancy, M.D.
    Deborah Parham Hopson, PhD, RN, FAAN
    David Hunt, M.D.
    James Scanlon
    Elizabeth Nabel, M.D.
    Garth N. Graham, M.D., M.P.H.
    Jesse L. Goodman, M.D., M.P.H.
    Rosaly Correa-de-Araujo, M.D., M.Sc., Ph.D
    Neera Tanden, J.D.
    Joel Kupersmith, M.D.
    Michael Kilpatrick, M.D.
    Ezekiel J. Emanuel, MD, PhD

    • vp

      You are confusing using data with rationing. Effectiveness research is used to determine what treatment accompishes what end for what cost. Then, assuming the data is actually used, the government could (and should) decide to pay for the more effective, more effective treatments instead of or ahead of the more expensive, less effective ones. This is not rationing. It is rational. Same etymological root, but big difference in meaning.

      If someone wants to spend out of pocket, or through their own insurance for the more expensive, less effective options, then they are free to do so right? So how is this rationing? It is about the efficiency of taxpayer resources. Again, I would think a conservative would be for this. You guys are making yourselves into liberals in this debate. Protect medicare. Protect wasteful spending. What next?

    • John in Oregon

      > *You are confusing using data with rationing.*

      I have not. Determining the efficacy of treatment happens constantly within the medical profession. It’s a major tenant of modern medicine. Two examples. The study of Hormone Replacement for menopause and study of early catheterization of ER heart patients.

      The hormone replacement study found increased risk for other disease. The angiogram study found a targeted group of patients that receive significant benefit in reduced future heart attacks. The study results were given to doctors and patients as an additional factor to be considered as the patient makes individual treatment decisions. Together the patient and doctor make the personal choices.

      The Federal Coordinating Council for Comparative Effectiveness Research is very different. They will have access to the study data like that above.

      However. The council will also consider cost, life adjusted quality years or what ever other criteria the council may so choose. Further the council has the authority to compel particular treatment behaviors. These are considerations that are currently made by doctors and patients.

      I’m sorry but there is no other way to spin it. That is rationing. Actually rationing may well be the best face possible that could be put on what that council will do.

  • Bob Koski

    Here’s another one for you…

    Capitol Hill Police have no report of threats from Brian Baird (or any other Congress Critter for that matter…)

    http://www.clarkblog.org/vBulletin/showthread.php?t=5084

  • Anonymous

    vp

    You sure prove my 7:30 points

    You use “50 million without health care” instead of the truth of 50 million without insurance. There’s a big difference liberals don’t like to to acknowledge and it sounds better to say no health care. So they lie.

    Then there’s your dance on rationing. Real rationing. Of course Obama -universal health care would have to use rationing. There’s not enough money to even borrow to pay for coverage without rationing. Yet you’re trying to mislead people into believing there will be no difference from what we have now.
    And you try and cover over that fact that rationing will be necessary by saying “no one has proposed rationing”.
    Of course they haven’t. Just as no one has proposed covering illegals. That’s liberals for you. They can’t spit out the truth.
    Illegals are a big part of the 50 million that liberals want to give free insurance to.

    Your, the left’s, inference that there will be no rationing or coverage for illegals because no one has proposed it is manipulative rhetoric.

    Then you pitch that ridiculous idea that anyone can simply get other insurance if they don’t like the government coverage?

    You mean to say they’ll be forced to buy supplemental insurance because the government coverage they’ll get through work will be crap.

    Honestly this is exactly the same kind of circular obfuscation as the left used in the Amnesty debate.

    They’ve tried it in the global warming/cap and trade and now Americans are blowing back the effort to take over health care.

    It’s a sham, not paid for, won’t work and Americans know it.

    On top of that there’s already enough big fiscal problems to fix,

    How about our electeds go after those savings in Medicare as a stand alone effort?

    What, they won’t do it unless they get health care?

    Sort of. They won’t do it period. They’re only saying they’ll find savings in order to advance health care.

    • vp

      “Of course Obama -universal health care would have to use rationing.”

      First, you just said it isn’t about universal health care. We already have that if one counts emergency rooms. What Obama is advocating is making actual insurance affordable and available to every US citizen, and one presumes legal immigrants are included, but not those here illegally.

      As for rationing, here is the definition of the word ration from the OED:
      “a fixed amount of a commodity officially allowed to each person during a time of shortage.”

      I don’t see where the propsals on the table treat health care as a fixed commodity that is divied out equally amongst all Americans. And I don’t see anything that suggests this is a “time of shortage.” They extend insurance coverage, they prevent private insurance companies from high grading or kicking people out once they make a claim, and they open up the market to more choices (possibly including a publicly managed insurance choice. They proposed to pay for the extension of insurance to those who can’t afford the full price by eliminating lousy deals within Medicare and Medicaid that cost we taxpayers more than should be the case. And by raising taxes slightly on those with very high incomes.

      That is the deal in a nutshell. Rationing is nowhere in sight. Now we all know that when it comes to public expenditures there are limits as to how much we are willing or able to pay. We also know that when an individual on Medicare or Medicaid needs a treatment they or their families may not care how much it costs the rest of us. So the proposals include measures to help insure that the least expensive, most effective treatments are the ones prescribed, as opposed to the most expensive, least efective treatments. To me, that is wise fiscal policy. It is not rationing. If people want to pay out of pocket or through supplimental insurance for the most expensive treatment out there, then they would still be free to do so. No rationing, but some limits on what the public is on the hook for.

      If you want to go on writing blank checks from the taxpayer to doctors and hospitals who use ineffective or overly expensive treatments, then fine, make that argument. But don’t call yourself a conservative, because that is something only a liberal would support.

    • John in Oregon

      > *here is the definition of the word ration from the OED.*

      That is the definition as a noun, that is the allotted amount. Your definition is the incorrect usage for the discussion here.

      The act of rationing [verb] is the centralized control of resource distribution in which the rationing authority controls the size of the ration [noun] and chooses those groups eligible to receive the ration [noun].

      > *Rationing is nowhere in sight.*

      Oh Really. One could show rationing in all nationalized systems. An abundance of proof. However there is proof much closer to hand.

      The Federal Coordinating Council for Comparative Effectiveness Research has the task of allowing and prohibiting treatments. Further the council has the authority to compel particular treatment behaviors. The council exists, is in place, and is operating as we speak. Tell me again how rationing is nowhere in sight?

      > *If you want to go on writing blank checks from the taxpayer to doctors and hospitals who use ineffective or overly expensive treatments, then fine, make that argument.*

      No conservative, libertarian, market capitalist, free market entrepreneur, constitutional adherent, or Friedman economist made any such proposal. They would not support health services funded by the government and controlled by the government.

      As to treatment efficacy this is constantly monitored within the medical profession. It’s a major tenant of modern medicine. What is the justification for a government council duplicating this function?

      Lets consider s situation more like real life.

      The patient is a Caucasian female who appears her stated age.

      She cannot speak nor comprehend the spoken word. She often babbles incoherently for hours on end. She is disoriented to person, place and time, but will occasionally recognize her own name.

      She is often soiled and her clothes are dirty from incessant drooling. She makes no effort to care for herself and is utterly dependent upon the efforts of others.

      She cannot walk. She must be fed a special pureed diet and is 100% incontinent, requiring frequent bathing and changing. Several times a day, she becomes agitated for no obvious reason, and will scream loudly until someone attends to her.

      The patients family has insisted that the patient receive any and all care necessary to meet all of the patients needs.

      Here is the question for you Doctor VP. Would you;

      Follow the terms of the UK NHS that patients unable to communicate with hospital personnel are considered to be “due to die” and are removed from all forms of life support, including food and water?

      Or would you

      Follow the wishes of the family?

      Or would you follow some intermediate course of action?

      • vp

        “The act of rationing [verb] is the centralized control of resource distribution in which the rationing authority controls the size of the ration [noun] and chooses those groups eligible to receive the ration [noun].”

        Then you have zip to worry about, since the current Congressional proposals contain no such thing. There is no “size of ration.” There is merely a logical limit as to how much to spend, which may mean plenty of bread and cheese to go around but less fillet mingnon.

        “One could show rationing in all nationalized systems…”

        Again, you confuse budgeting with rationing. Governments limit what they spend on health care, which limits what they spend on procedures. But any system that retains a private insurance option, which includes most if not all single payer systems gives those with resources or other priorities a path around what the masses are entitled to on the taxpayer dime. And, since the Congressional proposals are nowhere near single payer, we don’t even have to go there.

        “The Federal Coordinating Council for Comparative Effectiveness Research has the task of allowing and prohibiting treatments..”

        Based on *cost and effectiveness.* Again, I would think any conservative would want to spend taxpayer money wisely and well, but I guess I missed the mark on that.

        “Tell me again how rationing is nowhere in sight?”

        It is only in sight only if one has a periscope that can see around the next several bends. Current proposals retain all present private insurance options, and they retain the right for you to spend yourself silly or bankrupt on over expensive and ineffective treatments with your own money. Therefore there is no rationing in sight. Period. Rationing only exists when the supply is limited. It isn’t.

        “No conservative, libertarian, market capitalist, free market entrepreneur, constitutional adherent, or Friedman economist made any such proposal. They would not support health services funded by the government and controlled by the government.”

        Then it is a matter of principle, not a matter of what works or doesn’t work. Thanks for clarifying. Your side should be calling for the abolition of medicare, medicaid, the VA, the military health services, public university student clinics, school nuses, and all state and county level funding of health clinics for the poor to maintain your consistency. You should get a lot of votes on that platform, given the many geezers who are yelling at their elected reps to “keep your hands off our medicare”.

        “As to treatment efficacy this is constantly monitored within the medical profession. It’s a major tenant of modern medicine.”

        Then why do medical services delivering the same results cost twice as much in some cities as in others? I’ll tell you why. Because the medical profression does no such thing. It is a decentralized, largely private and for profit system that finds no benefit in cutting costs since incomes are derrived from services, not results. The system is badly skewed towards performing unecesary and often counter productive services, not towards keeping people healthy at low cost.

        “What is the justification for a government council duplicating this function?”

        The justification is precisely because the medical practitioners don’t accomplish this. Therefore it is not duplicative.

        “Here is the question for you Doctor VP.”

        I’m not a doctor, nor do a play one on blogs. However, lets start with your first premise, that a patient who cannot communicate is as good as dead in Britain. Your premise is flat out wrong. And I would think after the Steven Hawking fiasco you would be more cautious making those sorts of claims.

        If I were on a medical ethics panel charged with spending taxpayer furnished dollars wisely and well, and with following the hippocratic oath, and knowing there are many other patients who need various services, I would want a neurological diagnosis to determine the brain functioning of the poor woman you describe, and I would cast my vote for treatment based on her cognitive function and her prospects for recovery given the available treatments. If she has none, or very slim, I would cast my vote for palliative care only, and spend the money on the 14 year old with CF.

        Now you can divulge the rest of the story, that she really was fine and recovered and was actually Margaret Thatcher and had only eaten some bad shrimp.

  • Anonymous

    vp,
    Get a grip on the circumstances we face and stop the irrational and reckless advocacy for expanded government.

    From an AP article —
    ————
    ———————————-
    Tax receipts are on pace to drop 18 percent this year, the biggest
    single-year decline since the Great Depression, while the federal
    deficit balloons to a record $1.8 trillion. Other figures in an
    Associated Press analysis underscore the recession’s impact:
    Individual income tax receipts are down 22 percent from a year ago.
    Corporate income taxes are down 57 percent. Social Security tax
    receipts could drop for only the second time since 1940, and Medicare
    taxes are on pace to drop for only the third time ever. The last time
    the government’s revenues were this bleak, the year was 1932 in the
    midst of the Depression.

  • John in Oregon

    With rationing you reassure us that > *Then you have zip to worry about, since the current Congressional proposals contain no such thing.*

    Well of course rationing isnt contained in not yet completed proposals as rationing was implemented in already passed H.R.1.

    Why is it again that readers of your reassurances should be reassured that they have zip rationing to worry about?

    > *Again, you confuse budgeting with rationing.*

    Oh I see. Its not rationing because its budgeting. Why is it again that readers of your reassurances should be reassured that they have no rationing to worry about?

    The Federal Coordinating Council for Comparative Effectiveness Research has the task of allowing and prohibiting treatments. You reassure us that is > *Based on cost and effectiveness.*

    Why is it again that readers of your reassurances should be reassured that they have no rationing to worry about because the rationing will be based on cost or any other criteria?

    We are told that we have the > *right for you to spend yourself silly… Therefore there is no rationing in sight. Period. Rationing only exists when the supply is limited. It isn’t.*

    Of course rationing exists any time a rationing authority says a good will be rationed. Why is it again that readers of your reassurances should be reassured that they have no rationing to worry about because we are allowed to spend money on approved treatments and not allowed to spend money on prohibited treatments?

    > *Your side should be calling for the abolition of medicare, medicaid, the VA, the military health services, public university student clinics, school nuses, and all state and county level funding of health clinics for the poor to maintain your consistency.*

    Isnt it interesting that having created an unsustainable program the progressive statist then finds it necessary to pass off the mess to constitutionalists and capitalists to clean up. However, ignoring that.

    Of course had the representations made from the floor of the Senate that Medicare would not harm private health care been truthful… However, ignoring that as well.

    Had the government not spent the money extracted from people it could be returned with compound interest. Ignoring that as well.

    The bulk of indigent health care is delivered by ER walk-in, private clinics, and Medicare/Medicaid cost shifting. That is funded by the private sector.

    In support of your claim that the medical profession does not monitor treatment efficacy you state > *Then why do medical services delivering the same results cost twice as much in some cities as in others? … It is a decentralized, largely private and for profit system that finds no benefit in cutting costs since incomes are derrived (sic) from services, not results.*

    Two parts to your claim here.

    First that the USSR centralized decision making in Moscow was more effective and efficient than US free market capitalism. Nothing further need be said.

    Second you ask about why regional the disparity in cost? That’s easy. Same reason the taxes and fees in Oregon are near the highest in the world, and not in Texas. The same reason the same home costs near twice in Oregon what it does in other parts of the country. And the same reason health insurance costs $8,537 per year in Massachusetts and $1,254 in Wisconsin. Government.

    You mention > *the Steven Hawking fiasco*

    Of course Steven Hawking is famous now. Paul Krugman is all proud of him self. BUT lets review the things Paul Krugman hid from his readers. (Is withholding information the same as a LIE?)

    Via Hawking’s biographers.

    In the mid-1960s, Hawking’s father found it necessary to rescue Hawking from the NHS and take over his son’s treatment himself, doing his own research and prescribing treatments.

    Then in 1985 when Hawking wasn’t yet really famous Jane (his wife) wrote letter after letter to charitable organizations around the world and called upon the help of family friends in approaching institutions that might be interested in assisting them when the NHS would not.

    Yupp, yupp. Your usual good work Krugman.

    Now about the Caucasian female patient who often babbles incoherently for hours, makes no effort to care for herself and is 100% incontinent.

    The suggestion is that the Federal Coordinating Council for Comparative Effectiveness Research would want a battery of brain function tests. You highlight the point nicely. The council will issue blanket rules and never consider the individual patient.

    I will tell you that were a brain function test done the result would be no better than a 6 month level.

    While the patient is not in the preferred age group to receive treatments, as I said the patients family has insisted that the patient receive any and all care necessary to meet all of the patients needs.

    In fact the family would likely resort to any measures necessary to insure same. Your suggestion of palliative care would be unacceptable.

    • vp

      “because we are allowed to spend money on approved treatments and not allowed to spend money on prohibited treatments?”

      My point, which I suspect you are deliberately missing, is that if you are allowed to spend your own money or a private insurance company’s money on a medical procedure that the government has chosen to not waste taxpayer money on, then there is no rationing. There is a decision by the government, which is responsible for wise use of taxpayer resources, to not waste money.

      Forget Krugman. It is Hawkings himself who says he would not be alive today without the NHS. Now picture a young, badly physically disabled kid with a genius brain here in teh US, unfortunate enough to be the child of working parents with no health insurance, yet not poor enough for Medicare. What happens to this kid? He dies John.

      “In fact the family would likely resort to any measures necessary to insure same. Your suggestion of palliative care would be unacceptable.”

      Then fine. THey can pay for it out of pocket or through their pivate insurance. Just don’t ask the taxpayer to pay for it.

    • John in Oregon

      > *My point … is that if you are allowed to spend your own money … on a medical procedure that the government has chosen to not waste taxpayer money on, then there is no rationing.*

      The operative word in your statement is IF. If you are allowed to spend your own money.

      For sake of argument assume you are theoretically allowed to spend your own money. Lets hear it from the horses mouth. Andrew Dillon, the head of the UK rationing authority NICE.

      The way this works, as Dillon explained was that if NICE says something’s off limits —

      A doctor won’t prescribe it.
      …And if the doctor did prescribe it —

      The pharmacy wouldn’t fill it.
      …And if the pharmacy tried to fill it —

      The pharmacy wouldn’t find it because it wouldn’t have been purchased.
      … And if the patient obtains it from a foreign pharmacy —

      The NHS will terminate the patients health care for improperly toping up. (Getting improved health care.)

      Of course Hawkings is happy with the NHS treatment today. He is famous and has access to the latest and cutting edge treatments.

      Treatments no other UK ALS patient receives. That is exactly the point. Government health care is politically motivated and politically run.

      How did young Hawking do when he wasn’t famous? When his father found it necessary to rescue Hawking from the NHS?

      How would the anonymous US ALS patient do? Quite well with the assistance of the many research and support foundations in the US.

      And one should NEVER discount the determination and fortitude of Stephen Hawking him self. In the end I would say that may be the largest single factor in his life.

      • vp

        “The operative word in your statement is IF. If you are allowed to spend your own money. ”

        Yes, and there are no proposals on the table anywhere that say otherwise. There is nothing “theoretical” about it. What is “theoretical” is speculating that the current legislative
        proposal(s) inevitably lead to a ban on private health care spending, which is ridiculous on its face since nearly all nations with much more socialized systems do not prohibit private spending on health care.

        The British system is way beyond any proposal here in the US. Even a complete single payer system, like Canada, still has private medical providers. The UK does not. Yet in the UK, one can obtain private insurance if one wants to bypass the state system for some treatments.

        “Of course Hawkings is happy with the NHS treatment today. He is famous and has access to the latest and cutting edge treatments.”

        Hawkings has had ALS since 1962, when he was an unkown student. He has been wheelchair bound since He has been cared for by the British health system ever since that time. His fame came much later. You are making claims about him that he himself disputes. And you are making claims about the US health system that are ridiculous. If you have money here, you can get great care. If you don’t you won’t. A person diagnosed with ALS is more than likely going to be dropped from their private insurance, even if they have been paying diligently.

        So what you are doing John, is comparing the US to a system we have no plans to emulate (other than for our veterans, who get great care). And you are making false assertions about the British system, to make what point I have no clue.

        What you and other critics of current proposals should do is state what you like and dislike factually, and offer alternatives in the spirit of comprpomise. If you want to waste your time defending the status quo, be my guest.

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