Anesthesia relief- Haiti

[sevoflurane]

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With over 150K dead, and many, many injured I have decided I would like to head out there to provide anesthesia relief. My understanding is that there is a substantial lack of anesthesia providers. There is always more providers early on... so my plan is to head out there in 2-4 weeks when relief starts to recede.

I've never tried to do anything like this before. Doctors without boarders wants you to commit 9-11 months. Obviously, can't do that. I do have an attending from residency who is out there right now. I sent him an email yesterday, but in the mean time I'd like to look into it a bit further.

For those of you who have done this sort of thing before. How do you go about it? Any particular organizations to get in contact with?

 

[doctor712]

I'm PM'd you, Sevo.

 

[checkov]

With over 150K dead, and many, many injured I have decided I would like to head out there to provide anesthesia relief. My understanding is that there is a substantial lack of anesthesia providers. There is always more providers early on... so my plan is to head out there in 2-4 weeks when relief starts to recede.

I've never tried to do anything like this before. Doctors without boarders wants you to commit 9-11 months. Obviously, can't do that. I do have an attending from residency who is out there right now. I sent him an email yesterday, but in the mean time I'd like to look into it a bit further.

For those of you who have done this sort of thing before. How do you go about it? Any particular organizations to get in contact with?

This is flat-out awesome. It's great to see an anesthesiologist who is willing to take the time/effort to help those who are in need.

sevoflurane, do you have a Paypal account? If everything works out, I'd be happy to contribute money if you'd like aid supplies to take with to Haiti / funds to travel to Haiti.

 

[GoodmanBrown]

I'm PM'd you, Sevo.

Does Doctors Without Borders really want that much time? I looked into this recently, and I thought that anesthesiologists were an exception and could stay for only 2-3 months? Still a good amount of time, but less than commitments of 6 months for other doctors.

 

[pgg]

Having

• just read this CNN article published yesterday ...
• done similar type of relief work in Iraq & Afghanistan ... with the benefit of 20-200 armed Marines pulling security for the medical group ...

I would be very, very cautious about attempting to tag along on some hastily thrown together group, or a group that hasn't done this kind of work before.

I don't know anything about Haiti beyond what TV and the internet tell me, but the security situation still sounds marginal. In a few weeks when you want to go I'd guess that the mobs will have run their course and the logistics will be more or less established. But anyway, good intentions minus logistics and security are dangerous for everyone, so go with a group that has a plan, experience, and contacts in place.

 

[sevoflurane]

Having

• just read this CNN article published yesterday ...
• done similar type of relief work in Iraq & Afghanistan ... with the benefit of 20-200 armed Marines pulling security for the medical group ...

I would be very, very cautious about attempting to tag along on some hastily thrown together group, or a group that hasn't done this kind of work before.

I don't know anything about Haiti beyond what TV and the internet tell me, but the security situation still sounds marginal. In a few weeks when you want to go I'd guess that the mobs will have run their course and the logistics will be more or less established. But anyway, good intentions minus logistics and security are dangerous for everyone, so go with a group that has a plan, experience, and contacts in place.

👍

I hear you. I'm used to 3rd world countries. I lived in one for 13 years. They most certainly can dangerous, especially after a natural disaster. Thank you for the comments.

 

[Fastrach]

Last I heard, they had no pipeline O2 supply down there and were switching their anesthesia machines to straight air without O2. Probably the least of their worries, no doubt. Good luck down there. 👍

 

[usnavdoc]

Haiti is just re-emphasizing what should have been learned by Katrina(and all the natural/man made disasters prior to that). We and the rest of the world are still just really poor at responding to large disasters.

When the AAMC sent out its request maybe ten days ago, I responded immediately. I have yet to hear back from anyone at all. It seems that these things get talked about alot but nothing really happens. Very disheartening.

I would not just fly down without a plan to fall into someone elses infrastructure. As PGG stated, the very first thing you need is a security plan. To go alone is foolhardy.

 

[DScully]

Does Doctors Without Borders really want that much time? I looked into this recently, and I thought that anesthesiologists were an exception and could stay for only 2-3 months? Still a good amount of time, but less than commitments of 6 months for other doctors.

If I remember correctly, you can commit to a much shorter duration in the field of surgery and anesthesiology (something like 6wks). However, I also think they require some sort of prior experience of living in an area where there isn't much resource available. In other words, they don't really want to fly someone who grows up in a big city for whole his life and has no clue whatsoever what it is like to live in a third world country.

 

[Planktonmd]

I find it amazing that many people who openly oppose giving freebies to others are willing to volunteer their time and money to help Haiti!
Is it because it is a big disaster?
I am not sure this is the reason, because we never witnessed such an overwhelming response with other major disasters before.
Is it because it is so close geographically?
I would argue that we did not see a similar response even when the disaster was right here in New Orleans.
So, anyone knows what's so special about Haiti?

 

[proman]

It's not because it's Haiti, you see a lot of giving during times of extreme need. I think it's the difference between being asked to give (volunteer) versus being mandated by law (taxed).

 

[proman]

HAITI QUAKE Plus 6 days: $156,044,390 Plus 13 days:$306,797,596
Tsunami Plus 7 days: $207,882,580 Plus 11 days: $401,784,551 Plus 13 days: $456,916,726
Katrina Plus 11 days: $632,783,990

Comparison of donations

 

[2win]

I find it amazing that many people who openly oppose giving freebies to others are willing to volunteer their time and money to help Haiti!
Is it because it is a big disaster?
I am not sure this is the reason, because we never witnessed such an overwhelming response with other major disasters before.
Is it because it is so close geographically?
I would argue that we did not see a similar response even when the disaster was right here in New Orleans.
So, anyone knows what's so special about Haiti?

Hi Plank - glad to see you back!
Situation IMO is different- New Orleans people had the chance to leave but they just didn't. They chose to stay there.
So - I would call it an informed decision - and I respect that. You wanna die? Go ahead and do it.

 

[urge]

I'm wondering why don't they ketamize everybody for the amputations.

PS: The other day I saw a video interview of a New York pacu nurse saying they "only had motrin as an analgesic, they should have dilaudid, or morphine pca". People's expectations are not in tune with reality. How about some IM morphine if you are lucky?

 

[2win]

I'm wondering why don't they ketamize everybody for the amputations.

PS: The other day I saw a video interview of a New York pacu nurse saying they "only had motrin as an analgesic, they should have dilaudid, or morphine pca". People's expectations are not in tune with reality. How about some IM morphine if you are lucky?

I tried to get there too - my mission was canceled ...The Academy of Ortho - the sponsor of the trip postponed the intervention.
I think that they really need help and we can do it.
The Doctors without Borders assignment is to long for me (2 mo).
I am available 2 weeks.
If anybody can help me I would appreciate.
Thank you,
2win

 

[doctor712]

2win, I'll PM you same I sent to Sevo...
D712

 

[ProRealDoc]

http://www.lumiereministries.com/

Not sure if you have to be of the same religious affiliation or not. I looked into it and your expense would be $800 to cover airfare, food and lodging.

 

[pgg]

I find it amazing that many people who openly oppose giving freebies to others are willing to volunteer their time and money to help Haiti!
Is it because it is a big disaster?
I am not sure this is the reason, because we never witnessed such an overwhelming response with other major disasters before.
Is it because it is so close geographically?
I would argue that we did not see a similar response even when the disaster was right here in New Orleans.
So, anyone knows what's so special about Haiti?

Do you mean from a medical or general relief perspective?

Medically, Haiti has a much much greater need for surgical services than post-Katrina New Orleans. That alone explains why support for relief efforts is so much more visible within medical communities.

Surrounding states were able to help absorb and dilute the big problems after Katrina (shelter, food, water); Haitians are stuck on an island. Katrina victims had fellow Americans to fall back on, they could ride buses to Houston and check into a Motel 6; Haitians have nobody, nothing, and nowhere to go.

Haitians were poor, helpless, and destitute before an unavoidable earthquake and everyone knew it. In contrast, many Americans had a very different perception of Katrina victims - we heard a lot (mostly whargarbl'd BS) about foolish, lazy, welfare leeches who were too dumb to get out of the way of a hurricane, serves 'em right for building below sea level, one of the signature photos of Katrina was a guy stealing/rescuing a bucket of Heineken, etc. Signature photos of Haiti are piles of dead kids in mass graves.


Even given all of that, it was the government/FEMA response to Katrina that was so weak and disorganized. There was an enormous outpouring of donations from other Americans. Unlike Haiti, it was possible for small groups of Americans to simply drive to NO to help out, and many did ... quietly ... without much attention.

I find it amazing that many people who openly oppose giving freebies to others are willing to volunteer their time and money to help Haiti!

So is this a dig at SDN gas forum posters who tend to be welfare-hating conservatives and yet are willing to aid Haitians? 🙂

 

[2win]

Do you mean from a medical or general relief perspective?

Medically, Haiti has a much much greater need for surgical services than post-Katrina New Orleans. That alone explains why support for relief efforts is so much more visible within medical communities.

Surrounding states were able to help absorb and dilute the big problems after Katrina (shelter, food, water); Haitians are stuck on an island. Katrina victims had fellow Americans to fall back on, they could ride buses to Houston and check into a Motel 6; Haitians have nobody, nothing, and nowhere to go.

Haitians were poor, helpless, and destitute before an unavoidable earthquake and everyone knew it. In contrast, many Americans had a very different perception of Katrina victims - we heard a lot (mostly whargarbl'd BS) about foolish, lazy, welfare leeches who were too dumb to get out of the way of a hurricane, serves 'em right for building below sea level, one of the signature photos of Katrina was a guy stealing/rescuing a bucket of Heineken, etc. Signature photos of Haiti are piles of dead kids in mass graves.


Even given all of that, it was the government/FEMA response to Katrina that was so weak and disorganized. There was an enormous outpouring of donations from other Americans. Unlike Haiti, it was possible for small groups of Americans to simply drive to NO to help out, and many did ... quietly ... without much attention.




So is this a dig at SDN gas forum posters who tend to be welfare-hating conservatives and yet are willing to aid Haitians? 🙂

Hey pgg - I think plankton is one of the good (if there is such a description...)"liberals" .
I agree with you.👍

 

[nap$ter]

I'm PM'd you, Sevo.

is anyone aware of opportunities for residents to help?

 

[Planktonmd]

Haitians were poor and were miserable but who's fault was that?
I am just amazed that many people I know personally who thought that the people of New Orleans did not deserve sympathy are now trying to go work in Haiti!
And yes pgg, this definitely includes some people on this forum.

 

[Narcotized]

I find it amazing that many people who openly oppose giving freebies to others are willing to volunteer their time and money to help Haiti!

If they are willing to give time and money to Haiti then obviously they AREN'T openly opposed to giving freebies to others. I think it's in poor taste to use a catastrophic crisis and people's generosity to it as a way of making a negative political statement about them. You're better than that.

 

[Narcotized]

D712, would you post your information openly? I imagine quite a few are interested.

 

[doctor712]

Narcotized,

Of course I want to help all that want to go in whatever way my info can, but I'm not sure the doc's email and email address I have are meant to be posted publicly, it was an internal email. And the only way to reply is to that email...

For those of you wanting to submit your names to get on the list, please just PM me?
I did just read that these 3-4 day trips will become 1 week trips very shortly. FYI.

D712

 

[Planktonmd]

I am not making a negative statement about any one, I am just saying that it is a remarkable phenomenon that deserves to be noticed.
Why would some people be opposed to things like medicaid, welfare, free health care... etc here in the U.S. But at the same time these same people want to go to Haiti?
Is it because Haiti is an acute disaster while poverty, illiteracy, and illness in the U.S. are chronic disasters?
Is it because of all the dramatic pictures on TV?
Notice that I did not say that it is wrong to go to Haiti or that it is wrong to oppose these social programs in the U.S.
I am just curious!

If they are willing to give time and money to Haiti then obviously they AREN'T openly opposed to giving freebies to others. I think it's in poor taste to use a catastrophic crisis and people's generosity to it as a way of making a negative political statement about them. You're better than that.

 

[Dogdaze]

Plank, I think it's because some people want to be... HEROES!

 

[RabbMD]

I am not making a negative statement about any one, I am just saying that it is a remarkable phenomenon that deserves to be noticed.
Why would some people be opposed to things like medicaid, welfare, free health care... etc here in the U.S. But at the same time these same people want to go to Haiti?
Is it because Haiti is an acute disaster while poverty, illiteracy, and illness in the U.S. are chronic disasters?
Is it because of all the dramatic pictures on TV?
Notice that I did not say that it is wrong to go to Haiti or that it is wrong to oppose these social programs in the U.S.
I am just curious!

Well, it depends on where you stand on issues of opprotunity in the USA vs Haiti. Some people strongly believe that in the USA there are ample opprotunities, even in the poorest environments, to allow those with enough motivation to suceed. Of those that do not, most would not be helped with thousands thrown at them in both funds and time.

Haiti however, is the closest thing to a failed state we have in the western hemisphere. There is no real opprotunity for people to suceed. Thus a different response, and as illucidated earlier, a voluntary one, not a forced one from the govt.

 

[pgg]

Is it because Haiti is an acute disaster while poverty, illiteracy, and illness in the U.S. are chronic disasters?

I think it's because of multiple factors mentioned above.

There is widespread - though certainly not universal - belief on the conservative side of the political spectrum, that poverty and disease in the United States is largely self-inflicted. Superimpose compulsory tax-funded support for them, with a more and more "progressive" tax system that every year shifts more of the burden to people who are actually working, and what you get is less sympathy for the American poor, and something closer to resentment.

To put it in anesthesia terms, who wouldn't rather help fix a Haitian child's earthquake-broken leg than do a repeat TKA on an uninsured 350 pound "poor" American?

 

[Narcotized]

.

 

[Planktonmd]

350 pound and poor American used together is somewhat of an oxymoron. The latest line of pc crap is that the poor don't have access to high quality foods, just junk food; obviously A LOT of junk food when you are commonly over 250 pounds. I have a large heart for poor people, but an extremely low tolerance for bull**** excuses.

You can buy a double cheeseburger for $1 at Burger King
http://www.bk.com/en/us/menu-nutrit...index.html?banner=value-menu&source=home-page

If you have $1 and you want to eat a full meal then you are not going to buy an apple and stay hungry all day are you?

 

[2win]

You can buy a double cheeseburger for $1 at Burger King
http://www.bk.com/en/us/menu-nutrit...index.html?banner=value-menu&source=home-page

If you have $1 and you want to eat a full meal then you are not going to buy an apple and stay hungry all day are you?

versus

Takes more than a burger to get there.

 

[pgg]

You can buy a double cheeseburger for $1 at Burger King
http://www.bk.com/en/us/menu-nutrit...index.html?banner=value-menu&source=home-page

If you have $1 and you want to eat a full meal then you are not going to buy an apple and stay hungry all day are you?

Couple issues here -

One, the cheeseburger meal I bought at BK on Friday cost me almost $8 (I might still be digesting it). If you're going to cherrypick promotional prices for individual items @ BK compare them to sale prices at the grocery store or Costco.

Two, it's not the $1 unhealthy cheeseburger that's making people fat, it's the THREE $1 cheeseburgers accompanied by a large fry and pie chased with a quart of dyed high-fructose corn syrup (which isn't on sale and goes for $1.89 or thereabouts).


You can buy a 50 pound bag of rice for $10-20. The fresh boneless chicken breasts may be expensive, but a bag of frozen chicken legs isn't. A can of store-brand vegetables is $.40. Healthy, staple foods are not expensive. They do require 10 minutes of preparation effort though ... and that is the problem.

I brought my lunch to the hospital yesterday. It couldn't have had more than $2.00 worth of food in it. Today my lunch cost me $7.50, but only because I chose to buy a half dozen tacos (god those things are good) from the Mexican grocery store. Which, by the way, had huge cheap bags of dry rice & beans stacked in front of the meat counter where the day's special was some kinda meat I didn't recognize for $2/pound.

 

[Planktonmd]

You are a physician, which means you are relatively educated 😛
That education you got is much better than the education the average junk food eater has and that's why you know how to eat well on a budget.

Couple issues here -

One, the cheeseburger meal I bought at BK on Friday cost me almost $8 (I might still be digesting it). If you're going to cherrypick promotional prices for individual items @ BK compare them to sale prices at the grocery store or Costco.

Two, it's not the $1 unhealthy cheeseburger that's making people fat, it's the THREE $1 cheeseburgers accompanied by a large fry and pie chased with a quart of dyed high-fructose corn syrup (which isn't on sale and goes for $1.89 or thereabouts).


You can buy a 50 pound bag of rice for $10-20. The fresh boneless chicken breasts may be expensive, but a bag of frozen chicken legs isn't. A can of store-brand vegetables is $.40. Healthy, staple foods are not expensive. They do require 10 minutes of preparation effort though ... and that is the problem.

I brought my lunch to the hospital yesterday. It couldn't have had more than $2.00 worth of food in it. Today my lunch cost me $7.50, but only because I chose to buy a half dozen tacos (god those things are good) from the Mexican grocery store. Which, by the way, had huge cheap bags of dry rice & beans stacked in front of the meat counter where the day's special was some kinda meat I didn't recognize for $2/pound.

 

[Planktonmd]

Are you saying that the problems we have here can not be fixed so we should fix the problems of other countries?

Well, it depends on where you stand on issues of opprotunity in the USA vs Haiti. Some people strongly believe that in the USA there are ample opprotunities, even in the poorest environments, to allow those with enough motivation to suceed. Of those that do not, most would not be helped with thousands thrown at them in both funds and time.

Haiti however, is the closest thing to a failed state we have in the western hemisphere. There is no real opprotunity for people to suceed. Thus a different response, and as illucidated earlier, a voluntary one, not a forced one from the govt.

 

[pgg]

You are a physician, which means you are relatively educated 😛
That education you got is much better than the education the average junk food eater has and that's why you know how to eat well on a budget.

I don't know plankton, there's just a limit to how far I can follow that "too disadvantaged or uneducated to buy cheap food and cook it" logic. Our poor are not so hopeless and pathetic that they can't learn how to cook a pot of rice. I know it's not your intent, but it just seems condescending and wrong to think of them as that helpless.

I guarantee you the Spanish-speaking day laborer who helped dig the hole for my pool didn't take his day's worth of near-minimum-wage and go through the El Pollo Loco drivethru to pick up his family's dinner. I know he didn't buy his lunch at McD's, because he brought it in a lunch box. You can't acknowledge the fact that 1st generation immigrants are phenomenally successful in this country despite greater hardships and less education ... while simultaneously lamenting that our own poor can't figure out how to microwave a chicken leg.

The relatively disadvantaged background of our poor may go a long way toward explaining why few become doctors ... but it doesn't explain why they're fat and unhealthy.

They're fat for the same reason rich people are fat.

 

[Planktonmd]

So, let's say that our poor people are fat because there is a cultural problem in this country and poor people as well as rich people are fat for the same reason.
Our poor people don't have health insurance to treat their obesity caused illnesses (secondary to our cultural deficit as you stated), and as a result they end up dying prematurely, is that OK?
If that's OK, why are we upset if Haitians are dying prematurely because of an earth quake?

I don't know plankton, there's just a limit to how far I can follow that "too disadvantaged or uneducated to buy cheap food and cook it" logic. Our poor are not so hopeless and pathetic that they can't learn how to cook a pot of rice. I know it's not your intent, but it just seems condescending and wrong to think of them as that helpless.

I guarantee you the Spanish-speaking day laborer who helped dig the hole for my pool didn't take his day's worth of near-minimum-wage and go through the El Pollo Loco drivethru to pick up his family's dinner. I know he didn't buy his lunch at McD's, because he brought it in a lunch box. You can't acknowledge the fact that 1st generation immigrants are phenomenally successful in this country despite greater hardships and less education ... while simultaneously lamenting that our own poor can't figure out how to microwave a chicken leg.

The relatively disadvantaged background of our poor may go a long way toward explaining why few become doctors ... but it doesn't explain why they're fat and unhealthy.

They're fat for the same reason rich people are fat.

 

[pgg]

So, let's say that our poor people are fat because there is a cultural problem in this country and poor people as well as rich people are fat for the same reason.

Yes, well put. 🙂

Our poor people don't have health insurance to treat their obesity caused illnesses (secondary to our cultural deficit as you stated), and as a result they end up dying prematurely, is that OK?

It's no more or less tragic than a poor, unskilled laborer dying "prematurely" because his workplace is more dangerous than the middle class IT guy's cubicle.

Health insurance and medical care isn't a right, no matter how many times people say it is. It is fundamentally different from actual inherent rights.

If that's OK, why are we upset if Haitians are dying prematurely because of an earth quake?

Dying sooner rather than later from preventable self-inflicted disease is neither 'OK' nor 'not OK' ...

It seems to me your basic complaint is that life isn't fair. How you extend that to criticism of how others choose to donate their time and money to help poor people is a leap of logic that I don't follow.

Every taxpaying American supports the American poor, sometimes in ways we don't agree with or feel are actually counterproductive. Why are you surprised that some of us want to give time and money to non-Americans in a manner of our choosing?

 

[Planktonmd]

Dying sooner rather than later from preventable self-inflicted disease is neither 'OK' nor 'not OK' ...

True, and dying because of the lack of infrastructure and preparedness in a natural disaster can be classified as a self-inflicted death as well.

It seems to me your basic complaint is that life isn't fair. How you extend that to criticism of how others choose to donate their time and money to help poor people is a leap of logic that I don't follow.

No, I never complained about the unfairness of life I am just trying to understand the logic some people have in opposing free social aid to the poor locally and rushing to go to a foreign country to volunteer time and money.

Every taxpaying American supports the American poor, sometimes in ways we don't agree with or feel are actually counterproductive. Why are you surprised that some of us want to give time and money to non-Americans in a manner of our choosing?

I am actually PLEASANTLY surprised.

 

[2win]

True, and dying because of the lack of infrastructure and preparedness in a natural disaster can be classified as a self-inflicted death as well.



No, I never complained about the unfairness of life I am just trying to understand the logic some people have in opposing free social aid to the poor locally and rushing to go to a foreign country to volunteer time and money.



I am actually PLEASANTLY surprised.

"free social aid to the poor" - I think some of my 250k in taxes is going to the poor.
And from where I am coming a lot of the "poor" in US are just called "lazy".

 

[Planktonmd]

"free social aid to the poor" - I think some of my 250k in taxes is going to the poor.
And from where I am coming a lot of the "poor" in US are just called "lazy".

You are paying $250 K in taxes!
So, your gross annual income is what 750K?
Can I apply for a job at your place right now?

And by the way, the ones called poor in this country are called RICH where I come from.

 

[medicinesux]

Speaking of Haiti, what the hell is John Edwards doing down there!?

http://www.cbsnews.com/blogs/2010/01/21/politics/politicalhotsheet/entry6124970.shtml

 

[2win]

You are paying $250 K in taxes!
So, your gross annual income is what 750K?
Can I apply for a job at your place right now?

And by the way, the ones called poor in this country are called RICH where I come from.

Family revenue - me and my wife are filling together.
"Can I apply for a job at your place right now?
Hey Plank - you know that I wanna relocate in the sunny Florida....
If you're really interested - shout me a PM.
2win

 

[RabbMD]

Are you saying that the problems we have here can not be fixed so we should fix the problems of other countries?

I am saying there is a rate of diminishing returns in the charity department. Since there are finite resources on this planet, then the logical use of those resources is to use them where they can do the most good. Haiti could become another costa rica with enough development. The poor in this country largely already have ample opportunity, such that expanding free college education to all, providing free unlimited health care, and unlimited food to all would likely change very little in the people that are poor in this countries overall productivity. That is my opinion, feel free to disagree.

 

[GoodmanBrown]

Health insurance and medical care isn't a right, no matter how many times people say it is. It is fundamentally different from actual inherent rights.

Really enjoying the discussion, guys.

One thought, pgg.

Health care doesn't have to be a right necessarily for America to consider it important enough to provide it for all. We provide grade school education, police and fire protection, and roads (off the top of my head) to everyone regardless of whether or not they can pay for them. As a society, we've deemed these things important enough to give to all. It improves society as a whole to do so. So, I think some people believe health care would/could do the same thing. Thoughts?

 

[IlDestriero]

.

 

[pgg]

Really enjoying the discussion, guys.

One thought, pgg.

Health care doesn't have to be a right necessarily for America to consider it important enough to provide it for all. We provide grade school education, police and fire protection, and roads (off the top of my head) to everyone regardless of whether or not they can pay for them. As a society, we've deemed these things important enough to give to all. It improves society as a whole to do so. So, I think some people believe health care would/could do the same thing. Thoughts?

Universal coverage is a worthy goal. But like welfare, if implemented badly or too broadly, the benefits of a government-run system may not be the self-evident Good Thing proponents say it is.

That something is desirable does not necessarily mean the government is the best entity to provide it. Universal employment would be great too, but I hope no one really believes that a massive government jobs programs and "busy work" is the best way to reduce unemployment. Oh ... wait ... they tried that.

Everything, and I mean everything, that the government does boils down to obligating a portion of the population to provide something for others while imposing no duty or responsibility on the recipients of that service. When it comes to things the government MUST do, the productive/wealthier taxpayers who fund the services clearly and directly benefit. E.g.,

• defense (obvious benefit)
• roads (also obvious)
• environmental protection (rich & poor breathe the same air)
• public primary & secondary education (an educated electorate is arguably a critical foundation for an enduring democracy)
• fire/police (emergencies happen to everyone)

Something else that all of these things have in common is that they are inherently unprofitable. They wouldn't get done at all if the government didn't levy taxes and do them.

Healthcare does not belong on that list. Beyond feeling good about ourselves, where's the universal societal benefit to giving everybody coverage? They can print fiat $s or raise my taxes to provide "free" healthcare for a previously uninsured person in my town, but if he gets his subsidized statin & beta-blocker and lives 12 years longer, the benefit to to me is intangible at best.

I'm not saying that keeping strangers healthier isn't a noble and worthy goal. It is. But let's call it what it is. It's charity, and government forced charity is oppressive and wrong.

Too long to cut & paste, but worth reading: http://www.theadvocates.org/library/christian-crockett.html