we do ration based on finance. Coming through the ER, is hardly even close to the same concept as getting comprehensive care. For example. If you have a 45 year old male come through the ED with painless hematochezia, he doesn't get a colonoscopy in the ED. He gets his hgb checked, and a referral is made. Problem is, if his finanical credentials, ie: insurance isn't adequate, he won't get the test. This happens daily across this country. To try and equate ED care with the best possible care, is not only disingenuous, it is flat out misleading. But thanks for parroting the Sean Hannity talking points.
I can honestly say to this day that I have watched Sean Hannity exactly once, and it was because I was visiting a colleague who was a fan. I personally don't care much for political talk TV. I have no idea what you are talking about with regards to not being able to get a colonoscopy. Maybe that's how it is at Mayo, but I can tell you that we give colonoscopies to people who can't afford them down here at Jackson Memorial Hospital all the time. The way we do it is stupid, because you end up going through the ED to get access to these things (thus the barriers to which I previously alluded). Perhaps the issue to which you are referring is that Mayo doesn't want to treat these patients charitably. I understand that perfectly, but it is certainly not an example of the way any other place works.
I agree with you on some potential constitutional problems, which is why I would like to see an amendment to clarify things permanently.
Speaking of rights. Isn't it strange that a man who is arrested for a crime, will get a lawyer appointed to him FREE of charge if needed, as a right.
The difference here, is that being tried for a crime is essentially the government actively attempting to remove your freedom, and the lawyer for the defendant is really there more to make sure that the legal system works to prevent false convictions. In other words, you only get a lawyer when the system goes after you. The government doesn't give you a lawyer for any other reason, including seeking redress for wrongs.
Yet, a man who becomes ill, and is trapped between making too much money to qualify for any government assistance, and too poor to pay for insurance with his now defined illness, and has no money, will get no care.
I personally find that odd.
Societies are judged by how they treat their sickest and oldest. I believe this to my core.
This doesn't address the fundamental issue at all. Your reference to the dysfunction of the current system has nothing to do with whether a federal takeover of the medical system would be good. We both already agreed that the current system is ridiculous.
Your last statement there is one with which I agree on some levels, but I disagree with it as a premise for the point you are trying to make. It's sort of like when many of our European friends turn up their noses at the US for the lack of "international aid." Our government may or may not be giving less money, but the individual gifts from individual Americans usually supercede all personal giving from the rest of the world combined in virtually every crisis. The government is not a substitute for you deciding to be a good person. We are not a better society because we give a bunch of power mongers in Washington a bunch of power to give things to poor people. This is at best, a reflection on a lazy citizenry that would rather turn all of those poor unfortunate souls over to someone else. It's cheering about how good we are while simultaneously giving the problem away. In my personal life, I have participated greatly in charitable giving, and it has nothing to do with who made what law. The government only has the power to make people do things with force. It is not a benevolent being. The whole system would only work because the government would jail people who failed to pay into whatever system they concocted. That's not benevolence. How great a society are we when we threaten force and jail against anyone who doesn't want to meet our definition of charity du jour? That's government healthcare.
As far as the VAT tax, I'm not inherently crazy about the value added portion, as I learned in all my econ classes eons ago, that they were structurally not great for some of the reasons you alluded too. To be honest, I would rather see a flat consumption tax.
That would be a more visible (and yet equally damaging) tax. It doesn't solve the underlying problem. Higher taxes impair the ability of business to compete. It drives up the price of goods. It makes the average family unable to afford as much. This in turn reduces demand, which reduces demand for workers. A giant new tax on consumption would be a really good way to continue the recession longer.
AS pertains to your federalist argument, there are certain duties that are, and need to be the purvey of the federal government.
Yes, and they are clearly enumerated in the US constitution.
We have the FDA, to ensure that all of our food, and medication supply is hopefully safe, and while they make errors from time to time. Could you really imagine every state having their own laws and rules?
We have the EPA, for many of the same reasons.
I have no problems with states getting together and agreeing to a uniform code. I do have a problem with making enforcement federal unless it crosses state lines. When it crosses state lines, it falls under the purview of regulating interstate trade, which is an enumerated right of the federal government in the US constitution.
We have National Defense, really the FIRST national organization, present even before the ratification.
This is also an enumerated right of the federal government in the consitution.
Personally, I would argue, that the government not only has a duty to protect our citizens from external invaders, but it has an equal duty to protect it's citizens when possible from illness.
You don't have to agree, I know you won't.
Why does it have the duty to protect citizens from illness? The only really valid argument for why we have governments is to protect the citizenry from external threats, and perhaps to deal with issues that impact the population as a whole. This doesn't mean every crisis that is a combination of individual bad luck or bad choices.
Is there a reason to have a CDC and prevent epidemic disease? Yes. Infectious disease is a problem that affects all people, and the spread of an epidemic impacts the entire citizenry personally. I can walk down the street and be infected by someone else through no fault of my own, so the spread must be stopped. On the flip side, if I get cancer, it's terrible, but it is certainly not a national threat. I am not contagious. If I eat too many steaks and smoke too many cigarettes and have a heart attack, it sucks, but it isn't a national threat. The provision of a road is a common good, because everyone uses the same road. The same is not true for healthcare, where treatment is not in-common.
It goes down to the core of political theory (which is really what most of us end up disagreeing on) and how you perceive the government. I view the government as the least of all evils. A power vacuum is bad. A tyranny is also bad. In a sense, we give individuals some priveledge to oversee certain common necessities and common defense. They are certainly not the solution to all social ills. Is there any real reason to believe that a motley crew of people who spend every 2-6 years winning popularity contests by promising things to people with other people's money are the most qualified to solve social problems? If you were looking at it objectively, would any of the people involved in the final healthcare decision making even be at the table if you were trying to come up with the most qualified to make these types of decisions?
