Hawk Loc: Washington DC

Slate has run a column by Adam Goldenberg, A law student at Yale and a former Canadian political speechwriter presenting a very benign view of a quasijudicial tribunal, the Consent and Capacity Board, that can make life and death decisions on seriously ill people. The core of his argument is

Goldenberg notes that the Hippocratic oath is enough to protect patients from abuse. He doesn't realize the Hippocratic oath is symbolic and not legally binding. (Read more: http://www.pbs.org/wgbh/nova/doctors/oath_doctors.html) It offers no protection to the patient at all.

The real question is for whom is Canada's healthcare system for? Is it for the patients or for the Canadian Government? If a person's life can be terminated by the government on the grounds that he or she is too expensive, does that person's life belong to the individual or the Canadian government? Can a person in that circumstance truly be considered free? Are they a citizen or a serf?

This is a the danger of a single payer government-run healthcare system. When the government pays the doctor (or any other healthcare provider), they work for the government and not the patient. That doctor has conflict of interest similar to that of an investment advisor who is paid according the stocks that he or she sells, not according to the needs of a client.

Other societies have gone down this road.

For a free and humane society, Government should not have a role in the delivery of healthcare. Just as much as our freedom of thought is protected by a separation of church and state, so should our freedom to live our lives need to be protected by a separation of healthcare and state.

bmac32 Loc: West Florida

This is where the US is headed. The ObamaCare web sight was designed to fail and their getting ready to throw more money at it to keep it afloat under insurance companies are out of business. Remember this was supposed to
the most tech savvy government and they have managed to spend huge amounts of money (6 times what Amazon rolled out) and built a system with the horse pushing rather than pulling the wagon. Another insurance company pulled out last night, Florida leaving 300,000 uninsured.

AnnMarie Loc: Madison, Wi

I think in a free and humane society, the profit motive should not have a role in the delivery of healthcare. The profit motive will always be on the side of less care, more profit. I really do not understand why ANYONE would think the profit motive is a BETTER champion of patient's rights, and why the same people who "want government out of healthcare" are happy to take medicare, happy to force unneeded vaginal ultrasounds on people. If the profit motive was the best champion of patient care, why did the government have to mandate no drive by mastectomies, requiring insurance companies to allow an overnight stay after a breast amputation or to mandate minimum stays after a delivery of a child? Insurance companies had to be FORCED by the government to provide a minium level of patient care, and THAT'S what you are complaining about??? Obamacare still uses insurance companies, but mandates minimum levels of care, maximum profit (80% of premiums must be used on patient care) and mandates giving insurance to people with pre-existing conditions, and does away with lifetime caps. This is a GOOD THING. The website is a mess, because so many people want to sign up. Websites get improved. This is good for the country.

bmac32 Loc: West Florida

You are reading the plans right. A 60 year old woman does not have the same needs as a 25 year old, it's forced on you.

Where is the incentive for good care it it becomes free for all? Where is your incentive when picking a doctor? Doctors are leaving the field because they won't be able to provide the care because of government regulations, since when is the government good at buying much of anything. Everything they but or supply has cost over runs and now you'll get to buy those first hand.

Dave Loc: Upstate New York

Should the profit motive exist for providing food? Food is a more intimate and needed economic good than healthcare - the reality is that those who suggest profit should not exist in generating the economic good called health care are either people who believe profit should not exist at all, or who are fuzzy thinkers.

AnnMarie - you are either one or the other.

Dave Loc: Upstate New York

Thanks for a well presented intelligent analysis. If we move in the direction that the left seems to favor like this, we will put in the hands of bureuacrats even more power over individual citizens - and it will only be a matter of time when such people decide that those born with serious birth defects that require considerable medical attention over their lifetime should experience a post-partem a******n.

bmac32 Loc: West Florida

I would suggest you learn how to process your own food. Prepare the earth, plant the seeds, water it as needed, pick it at the right time and can it. While your at it can enough for the whole street and do this for FREE.

VladimirPee

" If you like your health insurance you can keep it" Barack Obama

300,000 lost theirs in Florida
Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes

Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state. Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.


http://www.kaiserhealthnews.org/Stories/2013/October/21/cancellation-notices-health-insurance.aspx

AnnMarie Loc: Madison, Wi

Food is not a fair comparison with healthcare-food is more affordable, people know more about food, buying it everyday. If it is bad, people won't buy it again. It is easy to compare prices and quality of food. Healthcare is delivered in a moment of crisis, typically, there is no easy way to compare prices and quality. Also, it is purchased by people who are not knowledgable about say the relative merits of an angioplasty vs medical treatment, and although it is not purchased everyday, sooner or later everyone needs it.

I see healthcare more like fire protection, police protection, armies and navies, social security, stuff that is better purchased by nations than by individuals. Just like medicare. When your house is burning down, you are not looking for the lowest bidder. (actually a reverse form of that was done in ancient rome, when speculators would rush to buy buring houses at rock bottom prices before they put out the fire, save the building and sell it at a profit)

Not at all against the profit motive, and perhaps comparing food to medical care is a perfect example of fuzzy thinking. My amazement is with the fuzzy thinking that the unbridled profit motive is a better protector of patient rights than the goverment mandating limits to insurance companies under the ACA.

You did not answer my question-why are we better off with drive by mastectomies and no limit to insurance companies profit? How is it that mandating insurance companies spend 80% of there premiums on healthcare a BAD thing?

I think that some people have an ideological idea-profit is always good, private enterprise is always better than government, that does not allow them to look at facts and change their opinions.

AnnMarie Loc: Madison, Wi

BMAC, the minimum standards for insurance are part of the idea of insurance-spreading risk around-we are all in this together. Sure 25year olds don't need angioplasties, and 60 year old don't have babies, but over a lifetime it evens out. You pay premiums and the care you need for your age group is there when you need it. Where did you get the idea it was free?-people have to BUY insurance from the insurance companies. There is government assistance for the people who earn very little, just like right now the people who work for Walmart get food stamps because they earn so little. NOT FREE
Also where did you get the idea MDs are leaving the profession-it is still tough as hell to get into medical school so I think the profession still has appeal. Medicare has been working great for 60 years of single payer. Most of the baggers who post here are on it.

VladimirPee

The problem with healthcare is not insurance company profits. They were attacked and demonized as a plot to gain control by government. The problem is provider prices. Insurance companies are not the ones charging $150,000 for bypass surgery or $50.00 for a $1.00 plastic water pitcher. Providers are.

AnnMarie Loc: Madison, Wi

Provider prices are often price shifting to make insured patients pay for care of the uninsured. With single payer, like Medicare, the government can bid for lower prices (except on drugs, because Bush junior gave them an unbid contract). Single payer systems are cheaper all around, because the high volume and bidding make things cheaper to purchase by a single payer, like Health Canada. I worked in marketing for an anesthesia machine company. The same anesthesia machine that we made and sold all over the world cost 70K in the US and 14K Euros in Spain, because the government bid the prices of anesthesia machines. Single payer is much more efficient. The machines were ALWAYS much cheaper in single payer countries, and belive me, we were always trying to get the most for the machines, but they were ALWAYS most expensive (and by a lot) in the USA.

We pay more for medical equipment in the US, and then there is a hospital markup, as you described, and then the formerly 33% profit (average prior to ACA) and now the 20% profit from the insurance companies. All of which makes the US one the most expensive healthcare systems in the world, along with poorer health outcomes than countries who spend much less.

JerryMac

My wife is a nurse at a big hospital and she says that Yes doctors are closing up their practices because of Obamacare. I have heard varying different reasons as to why, but it is happening. Also Some people that had planned on going into the medical field have changed their minds and chose another profession.

VladimirPee

So you are saying a doctor or hospital does not put out requests for bids? Why would your company charge an American radiology firm more than Spain? If we are already paying for the uninsured then why do we need to spend an additional 710 Billion over the next 5 years on ACA? Why not just move the money around?

VladimirPee

Another issue is this parroted World Health Organization ranking of US Healthcare.

Would you prefer to be treated for a serious ailment or injury in Oman, Portugal, Greece, Colombia, Cyprus, Saudi Arabia, United Arab Emirates, Morocco, Chile, Dominica and Costa Rica as opposed to the United States? Probably not so there is something defective in how they rank.

This explains it very well

"
For example, one of the criteria is "financial fairness," related to the percentage of household income spent on health. The use of this measurement, Whitman notes, "necessarily makes countries that rely on market incentives look inferior."

Indeed, the rankings "are designed in a manner that favors greater government involvement" in health care (Whitman's emphasis).

It gets worse. The rankings are also adjusted "to reflect a country's performance relative to how well it theoretically could have performed."

It's as if the Los Angeles Lakers won the NBA title in five games but ended up being ranked No. 2 because, in the opinion of experts, they should have swept the title in four given their talent and resources.


Read more: Carroll: U.S. health care is not inferior - The Denver Post http://www.denverpost.com/opinion/ci_12667987#ixzz2ieB3jAk6
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