Monday, July 20, 2009

Life (for some) At All Cost

Australian philosopher Peter Singer, a professor of bioethics at Princeton University, wrote an intelligent article published in the NYT last week masterfully articulating the infantile and unsustainable nature of the current American health care system. A brilliant ethicist and utilitarian, Singer points to many of the forces behind the out of control upward spiral in costs. I would summarize with the expression, "Life at all costs."

Our "spare no expense" attitude is simply not tenable. While oversimplified, the following example illustrates one key fundamental problem. Say a man has two months to live. A $60,000 treatment could give 1-2 extra weeks. In the UK, forget it unless he pays. In the USA, if he has premium insurance, the insurer drops $60K, but to cover this, the system denies 200 children health care, dozens of whom suffer untreated illness and three die. America screams "life at all cost" with awareness of the man and blindness to the kids. A major cornerstone of our health care fiasco is the systemic denial of services to the less privileged so the more privileged can enjoy lavish levels of services at obscene expense.

In the USA, 54% reported they chose to do without medical care because of the cost (13% for UK and 7% for the Netherlands). Over half of the USA has gone without care due to cost. Medical expenses are behind over 60% of bankruptcies. Almost 50M have no coverage, and that number climbs rapidly. More than 22,000 Americans die each year for lack of health insurance. Costs have doubled in the last ten years and are expected to double again in the next ten.

The country desperately wants health care reform. They want coverage that can't suddenly be denied when they get sick. They want care that can't be denied because an insurance investigator finds a "pre-existing" condition. Ironically, the Harry and Louise couple used to derail Clinton era reform has come out in favor of it this time around. Also ironically, millions were spent attacking the Clinton plan on television. In the last two months, $40M has been spent advocating Obama's health care reforms on television.

Another significant part of the problem is greed, and the greedmeisters are fighting back. The health care industry has spent nearly a billion dollars on lobbying in the last two years, not to mentions millions in campaign contributions to Congress, which is turning 84 shades of purple. The blue dog democrats look ridiculous compared to the astute Republicans that have stated they in principle agree with Obama's fundamental goals. Of course we always have the Neanderthals who see everything in the context of their obsession with "breaking Obama" (14 second DeMint clip). Who cares what the country wants or what helps America? Anything that could be seen as a victory for the president must be vehemently attacked and opposed.

The country will continue to suffer until it recognizes what the rest of the industrialized world has already accepted. We simply do not have the resources to provide life (for some) at all cost.



Blogger Mariana said...

What part of "employer-financed health insurance exists only because the federal government encouraged it by making the premiums tax deductible. That is, in effect, a more than $200 billion government subsidy for health care" (some) people don't understand? Let's talk numbers, not slogans.

7/20/2009 9:55 PM  
Anonymous Observer said...

I hate the health care issue. It is absolutely infuriating. The rest of the civilized world thinks we're barbarians.

7/21/2009 1:42 PM  
Blogger The Navigator said...

Yes, it's infuriating. I'm disgusted with Congress, pansies.

Nay-sayers are trying to make the idea of "government run" stick, conjuring up images of a hospital operating like the license plate place.

Mariana, I don't think I follow your point. What are you saying? What numbers? What "slogan" are you talking about?

Every modern, developed country in the world has a public system to care for people, except the US.

Perhaps it really is this simple: We have government by the rich for the rich. Period.

7/21/2009 3:15 PM  
Blogger Mariana said...

Nav, I am frustrated too, that's why I get off on a tangent.
I was at the rally, I saw their signs, heared their slogans.
The quote is from the NYT article showing one more time that our government subsidies employer-financed health insurance. Without the subsidies, businesses wouldn't/couldn't offer benefits to their employees. So, our tax money indirectly support the existence of this cancer called private insurance companies.
If the teabaggers, republicans, conservatives -whateverelse they call themselves- would be fiscaly responsible, truly fiscaly responsible people, they would see the abnormality of this situation. The "numbers" are out there to prove it. The "slogans" are the meaningless words they use in lieu of logic and common sense.

7/21/2009 4:42 PM  
Blogger x4mr said...

Thanks for clarifying. I too was a little confused.

The issue is horrible, like a war where one has to fight on multiple fronts facing multiple enemies in a conversation that cuts to the quick, our access to medical care.

Greed seeks vulnerability and drinks deeply at this well lobbied well. Obama and the Democrats MUST enact a fundamental shift away from the current train wreck. It won't happen in August, but it must happen this fall.

7/21/2009 9:02 PM  
Blogger TexPatriate said...

Life at all costs means that Darwin was wrong.

Yes, I'm that harsh.
No, I don't want people to die, but -- let's face it -- appliance warranties are LIMITED, pets do not outlive people, and PEOPLE DIE. It happens.

The wrong comes in when a) we expect all to live forever and b) we expect others to pay for the privilege of keeping *our* loved ones alive when they are past their "expiration date".

We spend SO much on the outliers that the middle of the Bell curve sorta dips now.

It all comes back to logic. If we only spend on Ferraris and Yugos, then we will lose the Ford & Chevy midground. That's okay ONLY if no one ever drives a Ford or Chevy again, but I don't see that happening.

Personal responsibility has to figure into this debate as well. If you are a single mom with four kids and you're taking them to the ER for the SNIFFLES because you "don't want to wait for a Medicare doctor". . . there's a completely different issue going on. (Yes, I've seen this multiple times and it enrages me every single time.)

Use the system in a logical fashion -- untainted by "I can get my way because I can pay more" -- and you'll see all four wheels touch the road again. Otherwise. . . *shrug*.

7/22/2009 8:50 AM  
Anonymous Anonymous said...

Singer's article does a great job of showing how dysfunctional our system has become in terms of costs, and the example of the terminally ill burning six figure sums of public money for an extra month, etc., is a good part of it.

The USA suffers "death denial" worse than other nations. Actually, the USA is spiritually immature in a lot of ways.

The greed x4mr mentioned is also behind the massive fraud of unnecessary procedures and prescription medication is completely out of control. Drug companies spend $35 B (billion) per year telling us we can't sleep, screw, relax, feel good, pee, digest, control weight, without consuming all of their products, "Go see your doctor to find out if #$#$# is right for you!"

Our market advertising profit obsessed consumption driven mentality is killing us when it comes to health care.

7/22/2009 4:03 PM  
Anonymous Anonymous said...

I agree with most of what has been posted here, but you have all failed to mention the abomination of the malpractice industry and the extent to which costs are inflated out of concern over getting sued. Then you have the outrageous malpractice insurance premiums. Insurance companies are making record profits.

Hundreds of billions go to fat cats that do nothing for patients.

7/22/2009 7:32 PM  

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