Single-Payer Health Care: As Goes Canada, So Goes Vermont

The Something Awful Forums > Discussion > Debate & Discussion > Single-Payer Health Care: As Goes Canada, So Goes Vermont

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

This has taken a stupid turn. Whether it's smart for an individual to ski with no insurence is utterly unrelated to whether the nation should have nationized healthcare or not. At this moment it doesn't, so people making choices have to make them based on that reality.

# ¿ May 5, 2014 03:52

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# ¿ May 22, 2024 13:28

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

EvanSchenck posted:

It's possible that the distinction between euthanizing the disabled and merely "allowing them to die" is important to you, but it doesn't seem like a huge difference to me. In fact euthanizing would probably be more humane if they were going to be killed anyway, because death by neglect even in a controlled medical setting is unpleasant.

Infinite, no; sufficient, yes. Rationing in single-payer systems works by putting patients in a queue for care according to need, so that people with urgent problems are served quickly while non-critical cases wait. Remember that these systems actually exist in other countries, and by-and-large people get the care that they need and are satisfied with the system they have. Or at minimum, they would prefer it tremendously to the American-style system. I mean, it's not like there are mass numbers of Canadian women dying of breast cancer because of rationing.

You were talking about the cost of care for people with total permanent disabilities, which is almost entirely unrelated to the availability of radioactive isotopes or rare pharmaceuticals. If you want to take up an altogether different issue then yes, different factors do come into play.

To a certain extent this is true, but remember that the majority of Americans either had minimal access to healthcare or it was already mediated by onerous HMO plans. The "average American" is already used to struggling with an impersonal bureaucracy and paying through the nose for healthcare, and the people who could get all they needed on demand as if they were turning on a tap are actually a minority.

You're presenting this is a more black and white fashion than it really is. There isn't some hard standard for "care they need". Basically what's considered good practice is determined to a large extent by what the system is willing to pay for and one major component of costs in the U.S. is that we do lots more "stuff" to people than other places. There are basically always more drugs/tests/procedures that can be done.

My fiance is an NP in critical childrens care and works with ECMO systems which are capable of entirely replacing the heart and lungs and oxygenating blood external to the body. This is some cutting edge and exceedingly expensive equipment. This doesn't fall under the simple qualifier of "care they need", most places would (reasonably) let people who need this type of intervention die.

This isn't at all to rail against the idea of rationing. I think we need to become comfortable with that word and it's implications and I think currently, culturally, the U.S. has a huge problem in this regard. We need to give up and let things go sometimes.

But my point is that these types of choices and tradeoffs are anything but simple, it's never going to come down to just giving out "care they need", it's always going to be about making really difficult cost tradeoffs.

# ¿ May 6, 2014 01:27

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

menino posted:

The demand for the service is too erratic and immediate for pricing signals to make a difference. This is like health care markets 099

Not entirely. Having co-pays tied directly to actual costs would do something, and would be a good idea under any system in my opinion. Really most things arn't a trip to the ER.

# ¿ May 10, 2014 17:31

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

But it's actually not comparatively common.

And it has parallels to a whole bunch of other industries which deal with emergencies (plumbers, car repair) and respond to price signals just fine. So it's really a bad argument against posting prices and using prices as one peice of the puzzle.

# ¿ May 10, 2014 18:57

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

Redeye Flight posted:

If the problem is expense, really as a country we are not short on the money to pay for this end-of-life care.

It's just all going to an extremely small slice of the populace right now. This problem sort of sits at the head of all or at least most of our national ills.

Coming in and saying "we have plenty of money" as a way to downplay high healthcare costs is monumentally stupid. Healthcare is close to 20% of the economy currently. Exactly how much more would you like diverted to cancer treatment for the last 4 weeks of life? In our technological era the amount of money we can spend on healthcare is practically limitless.

Slobjob Zizek posted:

I'm sympathetic to your point of view. What's a more positive way to frame things, I.E. what policies should we support in order to achieve some of those ends.

I was health proxy, and thus making some of the decisions when my father was dying of cancer. So I know the momentum behind the end of life care. When the doctors asked if we wanted radiation for the brain tumor that spread, I just sort of nodded and said ok. They were recommending it, despite that fact that he was terminal, so how could I no. I didn't really think it was needed, but was the rest of the family going to judge me? God knows what it cost (the ambulance bills for transportation alone were $5k) and he died 3 weeks later so it didn't do any good.

The point is that besides being systemic on the caregivers side I also think the idea of fighting to the end is cultural. No one wants to give up, and is afraid of being judged if they might want too.

But again, what we're doing in general with end of life care just makes no sense whatsoever.

# ¿ May 13, 2014 01:30

The Something Awful Forums > Discussion > Debate & Discussion > Single-Payer Health Care: As Goes Canada, So Goes Vermont