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"Death Panels" revisited

Just in case the prospect of Obamacare hasn't scared the bejeesus out of you already, read this article in the Wall Street Journal. Then take a look at this article to see why health care rationing is contrary to Catholic moral teaching.

Comments

RAnn said…
And yet, we as a society, whether as a nation of taxpayers who have a national health system, or as premium payers who have individual health insurance, or some combination thereof, cannot afford to give unlimited care to everyone who wants it, and allow those giving the care to charge what they want for it. How do we tame the beast (as opposed to trying to arrange to have someone else assigned to feed him)? Is it ok to have different rules for the rich and the poor, such that the rich can by-pass lines or "try this, then that" formulary regulations? If you were designing the perfectly Catholic moral system of healthcare delivery and payment, what would it be?
Denise said…
RAnn,

You ask some very good questions. I think the role of the government should be that of a very tightly woven safety net. Everyone should have health care needs met. Health care wants should be the result of discretionary spending and market forces. The challenge is to define wants and needs.Convenience is often a want. We do have a government task force that has been working for decades to establish exactly what is a need when it comes to preventive services. The US Preventive Services Task Force outlines the minimum recommendations of preventive services. Seeing a physician at every visit is a want. The truth is nurse practitioners and physician assistants can handle many if not most clinic visits. They must be trained enough to know when it is time to call in the higher level of expertise. Similarly, primary care physicians can handle many if not most physician visits. They too have to know when it is time to refer to the higher level. This also means that there must be enough tort reform to avoid defensive referrals. Many people will want more than this bare minimum. That is fine. It is a want, not a need. They can pay for it either directly or through insurance premiums.

Allowing insurance companies to sell across state lines will increase the competitive market forces. Individuals, rather than employers should get any tax break for buying health insurance. This will increase the portability of insurance. Think about what happened to the cell phone industry when phone numbers became portable. When your phone company knew that you could change carriers with little inconvenience, prices came down, roaming fees went away, and service improved.

Catholic teaching does not require that there be a uniform level of health care utilization. It only requires that everyone's basic needs are met.
RAnn said…
But if you could design the system, what would it look like. Your son didn't need immediate surgery--you just wanted it, and were clearly unhappy when he didn't get it. How would you set up a system that insured that he (and the very poor child across town) got the treatment they needed, but which allowed you to buy the treatment you wanted? A government run HMO that those with money can opt out of? Subsidized insurance premiums? I guess what I'm thinking now is that we have Medicaid, but many doctors won't take it because of the low reimbursement levels (or because they don't want to attract that type of patient).
Denise said…
RAnn,
I would implement the changes I mentioned above to maximize the number of people who can afford private insurance. I think a government run HMO-sort of like a civilian version of military medicine--could be an option for those who have no other choice. This would prevent the government plan patients from having to compete with the private pay patients for the care and attention of their doctors. Most of the military doctors did not enter the military because they had a patriotic desire to serve their country. They do their time so they can get their medical school bills paid. Run a similar system for Medicaid. Many military bases have off base satellite clinics staffed by civilian contractors. Share those facilities with those treating Medicaid.

The medicine practiced in that setting is not pretty, but it is minimally adequate. My son had a case of intermittent testicular torsion. Once the testicle twists, you have no more than six hours to correct it or you lose the testicle. It is considered a true medical emergency. If my son's testicle had not untwisted on its own, he would have had surgery on the day I took him to the ER. Because it did resolve itself, the prudent thing to do at that point is to correct the underlying condition sooner rather than later. Sitting on such a medical time bomb for over 2 months is not great medical practice. If your care is a government hand-out,then you suck it up until you can afford better. If your care is part of a compensation package or something you have paid for either directly or indirectly, you have a right to expect more.

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