National health care [was Re: Medical technol

Paul Barton-Davis pauld at cs.washington.edu
Fri Jun 5 12:52:48 EST 1992

In article <1992Jun5.005245.19004 at yang.earlham.edu> allens at yang.earlham.edu (Allen Smith) writes:
>	The system that I advocate consists of governmentally coerced 
>(taxed) funds going only to support health care for those who are: 1. 
>poor enough that they wouldn't survive otherwise; and 2. have a health 
>problem that isn't their own fault. In other words, it wouldn't pay for 
>any health care simply because the person was old; it wouldn't pay for 
>lung cancer or heart disease if the person was a smoker; it wouldn't pay 
>for injuries suffered in a car accident if the person was a drunk driver 
>or wasn't wearing his/her seatbelt; it would pay for keeping alive those 
>who, not through their own fault, can't live any other way.

So lets see, I'm a doctor in an emergency wing of a hospital, and the
ambulance brings in a couple who were just in a car accident with a
drunk truck driver. They are both severly injured, need immediate
help, and the medical work to save them will probably cost tens of
thousands of dollars. Do I treat them first, and leave cost
determination till later, running the risk that if one them wasn't
wearing a seatbelt, I might not get paid ? Or do I threaten their
lives to establish that their "injuries" are not their fault ?

>	Some have pointed out that a system for deciding if some activity 
>was dangerous has some problems:
>	1. It could take up more funding than it saved. Obviously, this 
>would be unacceptable. Currently, that's what appears to be happening with 
>health care costs; cost-containment systems are escalating costs more than 
>they justly save. When such a system starts to do this, it needs to be cut back.
>	2. The problem of determining what is a reasonable action for 
>someone to take. In other words, a misinterpretation of this system would 
>lead to no car accidents being covered- the person didn't have to use the 
>car, did they? In today's society, it is unreasonable in most 
>circumstances to expect someone to not use a car for medium-to-long 
>distance transport. It is also, for instance, unreasonable to expect 
>someone in such a low income bracket to avoid food with allegedly 
>dangerous additives (I have my doubts as to whether such additives are any 
>more dangerous than various natural toxins). I might add that persons too 
>young to be responsible for their own actions are not cut off by the 
>provison of responsibility (no payment for costs resulting from one's own 
>actions). They cannot yet make a responsible decision, and should not be 
>held responsible for bad decisions of their guardians (insofar as 
>possible, their guardians should, however).

This sounds to me somewhat akin to Oregon's explicit and Canada's
implicit ranking of health care requirements. I get the impression
that you find these onerous when they apply across the board. Why do
find such arbitrary (even if "democratic") attempts to delineate
"deserving funding for health care" acceptable when they draw the line
so narrowly ?

>	This system uses coerced funding only to provide publically 
>subsidized health care for those truly deserving of it. It leaves others 
>free to make their own choices.
>	-Allen

Too many Florence Nightingales      |  Too many hands in too many pockets
Not enough Robin Hoods              |  Not enough hands on hearts
Too many zeroes, not enough heroes  |  Too many ready to call it a day
Coming up with the goods.           |  Before the day starts

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