by AgentR11 » Thu 26 May 2011, 13:06:43
$this->bbcode_second_pass_quote('PrestonSturges', 'H')ow is Grandma supposed to defend herself against predatory insurance companies who would enter the market under the Ryan plan.
No reason to assert that Grandma would choose the $50,000 /yr plan, so no reason to go to ridiculous extremes to contend against a plan that has been already rejected.
That said, the Ryan notion of a voucher + income tiered additional assist takes the debate to a core problem.
When to say, "No thank you" to the seller of Health Services (doctor,clinic, whatever).
In a NHS a combination of prioritized scheduling and panels that weigh benefit against cost provide that "No thank you". This is good, in that they get to be the bad guys, while the patient near end of life, and the doctor who's supposedly compassionate get to be the good guys. Its bad in that the patient (perhaps desperately afraid of dieing for some reason) views himself as being victimized by the system/government. (gov't should fear the people, not the people fear the gov't.).
Ryan's plan basically transfers that "No thank you" responsibility to the family/patient; this is good and bad because it allows the patient to decide what level of life extension provides them the best value compared with what they can leave to kin. Some people don't care to leave anything, and so would be perfectly within their capabilities to spend it all on health care and life extension; others (myself included) would rather draw the line once passed commonly prescribed drugs and modest physical intervention (ie, no, you aren't going to do surgery on my brain at age 70.). Its bad, in that the "fear" some feel as end of life approaches, can cause them to make decisions that they would deeply regret; or the family can end up feeling they are being somehow cruel by not paying for life extension XYZ even in the face of known patient wishes. Not even going into how bad it could be making those decisions to balance assets vs lifespan in the absence of known wishes.
Its definitely a discussion worth having in a serious, non-bombastic form. Someone has to pick up the responsibility to say, "no, thats not worth it.".
How are you going to balance the books when it becomes trivially easy to apply $1mil of services to grandma to extend her life one year? Everyone that has tried to put a price on this decision has been slaughtered politically.
What will you do when its not $1mil... but $50 mil. ??
That is certainly where medicine is going. It is getting easier and easier to focus thousands of hours of concentrated labor into a few hours of direct treatment.
We need to be ready with the answer.
$this->bbcode_second_pass_quote('', 'U')nder the Ryan plan, tens of millions of elderly people would be stripped of all their assets, which would be transferred directly to the insurance industry.
Only if they chose ridiculous plans that provided the same benefits as they had at 35.
Unfortunately... families often do very illogical things to change grandma's end of life date from 2012 to 2013.
Its really a harder question than you are making it out to be.