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As chellim correctly pointed out above, it is inevitable that 'enforced suicide' will be mandatory.

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Originally posted by jhe888:

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As chellim correctly pointed out above, it is inevitable that 'enforced suicide' will be mandatory.

All I have to do is apply a little rhetorical license to your comments, and I am right there at the "fall of mankind."

Surely you wouldn't be arguing in favor of mandatory suicide? And would concede it is counter to American principles? And human instinct?

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Originally posted by BamaJeepster:

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Originally posted by jhe888:

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As chellim correctly pointed out above, it is inevitable that 'enforced suicide' will be mandatory.

All I have to do is apply a little rhetorical license to your comments, and I am right there at the "fall of mankind."

Surely you wouldn't be arguing in favor of mandatory suicide? And would concede it is counter to American principles? And human instinct?

In the case of single payer.

There is no other way to contain costs and ration care in a single payer system. Someone has to make a decision on when a procedure is no longer 'cost effective' in a single payer system. Are extraordinary measures going to be approved for an 83 year old in a single payer system? Will the patient or their family have an option?

Of course I am not in favor of a system like that. I would be fine with JALLEN's position or some type of catastrophic only coverage.

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Originally posted by jhe888:
I agree that rationing could well be a consequence of a single payer system. Even a likely one. But that is a long damn way from euthanasia. Imagine a no-insurance system: I don't think you'd call a poor person being unable to afford an expensive treatment a suicide. In that same way, rationing is not euthanasia.

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Originally posted by BamaJeepster:

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Originally posted by jhe888:
I agree that rationing could well be a consequence of a single payer system. Even a likely one. But that is a long damn way from euthanasia. Imagine a no-insurance system: I don't think you'd call a poor person being unable to afford an expensive treatment a suicide. In that same way, rationing is not euthanasia.

The outcome is the same no matter how you label it. In a no insurance system the poor person could try to raise the money or negotiate treatment. In a rationing situation someone else makes the decision and the patient has no options. Give it whatever term you want, but the result is the patient having no choice and ending up dead.

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Originally posted by arcwelder76:
If you can't punch your own ticket, are you really a free person?

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Originally posted by jhe888:
That is the same argument that supporters of universal health care make. If you can't afford it and don't get treatment, the result is the patient having no choice and ending up dead. You can just hear some lefty saying the current system amounts to euthanasia of the poor, can't you?

I realize there is something to argue about - which system will get more healthcare to more people is one of the real arguments. And there will also be attempts to do that fairly. Opinions on how best to do that will vary widely. (And you and I probably mostly agree.)

But calling rationing "mandatory suicide" is just as illegitimate as calling the inability to pay "suicide."

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Originally posted by jhe888:
To the OP, if your life insurance policy excludes suicide, it wouldn't matter if it was assisted, recommended, or paid for by insurance.

As Joel9507 said, your health insurer can't even suggest a treatment in a particular case. Do you call Blue Cross when you have a fever or your doctor? And you are certainly getting ahead of your self when you suggest your insurer could "force you into" suicide. Maybe Tony Soprano can do that, but Aetna cannot.

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Originally posted by Dan:
There are a lot of wild ideas here. This is a doomsday thread, despite rebuttals that it is some kind of economics discussion.

That said, insurers are one of the greatest influences on healthcare in the country, of that there is no doubt. It may not be so for the 80 year old woman with a history of heart failure who is admitted for pneumonia. Actually insurers won't bother those hospitalists much at all. But consider certain fields, most prominently in my mind psychiatry, in which conversations with insurers happen daily. The results of those conversations most assuredly do influence care and have the effect of a treatment mandate. Everything from "nope, they can be treated as an outpatient," to "sorry, the patient does not meet criteria and therefore can not be admitted." The physician can surely overrule these opinions and not get paid. Of course that doesn't stop the patient from getting a whopping bill. The physician, aware of this, will attempt to spare the patient this pain and is influenced towards discharge. It also doesn't stop the hospital from running in the red. This is just one scenario. That, in my mind, indicates the insurance companies are able to strictly limit care to the point of recommending treatment - not the doctor. We would treat psychiatry patients entirely differently, to the point of serving entirely different populations, if insurance wasn't such a major factor.

Obviously there are limits according to politics. Will we ever see "enforced suicide?" Of course not, this is ridiculous. What about refusal to treat such that suicide becomes the only available option? Also ridiculous and I daresay borne of those whose hobby is predicting the next way big government will kill us.

But to deny that insurance companies have any ability to dictate care is the other side of blind.

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This is a doomsday thread, despite rebuttals that it is some kind of economics discussion.

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Originally posted by BamaJeepster:
In a single payer system (where we are headed), it would be illegal to procure care outside of the system.

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Originally posted by Dan:
There are a lot of wild ideas here. This is a doomsday thread, despite rebuttals that it is some kind of economics discussion.

That said, insurers are one of the greatest influences on healthcare in the country, of that there is no doubt. It may not be so for the 80 year old woman with a history of heart failure who is admitted for pneumonia. Actually insurers won't bother those hospitalists much at all. But consider certain fields, most prominently in my mind psychiatry, in which conversations with insurers happen daily. The results of those conversations most assuredly do influence care and have the effect of a treatment mandate. Everything from "nope, they can be treated as an outpatient," to "sorry, the patient does not meet criteria and therefore can not be admitted." The physician can surely overrule these opinions and not get paid. Of course that doesn't stop the patient from getting a whopping bill. The physician, aware of this, will attempt to spare the patient this pain and is influenced towards discharge. It also doesn't stop the hospital from running in the red. This is just one scenario. That, in my mind, indicates the insurance companies are able to strictly limit care to the point of recommending treatment - not the doctor. We would treat psychiatry patients entirely differently, to the point of serving entirely different populations, if insurance wasn't such a major factor.

Obviously there are limits according to politics. Will we ever see "enforced suicide?" Of course not, this is ridiculous. What about refusal to treat such that suicide becomes the only available option? Also ridiculous and I daresay borne of those whose hobby is predicting the next way big government will kill us.

But to deny that insurance companies have any ability to dictate care is the other side of blind.

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Originally posted by BamaJeepster:
There has never been any real discussion of doing away with health insurance and we've never had, nor has anyone proposed, a system where poor people could not access it. In fact, it is explicitly against the law for a hospital to turn someone away based on inability to pay - even illegal aliens.

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Originally posted by slosig:
Hospitals are legally required to proved care to people "actively dying" (P226RN could describe a lot better). It is legal for a hospital to have a medical professional evaluate potential patients who are unable to pay and if they don't meet the rather narrow criteria give them directions elsewhere. Whether this is moral or right is a separate question, but it is legal.

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Originally posted by slosig:

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Originally posted by BamaJeepster:
In a single payer system (where we are headed), it would be illegal to procure care outside of the system.

It is hard to say what would come in a single payer system until the legislation is written. Let's hope we don't find out.

Having worked in the UK, I can say that is not how their system works. Everyone gets National Health. Many of those who can afford it buy private insurance through BUPA and use that instead of National Health. I suspect that in addition to BUPA, Harley Street physicians (and other private docs) also accept direct payment.

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Why shouldn’t we let people buy better health care if they can afford it?

Whenever we allow the wealthy to buy better care or jump the queue, health care for the rest of us suffers. If the wealthy are forced to rely on the same health system as the poor, they will use their political power to assure that the health system is well funded. Conversely, programs for the poor become poor programs. For instance, because Medicaid doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered politically important. Moreover, when the wealthy jump the queue, it results in longer waits for others. Studies in New Zealand and Canada show that the growth of private care in parallel to the public system results in lengthening waits. Additionally, allowing the development of a parallel, private system for the wealthy means the creation of a permanent lobby for underfunding public care. Such underfunding increases the demand for private care.