Posted on 08/02/2006 10:57:07 PM PDT by FairOpinion
With the current system we have universal "health care" but not universal "coverage". Joe Smith might not have insurance but the hospital is required by law to provide emergency stabilization care. If he need a million dollars of treatment and can't pay he can apply for medicaid which will pick up the tab. Private Insurance increases because that is where the hospitals and other providers make up the losses for providing the free care for no insurance and for care to medicaid and medicare patients whose reimbursement, per procedure aand/or patient day by the government, tends to go down every year.
We may need a system where everyone is forced to have catastrophic insurance (Like the bare bones in a HSA) this would bring many healthy young people into the risk pool who otherwise would skip the coverage. Additionally if you have an economic incentive to economize you will become a better consumer of healthcare. Just my halfcent worth.
It is NOT rationing in this case.
In the case of a liver transplant, perhaps.
Not in the case of a cardiac arrest and a 911 call. EVERYONE gets treated, no matter what. They may ask you what your insurance is on the way to the hospital. They may tell you you are financially responsible for any care you receive while in the hospital.
Nobody...NOBODY in the USA is denied emergent medical care because of their lack of insurance.
And once you are in the hospital, you get the same care as a rich person or someone with insurance coverage.
AMEN! Another thing to think about, what if you or someone you love was that 1 person in 500 that survives? How can a paramedic be expected to tell which patient that might be? It appears to me that they are asking EMTs to play God.
When I was in charge of such things, I used to start by examining the retina for clotted blood (a/k/a "boxcars").
If the blood in the head is clotted postmortem, nothing good is going to happen after that (in this world).
CPR has become another tool in the battle between prolifers and the pro-death crowd, but a lot of families of the recently deceased suffer as a result.
It is NOT merciful for the loved ones to know, or to witness (as is increasingly common), violent attempts to reanimate a corpse after the person who used to live at that address is no longer there.
Most CPR attempts, especially those that take place in hospitals or at disaster scenes, are futile (futile in the sense that the body is already dead).
CPR is not "necessary" when the object of the CPR is a corpse.
1 - those who will survive anyway without immediate attention
2 - those who can survive only if immediate attention is given
3 - those who will likely die even if given immediate attention
It's not considered immoral or a violation of the doctor's oath to concentrate on category 2.
I do believe that the inability of any society (regardless of economic system) to generate effectively unlimited health care resources for every person will eventually bring about a civilian equivalent.
Let's start simple:
1) Stiff
2) Burned to a crisp
3) Head blown off by shotgun in the mouth
4) Bled out, blood clotted, no longer bleeding.
I could go on and on. EMTs are now required in most jurisdictions to "resuscitate" the cadavers listed above, and many others. This is wrong and should be stopped.
Who's going to pay for it?
Charities have for centuries been the guiding force behind medical care for indigents. A local charity paid for the bill for my uninsured nephew's emergency appendectomy.
Perhaps if we paid less taxes, more money would be freed up for charitable giving.
If paying less taxes, people could afford major medical insurance.
There are lots of ways to pay.
Ultimately, It's sad that some people see life only as it relates to dollar signs.
what do ya expect? this comes from a canadian. we in michigan have a canadian governor that makes no sense all of the time. we are used to this type of drivel coming out of government.
FWIW, we have one that wasn't. We didn't wait for the ambulance, either. Caught a ration of excrement from the ER doc at the time, but there was the possibility of as long as a 20 minute wait for an ambulance. Wish I'd had this article to show him.
As an aside, I have read several times that half of all the money a person spends on health care in his whole life is spend in the last six months...
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As a corollary to this, I heard an expert yesterday on a Larry Kudlow discussion, say that all elderly have the same amount of dollars spent on health care before they die. Healthy people spread the amount over many years, and unhealthy on their much shorter life span. She was trying to refute the argument some were making about all elderly costing x dollars per year.
Allowing CPR not to be started in certain circumstances is an idea that all health insurance/government agencies have to address. I worked in Neonatal Intensive Care for many years and the discussions of how to recognize futility are ongoing.
The assessment of 1,240 cardiac arrest rescue runs over two years in Ontario, Canada, found that only 1 in 500 people survived to be discharged from the hospital if EMTs could not restart the circulation, automatic defibrillators did not shock the heart, and rescue workers were not present when the heart stopped beating effectively.
&&&&&
There are a lot of qualifications that this retrospective study addressed. They are not talking about every cardiac arrest. 2 and 1/2 persons (according to their math) survived to leave the hospital out of the 1240 who fit the category of prolonged lack of resuscitation efforts. They could have been children in near-drowning situations, not any random two.
Better guidelines are not just for the economic bottom line, but for the emotional support of the families, the first responders and the medical personnel who have to, in many instances, abuse a dead body by going through the motions of CPR.
The assessment of 1,240 cardiac arrest rescue runs over two years in Ontario, Canada, found that only 1 in 500 people survived to be discharged from the hospital if EMTs could not restart the circulation, automatic defibrillators did not shock the heart, and rescue workers were not present when the heart stopped beating effectively.
The University of Toronto team led by Laurie Morrison said new guidelines letting EMTs know when to give up "would result in a decrease in the rate of transportation from 100 percent of patients to 37.4 percent," a reduction she characterized as "pretty phenomenal."
"These findings suggest that it is possible to identify a subgroup of patients ... in whom resuscitative efforts can be discontinued and the patient pronounced dead in the field," Gordon Ewy of the University of Arizona Health Sciences Center added in an editorial.
* * * *
Nor do they apply to paramedics, who can use various medicines and intubation to try to restart the heart and keep patients alive. Paramedics already have similar standards.
You can't revive more than one in 500 if no one starts CPR when the patient collapses. That one probably has some sort of circulation that wasn't observed by the responders. The others are already dead.
If there are rules as to which people are revived based on the evidence at the scene, that is good medical practice.
The abstract says "Of 776 patients with cardiac arrest for whom that rule recommended termination, 4 survived."
But the authors consider the rule a Good Thing because the rule has a predictive value for death of 99.5 percent when termination was recommended. The four deaths that would have occurred apparently don't matter.
This shows that there is a big difference between medicine that focuses on individual patients one at a time and medicine that is statistical and focuses on group averages.If those who advocate socialism succeed in institutionalizing so-called evidence-based medicine and pay for performance process measures it'll be group medicine all the way and physicians will likely be prosecuted for wasting money by treating individuals who are outside the statistically determined norms.
There is no point in keeping the body alive with the brain dead. This is a subject that needs guidelines in the worst way.
We may not like to think of it but we will all die; every one of us. Not one of us or anyone has or will beat the rap. We are all condemned to death.
No reason to bankrupt the surviving family or society. And let's stop the craziness with funerals. That's another unnecessary expense. Let the living go on living and the dead be dead. What did Jesus say? Let the dead bury the dead. Good advice.
In my husband's situation, when he had his heart attack, TriCare paid for it. Now he's back at work, and still collecting military retirement and disability, as he was before. A lot of tax-payer dollars could have been saved by refusing him the medical care that he earned during 21 years of service. He's paying income taxes, property taxes, sales taxes, and a host of other taxes. But he probably won't pay enough taxes during the remainder of his life to cover the cost of initial treatment, much less the continuing treatment he'll receive for the rest of his life.
Of course, not every situation is the same. Maybe we should require a financial impact statement before dispatching an ambulance or admitting a patient for treatment. If their usefulness to society has reached its peak, they shouldn't be allowed to suck up medical resources.
Then again, that's not the America my husband fought to preserve.
I'm not saying we should require a financial statement. I'm just saying that everything has a cost, and somebody's going to pay for it one way or the other. Glad your husband is okay.
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