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Sunday, August 02, 2009



Thank you for the acknowledgment. I hope you do not interpret my comments as dismissive of your concerns regarding who may or may not receive treatment under a reformed health care system and the criteria used to make such decisions. What I wish to convey is that those concerns should be considered in context.

For example, under our current system a chronic illness often results in premium increases far beyond those imposed on healthier people or cancellation of coverage. This is true not only for individual policies, but for groups--meaning either a group's premiums are increased beyond the norm because of an unhealthy member or the group gets rid of that member who, we must remember, is a person. In any case, the fate of the individual is not necessarily linked to any quality of life that might yet be enjoyed or any contribution the person might yet make to family, friends and society. Instead it is linked to the insurer's ultimate goal which is to make a profit.

Note there is no scarcity of treatment involved here beyond the monetary. The person might be a breast cancer survivor requiring costly monitoring and presenting a greater than average risk of needing expensive treatment for a recurrence of the disease. The care needed is readily available; the only obstacle is cost. So I ask, if EE's system were applied to allocation of all medical care--and I do not concede it will be, would it be worse than the criteria applied now?



Health care is currently rationed and will always be rationed. We'll never pay for a 50 trillion dollar treatment, for example, but were someone to have 50 trillion dollars personally, they might purchase that treatment to save their own life. Right now the rationing is based on how much money/insurance you have.

Well, when everyone has health insurance and we have a finite amount of resources we would do well to define where the cut off is for various treatments. As explained in this particular article, a treatment that saves a 90 year old for 1 year and equally saves a 9 year old for 50 years should not be treated equally. In this sense we have to define our value on life at different ages since we MUST put value on human life. Right now we have no system to do it, poor people die, wealthy live. That's not palatable for anyone with any semblance of a conscience.

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