You're talking about another issue, angus. I was talking about insurance. There's no such thing as secure private insurance, unless it is essentially a regulated public utility.
My frail attempt at misdirection. It was intentional, I must admit. The argument is tiresome.
Regarding pre-existing conditions, I think any company that is in a business to make money--and I can't think of any other kind--really ought to be able to make its business decisions based on revenues and costs. Insuring folks with pre-existing conditions will, on average, usually by some well-documented probability, increase costs. In such cases it makes sense to offset these likely greater costs with greater revenue. Folks should be able to buy insurance, but they can expect to pay more if they already are diagnosed with some degenerative disease. Just like life insurance costs more if you smoke. This seems to make perfect business sense. But it needn't cost everyone more. And if some of the suggestions I'll try to list are followed, the increased premiums paid by those with pre-existing conditions needn't drive most of them to bankruptcy.
Let's say you are 20 years old only need a five thousand-dollar procedure, and if you get that, then based on well-documented histories and a solid probability distribution function, it can be shown that there's a 97.3% chance you'll be fine. I think most folks could get behind that.
Now, let's say you're 65 years old and what you need to make it to 66 is a one hundred-thousand dollars worth of procedures. And suppose that the best that a team of expert physicians and statisticians can say, based on their histograms, is that you have a 23.4% chance of lasting another year even with the procedure. Most folks won't get behind that.
Now, the way it works now is that whichever of these two cases has insurance gets the service. The other is denied. Since we generally have economic security as we grow older, chances are that it is the 65-year-old that will get the procedure. This, in part, is why we are spending so much money.
On the other hand, if the state either takes over the industry, or regulates it much more, then wiser economic decisions will be made. Thus, the so-called Death Panels. The name is inflammatory, of course, and they might just have easily been called Actuarial Adjustment Agents. I like the alliteration on A, don't you? But that doesn't really fire up the base so much. It's worth debating, I'd agree. Ultimately, we have to decide upon the goal. Is it really to lower costs? And, if so, does increasing the bureaucracy really do that? Wouldn't a better strategy be a national education initiative, focusing on healthier lifestyles? Rescheduling certain prescriptions in order to make some drugs available over the counter would offset costs as well. As would a greater emphasis on holistic and preventative medicine. (Of course, these practices are currently at odds with the way insurance payments are structured. I think most of us, including medical workers, would welcome some mitigation of that problem.) Additionally, allowing other levels of practice besides licensed physicians and surgeons. The physician's assistant (PA) program is gaining popularity. We should also have trained medics, like they have in the military. Of course, there are EMT types, but the bureaucracy involved with their services drives up costs. That is largely because we are such a litigious society. And only some fundamental change in attitudes will change that, and such changes take a long time. Again, aggressive education would help in this regard.
If you're an American, then there's a good chance that you subsist on Snickers, potato chips, Big Macs and coca-cola, and the only exercise you get is walking to find the remote for the television that you spend, if you're an American, five hours on an average day watching. If you're an American, there's a good chance that don't even to walk two blocks to buy your cigarettes. If you're an American, then there's a good chance that your idea of "sport" is watching a monster truck show or a college football game. It is no surprise that by the time you're 40 you're having heart problems can no longer be insured because you're too fat, It's 's difficult to expect that the reasonably healthy minority should foot the bill to extend your miserable life by a few years. I recognize that this doesn't describe every single American who has struggled to pay for medical services, and many folks have gone broke paying for conditions which they contracted through no fault of their own, but a good many have tragically caused their own degeneration as well. Maybe it's all of our fault. The purpose of my diatribe isn't to attach blame for the sorry condition of our collective health, but rather to point out that that condition has less to do with the medical insurance structure than with our culture. We have deeply-rooted health problems in our society and this Medical Insurance Bill isn't going to solve our fundamental problems.
