Death Panels? What Death Panels?

[dreadfulpenny81.livejournal.com]

During the heated debate last summer over the proposed health care legislation, Sarah Palin and Barack Obama kept bringing to the media the phrase 'death panels', groups of people that would decide whether or not to "pull the plug on Grandma". While Palin was misguided in her analysis (as she was trying to say that end-of-life care or the living will system was the 'death panel' when it actually wasn't), she may not have been entirely off-base.

Stories have been featured recently through several media outlets of patients in Arizona and Indiana who have been denied life-saving surgeries in the past several weeks and months due to cuts in state Medicaid budgets. In Indiana, a six-month old infant named Seth Petreikis has complete DiGeorge syndrome. A surgery that was deemed "experimental" by Medicaid was denied to him, but the company that manages Indiana's Medicaid program has offered to pay for the surgery themselves. [Source]

In Arizona, 98 people who were already approved for transplants were later told they couldn't receive the surgeries because of recent cuts to Arizona's Medicaid budget. One man was set to receive a new liver, which was donated to him by a friend who'd recently passed away. Because he couldn't pay for the $200,000 surgery, the liver went to another patient. [Source] The reason for this? On October 1, 2010, the state of Arizona removed transplants from a list of medical services that can be funded through the Arizona Health Care Cost Containment System (AHCCCS). Keith Olbermann is asking viewers of his show Countdown to donate in the hopes of funding the transplants. Meanwhile, Democrats in Arizona are now using the 'death panel' analogy as an attack against Gov. Jan Brewer and Arizona Republicans, who agreed to Medicaid cuts to balance their budget, despite protests from Democrats. [Source]

The 'death panels' Palin referred to have little to do with federal government action and more to do with state government blunders. There should be some legislation on the table to mandate organ transplant surgeries be paid for through all health care providers, public and private.Transplant boards are still necessary to sort through the amount of transplant candidates but at least someone who's promised a chance at renewed life wouldn't have to worry about that promise being taken away.

Comments

[light-over-me.livejournal.com]

Well 'death panel' is a sensationalized way to phrase it. It's not that literal. But whether it's a private company or the government someone's going to have to manage available funds and resources, and make the hard decisions about what's covered and what isn't.

The thought with private care is that, potentially, if one company denies you coverage for something, you could at least theoretically try another competing company...and keep shopping around until you find one who give you a better deal. If there is one single centralized authority, however, that makes this shopping around more difficult.

Now, take for example, the recent controversial government recommendation about mammograms: http://www.scientificamerican.com/blog/post.cfm?id=government-panel-recommends-fewer-a-2009-11-17

Suppose, based on this, government run health care programs decide to stop covering mammograms and breast cancer screening under the age of 50.

These are the types of 'panels' people are talking about.

[paft.livejournal.com]

I could just as easily ask what's to prevent someone from shopping around for a private company if the government disallows the aid?

I'd love to hear you explain to some of the people who now find themselves cut off from the transplants they need to live that they have to die in order to save the state money.

[light-over-me.livejournal.com]

I'm not sure how your question relates to my comment-- can you rephrase?

I'm talking about the concept of a single payer system. Whether it's private or public, we will still have the same problem. A group of people will still have to decide what to cover and where to distribute funding. Giving government this power changes nothing. But at least with privatized care, you could threaten to take your business elsewhere, and that gives you a little bit of leverage that you wouldn't otherwise have if there were no alternatives.

I'd love to hear you explain to some of the people who now find themselves cut off from the transplants they need to live that they have to die in order to save the state money.

No, this is the very scenario I'd want to avoid.

[paft.livejournal.com]

A single payer system does not eliminate the option of going to a private company any more than the existence of public schools has eliminated the option of private schools.

What it WILL do is make expensive healthcare available to those who cannot afford it.

lom: No, this is the very scenario I'd want to avoid.

Without some level of public aid, that "scenario" is inevitable. That "scenario" is happening right now in Arizona.

Compassionate conservatism at work.

[light-over-me.livejournal.com]

A single payer system does not eliminate the option of going to a private company any more than the existence of public schools has eliminated the option of private schools.

Perhaps, but we were discussing death panels and comparing the merits of private health care, versus public. Whenever you have a system of detached policy makers calling the shots, whether they be company CEOs or a government appointed panel, you will have the same issue of people being denied coverage. This is an issue that will continue to exist, because there is no longer a direct relationship between patients and their doctors. We can barely purchase cold medicine without insurance. This is the real root of the problem, and a public option doesn't even begin to address it.

[paft.livejournal.com]

paft: A single payer system does not eliminate the option of going to a private company any more than the existence of public schools has eliminated the option of private schools.

lom: Perhaps

??? Perhaps? There's some doubt about whether or not private schools still exist?

lom: but we were discussing death panels and comparing the merits of private health care, versus public. Whenever you have a system of detached policy makers calling the shots, whether they be company CEOs or a government appointed panel, you will have the same issue of people being denied coverage.

Except that the issue of a for profit company is whether or not the person is rich enough, while the issue of a public provider is how badly the treatment is needed, and how likely it is that it will have a good outcome.

Death panels currently exist in this country. They are moderated by for-profit companies intent on the bottom line and perfectly willing to allow people to die -- or drive medical patients into bankruptcy -- if it means making them more money.

Other countries, like Canada, manage to provide a more humane version of healthcare -- one that does a better job than ours of providing lifesaving treatment and medication to those who need it.

[light-over-me.livejournal.com]

Except that the issue of a for profit company is whether or not the person is rich enough, while the issue of a public provider is how badly the treatment is needed, and how likely it is that it will have a good outcome.

Sure, long as the government has very deep pockets such that it can always give everyone what they need and want without ever worrying about funding... on the other hand, that's not reality. They still need to figure out how to afford it, and determine what they can afford and what they cannot. So you see, they are still quite motivated by the bottom line after all, or worse- by greed, power, and votes.

Death panels currently exist in this country. They are moderated by for-profit companies

Private insurance companies, as they currently exist, are not as private as you seem to think they are. They are already highly regulated. Given even more government involvement, I'm not confident we won't continue to see more of the same. Obamacare is going to take the same existing broken system and amp it up to 11.

perfectly willing to allow people to die

I think that you are looking at this in a very black and white "government = good, corporations = evil" world view. But the issue is a lot more complex than that.

Other countries,

American health care is second to none, in fields like cancer treatment. We have the technology and the know-how, we just need to reestablish a relationship between the health care providers (the doctors, hospital, etc), and the patients. We have made it all about the middleman.

[paft.livejournal.com]

lom: Sure, long as the government has very deep pockets such that it can always give everyone what they need and want without ever worrying about funding...

An argument you can make about any government service, including law enforcement and emergency services. Nobody is suggesting that the government is going to be able to pay for nose-jobs or boob-enhancements. This is about ensuring that people don't end up disabled or dead because they don't have the money to pay for medical care.

lom: They still need to figure out how to afford it...

Canada spends less per patient than we do, and has a lower infant mortality rate.

lom: Private insurance companies, as they currently exist, are not as private as you seem to think they are. They are already highly regulated.

Which has not prevented them from effectively delivering death sentences to patients with "pre-existing conditions."

lom: Obamacare is going to take the same existing broken system and amp it up to 11.

How?

paft: perfectly willing to allow people to die
lom: I think that you are looking at this in a very black and white "government = good, corporations = evil" world view.

Those are your words, not mine. I'm simply stating a fact. As they exist now, health insurance companies have no problem allowing Americans to die for lack of healthcare.

Would you care for some names? Cases? I think you know that they exist and I can provide them.

lom: American health care is second to none, in fields like cancer treatment.

Which is worse than meaningless when that treatment is unavailable to so many Americans.

[light-over-me.livejournal.com]

Canada spends less per patient than we do, and has a lower infant mortality rate.

This has less to do with whose funding it, and more to do with the fact that our prenatal and maternity care is way over medicalized. We also have the highest rate of c-sections. I believe this one could be addressed by re-establishing the role of nurse midwifery, as many other countries do. But if the government simply takes over, but doesn't address these fundamental problems in our care, then nothing is going to change here. I doubt that it would, because a lot of this is a direct result of over regulation and fears over malpractice in the first place--two things our government highly encourages already. Because remember, our insurance companies are *already* government regulated.

As for Canada. Canada's health care is currently ranked 30th by the WHO. However, that same study ranked the U.S. better in overall speed and responsiveness of care than Canada. Also, one should note, over all health care in Canada is actually funded 70%/30% private-public, so most services are still actually provided by the private sector.

So, compare apples to apples, setting aside the private sector from the equation (since both systems use it): our government already spends MORE than Canada's government spends on health care. So what you are saying is that our government already spends far more but has far worse quality of care. Gee, with that kind of track record, this is supposed to be an argument FOR more government involvement??? Is there evidence government has done a quality and efficient job covering the people it is already supposed to be covering?

Which has not prevented them from effectively delivering death sentences to patients with "pre-existing conditions."

Right. Our insurance companies are already highly government regulated-- and what has happened as a result? It has created virtual monopolies of companies in certain states and regions. You cannot purchases policies across state lines because all of the state regulations creating red tape. Which means, less consumer choice for everyone. Government regulation has not only made access to things worse and more expensive, it has encouraged insurance the companies to all operate the same way! They can deny us coverage only because they know we have no where else to go.

lom: Obamacare is going to take the same existing broken system and amp it up to 11.

How?

Because it is not a real reform. It changes nothing about the fundamental way the system operates. All it does is expand government. It's a band-aide on the problem.

Would you care for some names? Cases? I think you know that they exist and I can provide them.

Not necessary, because I'm not arguing that the system is fine the way it is now. It's broken, and that's what I'm saying.

Which is worse than meaningless when that treatment is unavailable to so many Americans.

Treatment *IS* available to all Americans. What we are really talking about here is insurance. I think there's a problem with the fact that we cannot afford health care services without insurance. How does ObamaCare deal with the exploding cost of health treatments? Does it address this problem at all??

[paft.livejournal.com]

lom: This has less to do with whose funding it, and more to do with the fact that our prenatal and maternity care is way over medicalized.

Actually, it has everything to do with greater access to prenatal care -- which Canada has.

lom: As for Canada. Canada's health care is currently ranked 30th by the WHO.

Uh huh. And we're ranked....?

Don't bother, I already looked. (Did you really think I wouldn't?)

http://www.photius.com/rankings/healthranks.html

37th. Just under Costa Rica.

lom: However, that same study ranked the U.S. better in overall speed and responsiveness of care than Canada.

And yet we're still listed as below them overall. Way below them. Possibly because, according to that same report:

"In North America, Canada rates as the country with the fairest mechanism for health system finance – ranked at 17-19, while the United States is at 54-55."

Lom: Also, one should note, over all health care in Canada is actually funded 70%/30% private-public, so most services are still actually provided by the private sector.

And yet you were earlier implying that the existence of a public option would eliminate these options. How very odd

lom: So, compare apples to apples, setting aside the private sector from the equation (since both systems use it): our government already spends MORE than Canada's government spends on health care. So what you are saying is that our government already spends far more but has far worse quality of care.

No. I'm saying that we have far worse access to care. Quality care means nothing to people who can't get it.

LOM: Our insurance companies are already highly government regulated-- and what has happened as a result? It has created virtual monopolies of companies in certain states and regions. You cannot purchases policies across state lines because all of the state regulations creating red tape.

All the kind of deregulation your promoting will result in would be health insurance companies moving their bases to states where they'll be allowed to continue gouging people.

lom: Obamacare is going to take the same existing broken system and amp it up to 11.
PFT: How?
LOM: Because it is not a real reform. It changes nothing about the fundamental way the system operates. All it does is expand government. It's a band-aide on the problem.

Specifics please.

How will Obama's healthcare reform make things worse?

Paft: Which is worse than meaningless when that treatment is unavailable to so many Americans.
lom: Treatment *IS* available to all Americans.

Really? Do explain this to those desperate transplant patients in Arizona currently left high and dry by Jan Brewer. They seem to believe that they aren't going to get their transplants because they can't afford them

Silly bunnies! Good thing you're around to tell them otherwise. Explain to me how they actually have access to their badly needed heat transplants and I'll pass it on to them.

[light-over-me.livejournal.com]

Don't bother, I already looked. (Did you really think I wouldn't?)

I was pointing out that Canada isn't necessarily the perfect model example you seem to think it is.

"In North America, Canada rates as the country with the fairest mechanism for health system finance

That's right, the study measured fairness, not quality of care.

Quality care means nothing to people who can't get it.

Tell that to someone who needs a highly specialized cancer treatment, but can't get it now because their employer forced them on an inferior plan that doesn't cover it. You see, it's no longer "fair" that they should have access to it.

And yet you were earlier implying that the existence of a public option would eliminate these options.

No, I'm implying they would make things in the private sector more expensive. In America, we have a system where employers are largely responsible for providing health insurance benefits to employees. What's going to happen is this:

All citizens are mandated to purchase health care. Therefore, all companies will be required to provide health care benefits, and all employees will be mandated to enroll. Insurance companies will in turn raise their premiums to offset the expensive cost of accepting many new applicants all at once, many of whom have costly preexisting conditions. Employers will find that their overall costs go up due to the higher premiums, and as a result they will either a) choose cheaper health care options that don't provide the same standard of care, b) require employees contribute more to the cost, or c) choose to opt out and pay the (much cheaper) fine, leaving employees with no choice but to go on the public plan. And of course "c" will naturally be the cheapest and most cost effective of the 3 options. Why offer any benefits at all when the government can simply take care of it instead?

Now *if* we had a system in place where individuals could afford to purchase insurance plans independent of their employers, and insurance companies could sell to whoever they wanted, then maybe things would be different, and the public option could peacefully co-exist for those who need it. But unfortunately we don't. And that's not the kind of reform Obamacare is after.

In fact, scenarios like a) and b) have already happened since the law was passed. It has happened at my company. What is the end result for average Americans who work and get their insurance through their employer? Higher costs and lesser quality service. Which, sure, will save us all a bundle-- providing no one gets sick and has to go to he doctor! People around the water cooler are already saying how they are going to hold off going to the doctor, come January, and people are trying to squeeze as many appointments in as they can before their existing preferred plans run out and costs go up.

But I guess this is all part of what you consider "fair".

All the kind of deregulation your promoting

Such as?

Do you know why companies can deny people with preexisting conditions and get away with it? Do you know why malpractice lawsuits are so expensive? It's not because they are actually possessed by satan, contrary to popular belief. It's because health services are expensive and customers have no choice. Insurance companies have a limited customer pool (thanks to government regulations limiting who they can sell to), and customers have a very limited choice in policies they can purchase. This is a lose/lose. Insurance companies cannot recoup their lost revenue by accessing the market, and customers can't take their business elsewhere.

companies moving their bases to states where they'll be allowed to continue gouging people.

No, companies based in one state and gouging people is what is currently happening now, under the existing government regulated system.

Silly bunnies! Good thing you're around to tell them otherwise.

There you go again trying to derail the entire discussion with emotional hysteria, implying I'd just assume people die. Why don't you just cut to the point and call me evil? You would waste a lot less time typing, and I would waste a lot less time replying to your ad hominem attacks.

[paft.livejournal.com]

lom: I was pointing out that Canada isn't necessarily the perfect model example you seem to think it is.

More argument by hyperbole, I see. Where did I claim the Canadian model was perfect?

lom: Tell that to someone who needs a highly specialized cancer treatment, but can't get it now because their employer forced them on an inferior plan that doesn't cover it. You see, it's no longer "fair" that they should have access to it.

Why would I need to tell them that? They already know it. It's something Americans face now, and were facing long before healthcare reform.

lom: In America, we have a system where employers are largely responsible for providing health insurance benefits to employees. What's going to happen is this:

lom: All citizens are mandated to purchase health care. Therefore, all companies will be required to provide health care benefits, and all employees will be mandated to enroll. Insurance companies will in turn raise their premiums to offset the expensive cost of accepting many new applicants all at once, many of whom have costly preexisting conditions...

You're presenting a very good argument for a public option that would give consumers an alternative to rapacious private health insurers.

lom: Do you know why companies can deny people with preexisting conditions and get away with it? Do you know why malpractice lawsuits are so expensive? It's not because they are actually possessed by satan, contrary to popular belief.

I've yet to hear anyone invoke satanic possession as a reason.

Again, lom, is it really asking too much for conservatives to actually address what was said rather than making stuff up? I realize that Rush Limbaugh has convinced an entire generation of Americans that this is a rational form of argument, but in fact it's not. As I've already pointed out, it's dishonest.

Insurance companies practice their inhumane policies because they are businesses that treat healthcare as a commodity. They are in the business of making profits, and sick people without money are not profitable. Insurance companies get away with it because they have tremendous financial clout and lobbyists calling the shots in DC. And frankly, many people are genuinely frightened by them. I've known more than one sick person who was furious with the way their health insurance company had treated them, but were afraid to complain or go public about it because their lives literally depended on their coverage.

lom: No, companies based in one state and gouging people is what is currently happening now, under the existing government regulated system.

Baloney. It would further erode those few protections that remain in place.

lom: There you go again trying to derail the entire discussion with emotional hysteria, implying I'd just assume people die...

I'm asking how your statement, "Treatment IS available to all Americans" squares with what's happening to those people who need transplants in Arizona.

Care to take a shot at explaining? Or is bringing up the fact that these people are desperately sick, unable to afford transplants on their own, and quite likely to die if Jan Brewer does not reverse her decision to deny aid an example of "hysteria?"

[light-over-me.livejournal.com]

I've yet to hear anyone invoke satanic possession as a reason.

You have stated that insurance companies would just assume see people die. So yes, I think you have a chip on your shoulder about "evil" corporations. It's not a difficult conclusion to draw when you keep making such comments. But not once I have ever implied anywhere that I'd just assume see people die. These are your words.

Again, lom, is it really asking too much for conservatives to actually address what was said rather than making stuff up?

Where have I made anything up? I have stated a mixture of personal opinion, facts, and personal anecdotes supporting those opinions and facts. My company has forced us on an inferior plan as a direct result of this new legislation. Premiums have gone up. It will cost me more next year, not less. So yes, I am correct in saying ObamaCare is going to cause this reaction. Because it already has.

I realize that Rush Limbaugh

What does Rush Limbaugh have to do with it?

I'm asking how your statement, "Treatment IS available to all Americans" squares with what's happening to those people who need transplants in Arizona.

I have already answered this a couple of times now. You are conflating insurance with treatment. Health care is not health insurance. These are two different concepts. Everyone has access to medical treatment-- except that treatment has gotten so expensive that no one can afford it without insurance. This is the real root of the problem that we need to fix. What I am suggesting are ways to de-couple these two things, such that average people can afford treatment. Right now free market forces can't work to control prices because there is limited consumer choice, too much middle man, and a lot of red tape keeping regional monopolies in place.

I am not suggesting we should simply let people die, I'm suggesting there are better options for reform to expand access to more people. That's all.

[paft.livejournal.com]

Paft: I've yet to hear anyone invoke satanic possession as a reason.
lom: You have stated that insurance companies would just assume see people die.

I believe you mean "just as soon," and yes, insurance companies are quite content to allow people to die in order to make a profit. Their record bears that out. Rather than actually address this uncomfortable reality, you pretend that I"m attributing it to something supernatural, like Satanic possession rather than the usual garden-variety corporate greed. By dragging Satan into it, you're trying to make my statement of fact sound irrational.

lom: Where have I made anything up?

When you strongly implied that I am claiming that Canadian system is perfect, and that I'm attributing the behavior of insurance companies to satanic possession.

Paft: I realize that Rush Limbaugh...
lom: What does Rush Limbaugh have to do with it?

You seem to be a fan, and you are using some of his "debating" tactics.

Paft: I'm asking how your statement, "Treatment IS available to all Americans" squares with what's happening to those people who need transplants in Arizona.
Lom I have already answered this a couple of times now. You are conflating insurance with treatment...

Since treatment is not currently available to many people in this country without insurance to pay for it, your statement about treatment being available is meaningless. Nobody is arguing that treatment doesn't exist.

That's the tragedy of it. It does, and it's NOT available to everyone who needs it. As things stand, people who could live productive, longer lives, are being denied that opportunity.

What do you think of Jan Brewer's actions in Arizona?

[light-over-me.livejournal.com]

I believe you mean "just as soon,"

Yes, sorry, I am quite exhausted, and have been sick. Lately I've been making typos and spelling errors all over the place.

you pretend that I"m attributing it to something supernatural,

I get that you believe insurance companies are gouging people for profit, and to a large extent I agree that they are-- but I disagree that they are doing so out of pure greed or evil intent, and that only government can stop them. I think that there are some very concrete reasons why they are doing so (which I have discussed previously).

Okay so, I was being facetious when I said "possessed by satan". This is because you keep making emotional appeals about people dying for profit....as if I'm somehow defending that. To the contrary.

You seem to be a fan, and you are using some of his "debating" tactics.

I generally like his show. But if I am saying similar things, I'm not doing so intentionally. But regardless, I'm quite capable of coming up with my own thoughts and opinions. I could easily say the same to you-- "oh you sound just like X stereotypical liberal pundit" but what would be the point? I'm not debating them, I'm debating you.

your statement about treatment being available is meaningless. Nobody is arguing that treatment doesn't exist.

It's not meaningless, because this is a key symptom of the problem. Since, this is a discussion about health care, I'm presenting alternative reform possibilities (which have been suggested by conservatives). I believe some of these ideas would do a better job in the long run getting more people affordable access to treatment.

What do you think of Jan Brewer's actions in Arizona?

The AHCCCS is Arizona's Medicaid agency.

I think that this kind of thing is going to keep happening, more and more, as federal and state governments continue to expand their control on health care, while they go deeper into debt. I don't care what letter she has next to her name, I think that it should never be up to people like Jan Brewer in the first place.

There have been similar things going on in Hawaii.

This is all the more reason to put the power back into the private sector, in the hands of people and their doctors, IMHO.

[paft.livejournal.com]

LOM: I get that you believe insurance companies are gouging people for profit, and to a large extent I agree that they are-- but I disagree that they are doing so out of pure greed or evil intent and that only government can stop them. I think that there are some very concrete reasons why they are doing so (which I have discussed previously).

Yes. The bottom line. Very concrete indeed. These are for-profit institutions. Therefore, their primary concern is not the well-being of the consumer (or would-be consumer) but how much money they stand to make.

To the health insurance companies, life-saving medical care is a commodity. A luxury commodity.

Sick, poor people are not profitable. Therefore, their interests are most likely to be met by NONprofit agencies.

lom: Okay so, I was being facetious when I said "possessed by satan".

No, you'd merely have been "facetious" if you'd been using the term "possessed by satan" as a way of exaggerating your OWN opinion. When you ascribe that exaggeration to someone else's opinion in order to paint their opinion as unreasonable, another word applies.

lom: This is because you keep making emotional appeals about people dying for profit....

I keep talking about denying people life-saving healthcare like it's a BAD thing.

Paft; your statement about treatment being available is meaningless. Nobody is arguing that treatment doesn't exist.
lom: It's not meaningless, because this is a key symptom of the problem. Since, this is a discussion about health care, I'm presenting alternative reform possibilities (which have been suggested by conservatives). I believe some of these ideas would do a better job in the long run getting more people affordable access to treatment.

Have the private insurance companies stepped up to the plate for those many, many people who can't afford their premiums? Or those who have pre-existing conditions?

lom: I think that this kind of thing is going to keep happening, more and more, as federal and state governments continue to expand their control on health care, while they go deeper into debt.

Please. This is not a case where someone was backed into a corner and forced to make these cuts. Covering those transplants in Arizona would require a miniscule amount of money compared to other expenditures. Arizona has been the recipient of a great deal of stimulus dollars that could easily have paid for these transplants.

lom: I don't care what letter she has next to her name, I think that it should never be up to people like Jan Brewer in the first place.

But it should be up to insurance executives out to make lots of money?

lom: There have been similar things going on in Hawaii.

The governor of Hawaii recently rescinded the Medicaid coverage of low income people in line for badly needed transplants? When did this happen?

lom: This is all the more reason to put the power back into the private sector, in the hands of people and their doctors, IMHO.

Are private insurance companies stepping up to the plate for those Arizona transplant patients?

[light-over-me.livejournal.com]

Please. This is not a case where someone was backed into a corner and forced to make these cuts. Covering those transplants in Arizona would require a miniscule amount of money compared to other expenditures. Arizona has been the recipient of a great deal of stimulus dollars that could easily have paid for these transplants.

But gee, they didn't. What a surprise. And yet, you want to trust government even more with this track record? If they could have done it so easily whey didn't they? Where is the evidence government cares so much for saving lives? Seems to me they are worried more about the state budget, their bottom line, power, and votes. The only people who really give a damn about health care are health care professionals working in the industry and their patients/customers. Insurance companies are in the business of selling insurance. Politicians are in the business of politics. Neither of them are in the business of saving lives. They are both middle men. So easy for them to make sweeping decisions like this because they are not directly effected. Upper class politicians get some of the best health care benefits in the country, while the working middle class pay for them through the nose. The rules, of course, will never apply to them.

The governor of Hawaii recently rescinded the Medicaid coverage of low income people in line for badly needed transplants? When did this happen?

No, they have been making (or were attempting to make) health care cuts. If you google Hawaii and health care cuts, you can probably find some news articles.

Are private insurance companies stepping up to the plate for those Arizona transplant patients?

If they were allowed unrestricted access to the free market, I bet you would see some competition popping up among them. Eventually they would start competing over rates, and offering deals to set themselves apart. Paying customers would flock away from those offering crap, and towards those offering the better services...instead of being limited in choosing the lesser of 2 or 3 evils in their state. There would need to be a lot of deregulation for this to happen, though, and it wouldn't happen over night. But it would happen. That would be step 1.

[paft.livejournal.com]

Paft: Please. This is not a case where someone was backed into a corner and forced to make these cuts. Covering those transplants in Arizona would require a miniscule amount of money compared to other expenditures. Arizona has been the recipient of a great deal of stimulus dollars that could easily have paid for these transplants.
lom: But gee, they didn't. What a surprise.

"They?" More like "she." And no, it's not a surprise, given Jan Brewer's nasty political philosophy. It's similar to someone who opposes the notion of a publicly funded fire department being put in charge of one, defunding it to the point where it can no longer afford fire engines, ladders, and hoses, and then triumphantly pointing at its subsequent inability to fight fires as a failure of public emergency services.

lom: And yet, you want to trust government even more with this track record?

So let's see if I understand you correctly -- You're claiming that the consistent track record of health insurance companies murderously screwing over consumers and the sick should be ignored in favor of deregulating health insurance companies even more and hoping that they'll miraculously figure out a way of gouging profit out of the poor and sick that will actually benefit the poor and sick. At the same time, we're to accept this instance of a governor -- who is HOSTILE to the concept of publicly funded healthcare and has plainly deliberately sabotaged Medicaid funding -- as the norm in social services and evidence of government incompetence.

Does that sum it up?

I googled Hawaii and health cuts and could find nothing comparable to what Brewer has done. There are just the usual disputes over what and who should be covered, (Mental healthcare, preventative medicine, the status of COFA residents) and while those are important, they are not the equivalent of referring "heart transplants" as "optional" and informing citizens that they can't have the operation that would save their lives unless they pony up half a mill.

lom: If they were allowed unrestricted access to the free market, I bet you would see some competition popping up among them. Eventually they would start competing over rates, and offering deals to set themselves apart...

First of all, I'm truly curious about what "deals" would maximize these company's profits while actually benefitting sick people who have little or no money to pay these companies, and little likelihood of ever getting any.

Second, you're asking everyone to flatly ignore history. Back during the industrial revolution, companies didn't need to bother with any of that pesky government oversight over product and worker safety, child labor, and living sages. The result was not them being "free" to treat their employees or consumers fairly. Quite the contrary. They maximized their profits by paying their employees as little as possible, working them into exhaustion, and tossing them aside when they became too sick or injured to continue. "Men are cheaper than shingles" was one railroad supervisor's response to the idea of insulating a building to cut down on instances of pneumonia among his employees. Children were worked long hours, and often maimed to the point where they were rendered unfit for employment as adults. Adulterated food was the norm among manufacturers.

Why should we bet human lives on the notion that this rule of the marketplace would magically vanish if health insurance companies were given a free hand?