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End-of-life care is something that needs to be discussed and incorporated into any health care legislation. Once this issue is clearly defined, then -- and only then -- can prognostications about the final costs of health care begin to be determined.
Option One: Health care shall include all treatments designed to prolong a person's life as long as is humanly possible and without regard for the effectiveness, cost or potential success or lack of success for any treatment. This option carries with it the highest expenses, costs and utilization of health care resources, while removing from the equation the possibility of the so called "death panels."
Option Two: Health care shall include such treatments that are necessary to attempt to cure a disease, but if it is determined that the disease is no longer treatable and the chances for recovery are non-existent, then the only health careprovided shall be that which is necessary to allow the patient to continuehis or herlife with as much dignity as possible, with appropriate steps taken for the management of pain.
While this option requires lower expenses and costs, it can open the door to the prospect of "physician assisted suicide" which some claim would be a true sign of a progressive health care system.
Other options would also have to be included to cover all possibilities for such treatments or procedures which would take into consideration a person's age, mental condition and physical abilities, and would cover things like joint replacements, heart procedures, etc. However, the primary question is: Are Americans willing to let "nature take its natural course" or do they demand that the health care system be used to wring the maximum amount of life out of an individual without regard to the cost, oreven the lifestylethe person willingly engaged in or is capable of today.
Again, we return to the concept of "preventive medicine." Fat people know that they should lose weight without having to visit a doctor. Liberals in particular are quite willing to make excuses for fat people, usually quoting sociological and socioeconomic reasons for obesity. What must be brought into the entire "economics of health care" issue at this point is the fact that the second largest expenditure of tax dollars today is for "income redistribution programs" (welfare programs operated by a variety of federal and state agencies) designed to assist poor citizens.
The conservatives of course are opposed to "throwing more money" at this group of people, and would no doubt argue that this group of people should be afforded only the care providedin "Option Two" above. This of course would give rise to constitutional issues, and those issues would probably prevail in a legal challenge, but not in the conservative"public opinion or sentiment" arena.
Health Care Reform Associated Costs
Assume for a moment that a single-payer system were to be passed. That would ultimately result in a virtual eradication of all "for profit" health insurance companies. One of the issues that would then have to be resolved is what would happen to the billions of dollars health insurance companies have collected and are holding as their hedge against future expenses? Any move by the government to seize those funds would meet great resistance simply because the monies were legally collected. Any efforts to force insurance companies to continue to pay for treatments that have begun would also face significant legal challenges because that requirement would be contrary to the contracts that private citizens entered into with private companies or entities.
Ultimately, the prognosis is that insurance companies and their shareholders would ultimately have extensive windfall profits -- once of course, lawyers had taken their fees for challenging the government on these issues. That could take years, and would extremely expensive for taxpayers who would be paying for the defense of these types of lawsuits and challenges.
Another consequence of health care reform is the loss of private and corporate investment in the American economy. Insurance companies routinely invest the premiums they collect into various investment vehicles to maximize their profits and to provide a hedge against unexpected costs covering health claims to be filed. A significant amount of the profits health insurance companies post each year is returns on their investments -- not from premiums collected.
It is not logical to assume that "Joe the Plumber" will begin to invest the savings he receives from a single-payer system vs. a private insurance system. Ultimately, his actual savings are not going to be as great as is being prognosticated by the proponents of a single-payer system.
Of course, with the failure of private insurance companies is the impact these failures would have on small businesses -- the independent agents -- as well as all the employees of these insurance companies. There is little doubt that a single-payer health care system operated by the government, or a government entity, would not be able to employ all these people. We then have the costs associated with tens of thousands of people being out of work for indefinite periods of time. This will once again sap the taxpayers.
Already, there is a movement to unionize nurses around the country. The United American Nurses -- AFL -CIO is organizing -- and pressuring Congress to make it easier to organize. According to their web site: "UAN RNs set the standard for registered nurses in organizing, collective bargaining and ground-breaking contracts. As an affiliate of the AFL-CIO, UAN staff nurses stand proudly with millions of workers across our country."
With a national health care system negotiating wages for medical professionals, there is little doubt that nurses will be at the bargaining table wanting more and more. More money. More benefits. Better working conditions. The end result: Higher medical costs.
Following the nurses will benurses aides, then the medical technicians without which no hospital or medical practice an operate. The end result: Higher medical costs.
