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Nataline Sarkisyan and the costs of health care

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Let’s be honest here: CIGNA is a corporation in business to make money. It is not in business to provide health care coverage; that’s simply the mechanism by which it attempts to make money. As a money-making entity, CIGNA, like any health insurance company, tries to maximize revenues and minimize costs. We could John Edwards, or any of the other Democrats running, and enact the health care plans that they have proposed, but given what they have proposed, nothing would change, because they all (with the exception of the minor candidates) depend on the private health insurance system to some extent!¹

But even if we went to a single-payer plan, completely removing (and bankrupting, though I’m sure such wouldn’t bother Mary Shaw), what CIGNA does to reduce health care expenses would be done by the government! Some hospitals already have “futile care” policies. Nor is it simply individual hospitals: Section 166.046, Subsection (e) of the Texas Advance Directives Act (signed into law by Governor George w Bush) allows a health care facility to discontinue life-sustaining treatment against the wishes of the patient or guardian ten days after giving written notice if the continuation of life-sustaining treatment is considered medically inappropriate by the treating medical team. Given Miss Sarkysian’s condition (requiring a liver transplant after three years of battling leukemia and a generally weakened state), a system in which taxpayer dollars paid for all medical care might well result in Miss Sarkysian’s liver transplant being regarded as futile care, a waste of literally hundreds of thousands of dollars on a patient whose long term progosis was not good.

Mr Willis and Miss Shaw might think that, oh, such couldn’t happen under a compassionate, government-run system where the profit motive is taken out of the equation, but that’s certainly not the case in the United Kingdom’s National Health Service. Please note that this article is from the left-wing Guardian:

    Doctors admit: NHS treatments must be rationed
    Fertility, multiple sclerosis and migraine therapies at risk


    Denis Campbell, health correspondent
    Sunday May 6, 2007

    British doctors will take the historic step of admitting for the first time that many health treatments will be rationed in the future because the NHS cannot cope with spiralling demand from patients.

    In a major report that will embarrass the government, the British Medical Association will say fertility treatment, plastic surgery and operations for varicose veins and minor childhood ailments, such as glue ear, are among a long list of procedures in jeopardy.

    James Johnson, the BMA chairman, will warn that patients face a bleak future because they will increasingly be denied treatments. He will urge the NHS to be much more explicit about what it can realistically afford to do and ask political leaders to engage in an open, honest debate about rationing.

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    The BMA proposes the drawing up of a new patients’ charter specifying those health services to which every citizen across England should be entitled, regardless of the local health authority’s financial situation. They also want to see a second list of all the treatments which the sick will get only if their primary care trust has the money, and if doctors decide they are clinically worthwhile.

    Senior BMA sources say their report recognises the reality that despite record investment in the NHS, ‘postcode lotteries’ are rife. Primary care trusts, the local NHS organisations that commission and pay for care from hospitals on behalf of patients, are increasingly rejecting requests to pay for procedures or drugs because they are not perceived to be the best use of funds.

    Some PCTs have been bitterly criticised for refusing to pay for expensive new cancer drugs; treatment to prevent older people going blind through age-related eye degeneration and operations to help obese patients lose weight through stomach-stapling.

    Each trust already has a committee of medical experts that takes decisions on whether to fund medication for complaints which are not covered in their basic contract with the Department of Health. These include treatments such as growth hormone for adults, neuro-stimulation for migraines, breast reduction and enlargement, treatments for incontinence and even some care for multiple sclerosis.

The truth is simple: regardless of who administers the funding for medical care, there will always be pressure not to pay for things that some people see as futile or inappropriate or experimental, because they just plain cost too much money.
¹ - Among the Democratic candidates, only Dennis Kucinich and Mike Gravel, both far back in the polls, have health care plans which do not utilize the current private insurance system:

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Cross posted on Common Sense Political Thought.

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