PS i have watched medicine for over 50 years and there is a history that got us here. That needs to be examined.

I guess you must be disappointed about not getting that free pony.

You seem to think that because I don’t agree with you, that I don’t understand your premise. I do. We do not have to agree, for a conversation to be beneficial.

So which answer was that? And why?

I do not care whether or not you are a “fan” of socialized health care. I am, however, interested in your considered opinion about how a socialized health care system (like Medicaid or Medicare) can attain desirable and realistic goals at a realistic and desirable expense.

The trouble with a free democratic republic with economic freedom and choice is that the people must be responsible. Communist, socialist, monarchist, and fascist systems do not expect or demand that their people be politically or economically responsible. They do not expect them to be reasonable and responsible. We do. They expect the people to be venal, lazy, greedy, deceitful, manipulative, covert and hostile. That is their undoing. We don’t, or should not. That is our strength. To the extent that our people fail in that regard, our republic and our happiness will fail

You may have noticed that it is not very easy to be economically and politically responsible. It takes constant vigilance and effort, even risk. There is always an available opinion to the effect; “Just let somebody else do it. Let the government do it. It’s close enough for government work. Nobody will ever notice. I’ll take care of it and it will cost you nothing. We’ll give you free stuff! (universal health care). Just vote for my ticket and I’ll take care of it for you. That’s George’s department. We’ll fix the deficit soon. You don’t have to worry about that. If you vote for me I’ll get a job for your worthless brother in law. Vote for me and there will be a chicken in every pot. Vote for me and I promise you universal health care!”

This is sort of thing that responsible citizens must always be on guard against, and which they must always be on guard against if our republic is to survive and prosper.

Do you get it yet?

Aren’t we already paying for the uninsured? Aren’t we letting decisions be dictated by insurance companies and ambulance chasing lawyers?

I still think your first answer was more pointing fingers than a solution and I actually did think it through before I posted my response. I thoroughly enjoyed reading this last post. Actual substance for me to think about.

EMTALA does help people – but it’s hurting a lot as well. As the scale is tipping more toward hurting, we have to re-evaluate. That doesn’t mean it wasn’t a step in the right direction. It just means it’s not a forever answer. We aren’t going to find the perfect solution. We will try things that work, some that don’t, and try to figure it out from there.

We have to move past the “it’s all their fault” mentality. This is our mess. We are the greatest country in the world. If anyone can fix it. It’s us. But we are going to have to start listening to each other.

Actually it isn’t, Whimsy, and I wish you would take the time to think things through before making such characterizations.

I have not seen any evidence at all that anyone has actually gone to and read the link cited by Care4All in post #2; the one about H.R. 676. This is the post that motivated my first comment in this thread.

This resolution promises pie in the sky, and it is not capable of delivering more than smoke, mirrors, and utter chaos. Why? If you do not see why, read it again.

Pay attention to the part where it says that no deductibles or copayments are permissible (encourages abuse). Pay attention to the part where it promises coverage for all aspects of health care services from chiropractic to cholecystectomy, from dentistry to defibrillation (insures the uninsurable, drives up costs) . Pay attention to the part where no private health insurance is permitted (government monopoly eliminates freedom of choice for both providers and “beneficiaries”). Pay attention to the part where it says this will cost $1100 per year per family of three (switches resource allocation method to rationing).

In my family of four, we pay out of pocket about $1200 per year for glasses and contact lenses alone, at Costco. I guess everything else will be paid for by a hypnotic gesture from our Beloved Leader.

This proposal clearly suffers from the worst faults of all the socialized medicine systems in the world. If you like waiting in line at the DMV, or waiting on hold to talk to the IRS, and the cheerful, speedy, sensitive treatment you get, then you will just love waiting in line for your appendectomy.

This proposal would spread all of the shortcomings of EMTALA, and more, across the entire health care system of the US. It would turn an excellent health care system into a train wreck. It is a simple fact that if the electorate does not watch our politicians like a hawk and call them on their mistakes, idiotic proposals like this will become law and chaos will ensue.

I guess it’s pretty tough being a citizen of a free republic. If the political system betrays us, it’s our fault.

Tort reforms need to happen. I know that. We’ve got to take so much of the burden off of the doctors.

What I have wished for in my own life is some kind of “group” I could join for health insurance. Buying an individual policy is crazy expensive. But what do you do if you can’t get into an employer based group? Heaven help you if you have a pre-existing condition. Or have a child with one. The times I worked the budget to be able to afford insurance, I was quickly told we didn’t qualify because I have a daughter with a heart defect and one with epilepsy.

I will admit that there were times we went to the ER for treatment instead of the doctor, because the hospital let us set up payments. Given the choices I had at the time, it was still the right one.

Personally, I think HSA’s are going to be part of the answer. But they still don’t help when you don’t have the cash to take your baby to the doctor.

In those countries with universal health care or national health plans, the designers and planners discovered very early on that without disincentives, abuse of the system was rampant. The majority of the European plans include deductibles, copayments, “access fees”, and service limits, which are variously apportioned among the different health care services offered.

With regard to the ER crisis in the USA, there are several things that need to be implemented soon if a collapse is to be avoided:

ERs need to be able to assess some sort of access fee or deductible as a disincentive to abuse.

There needs to be some method for compensating ERs for treating patients, especially indigent patients, especially those who fall through the cracks; who do not receive Medicare or Medicaid benefits. Requiring ERs to treat patients for free without somehow compensating them is not merely unfair, it is so impractical that it is causing the system to crash.

ERs need to be able to insist on reliable identification of patients, for a variety of reasons.

Tort reform is essential. The costs of professional liability insurance, malpractice payments, litigation, attorneys’ fees, etc., are large, but they pale in comparison to the costs of defensive medicine. Defensive medicine is probably the single biggest avoidable expense in the American health care system today.

If the public wants universal access to emergency medical care, it should expect to pay for it.

Why should our legislators get into this? Well first, they have created a significant part of the problem. Second, they are the only ones who are in a position to do anything about it. No one else can; not the doctors, not the hospitals, not the insurance companies, not the trial lawyers, etc. The fact that the legislators may be disinclined; that they might actually have to do their jobs instead of throwing trillions around randomly really should not be much of an obstacle. They can be fired.

BTW, Whimsy, don’t you have any positive suggestions?