Thursday, July 16, 2009

Why We Must Ration Health Care - NYTimes.com

Why We Must Ration Health Care - NYTimes.com

This is a national policy issue, but is also implicit at the state level with Badger Care, for example.

If the amount we can spend on health care is not infinite, then how do we allocate a finite resource? Here is one way of thinking through those issues.

But are they politically acceptable? Which candidate will run on this platform? What constituent will vote for such a candidate?

19 comments:

  1. Deciding how much a human life is worth is not a foreign concept. This has been done already by the justice system and many companies. The question here lies more in how to you compare one person’s life to another. How does one decide that paying $50,000 to extend someone’s life is more important than spending $10,000 to take away pain and suffering from a person who does not have a life threatening disease? I believe that a spending cap must be made for healthcare; this will help with this issue. If one can only receive $45,000 and their medication costs $60,000 to extend their life, they will not be able to do so, but a person who needs $20,000 to save their life will have this chance. Setting this cap naturally weeds out some of the questionable ethical issues surrounding this topic.

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  2. I don't agree with the cap concept, because we're still telling one person they can have the chance to live longer, and telling another no. I think it's unethical to tell one person they have more of a right to live than another person, so I don't like comparing one person's life to another. What happened to everyone was created equal? I don't really have the right idea to fix our problem, but if the European countries and Canada are enjoying high approval ratings with their health care system then I think we need to look into developing a system like they have, obviously with our own tweaks here and there. Everyone's too worried about America turning into a socialist country but I think we need to put health and human lives first here in the argument. I mean, we claim we're such a powerful and rich country but we can't even provide basic medical care to our citizens, it's pretty embarrassing. Reading that article really made me realize how crazy it is that we are actually putting a price on a person, and that many people die each year simply because they couldn't afford to see a doctor. If we can put a man on the moon, we can manage to see that every American has the right to see a doctor and seek the finest medical assistance around.

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  3. I have to agree with Jessica. A government should act ethically on behalf of its citizens, but it is not held to the same moral principals that are expected on an individual level. It must rather act in a manner that is "best" to the most number of people. Without a cap (as unethical as that may seem) spending would literally have no limit. To extend a life of a person even a day, at the cost massive premium increases on insurance is not a valid expense of the federal government. The economic devastation of this ought to be inescapably clear. More importantly however, is that universal health care (especially at any cost) is NOT a responsibility of the federal government, as outlined by the constitution. It should necessarily go to the state governments and the people.

    That being said, Singer is not the individual I would like to take advice from on health care policy. To say that the value of life is equal for humans and animals I believe is fundamentally false. There are differences between human beings and animals; differences I feel need not be explained. The value of life for a human cannot be compared to that of an animal, equating the two is not only foolish but barbaric.

    I am among the many who agree that our health care system needs to be reformed. But implementing a federal run insurance program would have repercussions on a catastrophic scale. Such a program would (by definition) not be out to make a profit, thus over time undercutting all other institutions and eliminating competition. Quality would plummet and prices would rise. Doctor-patient relationships would dissipate as clients could no longer shop around for their doctor. All the while crushing our already crippled economy; sentencing our posterity to an irreparable dept that we were too inept to deal with. Believe me; I know our system needs reform. It doesn’t seem right that some families remain uncovered while others easily flip the bill. However, our government cannot act on feelings. We need to make responsible decisions. The white house is asking people to start making sacrifices, to be responsible with their money. I simply suggest they do the same.

    -SamE

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  4. I have always liked the Talmud saying, “to save one life is as if you have saved the world” because to that one person, their life is their world. However, there needs to be ration and reason when deciding how much to spend on a person’s health. Allocating funds for one’s life is an extremely difficult task so I am not going to go into that here, as I do not have a sound answer for such a problem.

    Instead, I will quickly focus on an issue that I think should be reevaluated in the US health care system, that of preventive care. The article stated that, in comparison to other nations, “far more Americans [report] forgoing health care because of cost.” In general, the longer people wait to get treated the more severe their symptoms become. Rather than have these individuals suffer, get worse care in an emergency room because many of them do not have insurance, and pay a higher price dollar wise, it would be more beneficial to everyone if they had had the chance to be helped sooner. People should get the care they need early on, and that would be cheaper in the long run.
    -Sarah K.

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  5. I think the analogy used by opponents of rationing, that ill people are being given death sentences, is preposterous. If we were actually "saving" these people lives (returning them to a state in which the disease will not contribute to their death) then you cannot put a limit on the on spending for treatment. But when we are talking costs that are going to negativley affect the standard of living of everyone else who is paying for insurance to simply extend the patients life for a span of a year, then I think it is not at all immoral or selfish to disallow spending over a set amount. This is especially true, if the person is not going to enjoy a quality life during those extended months. What good is it to America or the individual that they should suffer a little while longer? If you had to make a decision to spend $50,000 dollars to keep your family pet alive for another year and by spending that money you would be putting your family at risk of going hungry, few people in their right minds would choose to spend the money rather than put the pet down. Neither the family or the pet would truly benefit from paying for the treatment, as the pet would be suffering, and the family would be saddened by this and unable to enjoy having the pet. I agree with the statements above that human beings and human life is not comparable to that of animals, but I also wonder whether this is a selfish rationalization. Anyways, before I go off on a further tangent, I will conclude by stating that healthcare is quite possibly one of the most difficult calculations that ever is made and perhaps one without a single perfect solution.

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  6. I think that Kurt makes a valid point in saying that what is important is if there is a good chance that a treatment would actually save a life. Though it is extremely unfortunate, some sort of spending cap needs to be put in place, or it could go extremely out of hand. If someone has little to no chance in living for more than a month or two, it doesn't make sense to stick the money into it (despite how sad and unfortunate the situation really is). What must be considered is the actual chance of the person living through whatever happens.

    On a different note, one chord that strikes me a lot in the debate about health care is the issue of spending in general. Many critics point out the huge price tag of reform, but I don't think that everyone understands the price tag of not doing anything and to continue to treat uninsured in the ER. This article points out at one point how inefficient it is to treat uninsured, and that is just the point. If ER visits could be substantially lowered, costs will be lowered as well.

    - Luke D

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  7. This article certainly jerked with my feelings a bit. It's so true - how can we just limit someone's access to a healthy, happy, longer life if that is what health care is supposed to be about, especially in America? Unfortunately though, health care to some extent has to be rationed. There is no way America can financially pay for a $54,000 drug (as mentioned), nor will the American public deal with such an unequal system.

    I think rationing has gotten a bad reputation of sorts though. The article really puts it in prospective by showing us that programs like Medicare and Medicaid are rationed when people cannot pay the high copayments, or the Department of Transportation setting a price on human life. When we look at it like that, it's really not that bad. The "Medicare-for-All" scheme that was introduced in the article sounds like a more feasible system that would allow many to keep their doctors and quality service, while still extending at least SOME form of health care to others. I also believe this would to some extent prevent people from really abusing or free-riding off the system. If people are only covered so much, then maybe they will think twice between a job with health care and a job without. This would also perhaps create more public support for the program. Yet, people could still get quality, basic coverage that every American should have.

    The problem with all this talk of universal health care is that I do not think the current bill being discussed will pass. There is talk of many Democrats on Capitol Hill that are going to work with Republicans to block the measure. And in some ways for good reason. My father currently owns a small business that employs close to 70 people. His health care costs under this measure are expected to increase something like 30 percent or more which would indefinitely force him to drop his plan. But there is a catch - his business which makes more than $300,000 a year (not a very large sum for most businesses) would be REQUIRED to provide insurance. My dad and others in his same position would have to make cuts somewhere and the first place they would look would be personal. More jobless claims for many workers who are already insured, or insurance for all? It's a tough question but it should be asked before anything is voted on.

    To answer Professor Franklin's question about the candidates who would run on this platform, it would be the candidates who have to protect jobs in the insurance and health fields. Dave Obey represents my district which encompasses (formally) Wausau Insurance and Sentry Insurance of Stevens Point. Both those businesses employ huge amounts of people. If Obey votes for a measure that will continue to involve private insurance companies, he'll be safe. If those jobs are lost, he'll be in trouble.

    While I was strongly against universal health care before reading this article, I am now in agreement that something needs to be done. I just hope that we can come up with a feasible solution that will keep tax payers, small business owners and others in the health and insurance fields in mind. If the proposal is going to help the country overall more than it is going to hurt it, we need to take a step back rethink a better solution.

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  8. After reading this article, which seemed to be the case with some of the other bloggers as well, I was completely torn by the subject of this discussion. Health care as been an issue in politics, especially with presidential candidates, for as long as I can remember. My biggest memory of health care in politics goes back to Hilary Clinton's proposal back in the 90s as the first lady...which failed more than miserably to say the least. This subject is one that I am completely unsure of how to respond to as far as a solution goes due to the ripple effect that each decision would undoubtedly have on every area of the government and its people. However, I fully agree that something needs to be done soon to solve this problem that has been plaguing our country for decades.

    First off, I am an advocate for universal health care in this country. Although I am completely understanding of the repercussions that this would have on businesses and such, I feel that health care, besides education, is one area which we as a country need to be able to provide to our citizens. It is outrageous how expensive it is to insure oneself in this privatized health care nation that we live in today, and as a result, many walk the streets without any coverage to their name. I think that these statistics regarding the number of U.S. citizens without any health care is appalling. We are sending a message to our citizens that the price of insurance is only affordable to the middle and upper class, and sometimes not even them. I strongly believe that there is a minimum standard of care that should be a right to each U.S. citizen, just as citizens in Canada and Britain enjoy, however flawed they may be. After watching Michael Moore's documentary, Psycho, I was absolutely shocked by what other countries can give their citizens and what ours, even being the "wealthiest nation" cannot, though I am not naive enough not to see the holes that are in their systems as well. But beyond my advocacy for universal health care is where I admit my inability to see/find a compromise in the creation of such a system. In relation to the rationing of health care, I agree with some of the others bloggers in that it is hard to decide in such a general manner who will be given the medicines they need to survive and who will not. Although I am not sure how this would work, I believe that some level of minimal dollar-amount coverage should be "awarded" to every citizen (possibly similar on the cap of $45,000 discussed in the article) and then from there discuss how the extra dollar amounts for those needed more funds be gathered, whether through individual family contributions or taxes.
    As far as who would run on this platform and which constituents would support it, I think that any business owner would say that insurance is a huge issue/liability for their companies and the way they have to run them. It would seem as though businesses would benefit from rationing health care in order to keep up with these plans financially and that elected official who had a strong push for this from their constituent bases would therefore have to advocate for this idea on his or her platform.

    Bottom line, this is a difficult subject that everyone has different opinions on. However, I strongly believe that implementing a well thought-out universal health care system would be better than what we currently have, or don't have, in this country today.

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  9. Great article by Singer. His thought experiments are very interesting, and his economic data is fairly eye-opening.

    Clearly, the health care system is broken. Everyone seems to be paying more money for less care, and both patients and doctors seem fed up with the way things are going right now. If we keep going at the rate we are now and health care ends up consuming a third of our nation's budget, a lot of important government programs are going to need to be cut to pay for such a bloated system. While an economic downturn is not the best of times to completely overhaul the health care industry, reform needs to happen sooner rather than later.

    What's the solution? I think that the concept put forth by Singer is step in the right direction. Like the quote from Churchill - "It's the worst one of all. Except for all the others." What bogs down the system right now is the uninsured and their lack of preventative care. If they only end up seeing doctors when their problems have warranted a trip to the ER, it takes more resources and time to take care of them. Those are resources which could have helped to prevent an illness in many others. The idea of "rationing" health care does seem immoral and wrong intuitively, but when the numbers are crunched it actually is more moral than our system now. Isn't maximizing the amount of care provided with the money available the ultimate aim of any health care system? The way we go about this may seem cold and harsh (placing a value on human life, how many teenagers are worth on 85-year old, etc.) but the benefit to society seems to be so great that we should ignore our initial distaste and take a serious look at a proposal like this.

    Some serious fine-tuning does need to happen in order for this to appeal to the American public. As it stands right now, any proposal to fix health care will NOT be to the benefit of private insurance companies. They can be a part of the solution, but drastic changes will be made to fix the system. The best things never come easily.

    -Eric Maloney

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  10. Healthcare systems are of course, businesses at heart. The main of the operation is the collection of cash. Pharmaceutical companies make tons of cash as well, limiting their involvement in low-cost, national systems of coverage. Although every year, I forget which drug company it is, but they give out tons of free meds to Africa. That is nice and all, but clearing the shelves for new stock is not the best solution either.
    The point is that no matter where the healthcare is, there seems to be a disparity in the quality of it. One thing that seems to continually happen is the excess of narrowly tailored requirements for good health care. Is GOOD health care too much to ask for? Too much to expect? How else can an economy thrive when its inhabitants are not taken care of?
    This ongoing argument gets more and more sickening as the days go on. Wisconsin needs to support better health initiatives. It is almost getting to the point where one wants to say, "Whatever, just try something else", as if to say, "We're lost!"

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  11. For anyone who has known someone gravely ill, they know the value and healing power of optimism. If you think you can beat it, if you put your faith in the medicine and in yourself, there is nothing stopping you from surviving the unsurvivable. However, when doctors and insurance providers do not see the silver lining and glimmer of hope, many people are dying far before their time is up. There are always the miracle cases with someone beating the odds. But if no one can beat the odds with our broken healthcare system, what do people have to do hope for?

    I think it's a major win on the part of the Obama administration in avoiding the use of such words as "ration" in response to health care. Besides just looking at the wonderfully written NYT article, in the Senate, even conservative Senators are finding themselves in some agreement with the President, which is unusual in this day and age. They all agree, that the healthcare system is broken. But the means of getting there is what is complicated. But those that do not see the end, will never agree on the means of fixing it. Those individuals live in a glass house, enjoying their government provided health insurance, which I personally know is incredible. My little cousins were born 6 weeks early and it cost $1 million to keep them in the hospital and keep them alive, but the government health insurance their father had covered the entire cost. They know call my cousins their "million dollar babies." But not everyone is this lucky. Not every baby gets to survive and have such a story.

    It is scary that there can be a dollar value on human life. But many of the upper class and individuals with private health care realize that as public healthcare becomes more common, their prices seem to increase. There has to be some kind of compromise without giving up quality along the way, if quality even existed to begin with. The British model truly puts a value on human life, but that's not the American Dream, the American philosophy. Each person deserves a chance to live life to the fullest, despite the cost.

    Gena W.

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  12. To begin, I definitely agree wtih Luke's statement I do think there should be a cap on the amount of money that should be spent by Medicare or Medicaid. Even if it is sad that by denying an extremely expensive drug from terminally ill patients it will shorten their life span a couple of months.

    I think if a cap was included in Medicare/ Medicaid that would limit the amount of profit that "evil" pharmacy companies' (as drug manufacturers are usually seen to be)profits. I say this as a result of hearing that by Britain limiting the amount they are willing to spend on covering medications for the public many companies lowered their prices (so that many people still could have access to the drugs). Yes this means that rare drug companies that cater to specific and horrible diseases, such as Sutent does, require their patients to shell out large quanities of cash for a couple extra months. After investing millions of billions of dollars into medication there comes a point where drug companies have to supply drugs (like Suten) at such a steep price because so much money has already been put into it, in which there will be few users and few people for the cost of developing and production to be distributed across.
    Our government was created to provide for the natural rights such as life. However, healthcare is a service that the government and its people have a choice to provide. By denying full and complete Medicare service to a terminally ill patient it is not putting a price on a life, but rather an attempt to outweigh a few to save the many. Over the years our life expectancies have expanded, possible deaths by common things such as child birth have been overcome, as a result of new medical research. However, when are we asking too much from scientific progress and going against nature? Giving people more time on Earth is not always the best for them, suffering does not always ease with time. I say this from my own personal experience, with a relative having Parkinson's, which is not only a debilitating but life threatening disease. Time does not stop them from hurting if anything it prolongs it, drugs cannot fix everything even the most expensive ones.

    I do think that the Medicare for All concept that Australia has is a great idea. In a world where the free market system is what our economic world is based on, means people need choices to satifsy their needs and to push companies toward innovation. Also, if you can opt out of paying it by making enough money you have the choice (which many Americans I'm sure wish they had) of not funding a system they don't believe in is a great idea.

    I think any representative that votes in accordance with how their district wants will always find favor regarding re-election by their constituents. For instance, our district has an extremely high unemployment rate and therefore there are many that rely on the help of government programs to get them through. If your district relies on help and you vote to abolish it, then you will probably not be re-elected. People realize money is finite. You get your paycheck and the next thing you know somehow all your money has vanished into bills. So I think people are understanding that the government needs to make choices. If constituents have been affected by someone being denied Medicare, based on the cost, clearly they would want there to be no cap on the Medicare spending limit and definitely no rationing. Personal experiences affect opinions on issues and ideals of how representative's are suppose to represent their constituents, all of which are highly variable; and if this could be predicted no one would ever lose elections.

    To summarizeI think changes do need to be made, Medicare should be provided based on cost affective and scientifically evaluated cases, and that caps should be put in place. Denying medication is hard and controversial but sometimes the hardest decisions are the right ones for everyone in the end.

    -Lauren C.

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  13. It seems ridiculous that terminology can sink legislation, but its true. The Rwanda Genocide springs to mind, and how President Clinton's administration shied away from using the word genocide and instead called it ethnic cleansing, for fear of having to intervene as a signatory to the UN Human Rights Charter. The way the article described health care raitoning makes it seem an intelligent choice. However if I was in a different economic bracket I might not be so happy to have my options limited because I could not afford better coverage. I first learned about Peter Singer for his philosophical writings on animal rights. He wrote a controversial book stating that all animals feelings deserve equal consideration, even slum rats that bit slum children. This caused quite a stir. However his teachings are solid, that all animals suffer and therefore they all deserve equal consideration. From the article it seems that the British and Canadians are happy with their health care system. They are even happier than Americans. Changing over to rationing health care might not be universally accepted, but it is one option that should be seriously considered in this faltering economic climate.

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  14. As "unethical" as it may seem money makes many aspects of this world go round. This is true even in regards to a human life. If America wants to figure out how to provide healthcare to the 46 million who go without and the countless others who don't have enough coverage, then a rational (and more than likely "rationing") option will need to be brought to the table. I agree with Maggie G. about it being disappointing that terminology can sink legislation. Healthcare is a serious problem in this country and cannot rest on a connotation.

    To answer Prof. Franklin's question on what type of candidate would run on this platform, there are many moderate, libertarian, socially left, fiscally right-minded politicians out there that I think would benefit greatly from such an approach. Constituents who question whether this type of reform is appropriate during the tough economic time our country is facing may reconsider given both a socially and fiscally responsible approach.

    That is exactly what a rationed health care policy would provide, a responsible approach to the problem of uninsured in our so-called advanced country. With our country's minimum wage at miniscule $7.25, how can people be expected to insure themselves in all situations. In the end, there health problems will end up costing us down the line. By providing people access to basic level preventive services more lives will be saved as well as more money.

    As far as damage to the private sector, I disagree with Sam E. and believe that a federal program may kick start the private sector to provide better benefits. Even those with coverage now often find themselves paying high deductables and fees. It is common knowledge that in most cases private sector services are better than those provided by the government, but as of right now the private sector is failing to provide what is necessary for the public.

    "Rationing" federally provided health care does not mean that people won't be able to get the services they need. It just means there is a limit on what will be paid for them. Currently there is a limit, one which is set by people's incomes. This system fails, especially when it comes to the children and the elderly. A spending cap on a human life may sound unethical, but is a much better option than the status quo which leaves millions without any care at all.

    Julie B.

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  15. The first thing I noticed when reading this article was that it was written by Peter Singer. Maggie G. and others noted his position as a strong animal rights activist. I was introduced to him in a Medical History course entitled the History of Western Disability. It was eye-opening to hear his positions regarding people with disabilities, especially infants. His argument is purely utilitarian, supporting killing people with severe disabilities that are an economic drain on more able bodied people. It is through this lens that I read his article.

    So while I do think that rationing health care must be done to some extent, I think there are MANY wrinkles that would need to be ironed out. The spectrum of people looking to influence policy making ranges from folks like Singer who belive that people with disabilities can be less than human to those like the Rabbi in the article who say one life is equal to every other life on Earth combined. As Gena said, there needs to be some form of compromise, but just how that compromise will be reached will be a long and difficult process.

    -Paul L.

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  16. I would also like to agree with Maggie G and Julie B who pointed out that the affect that the word healthcare "Rationing" changes how people think about this policy. No wonder Obama is reluctant to use the term rationing. As I said before I do think people understand that with a limited amount of money, tough choices have to be made regarding the fixed amount of money available. Rationing has such a negative connotation (for example the rationing of World War II and the Great Depression). Rationing was meant to provide equal sustenance so that in times of economic hardship people could still be productive members of society. However, if it reaches a point where just being fair keeps lowering the standard of life for everyone that is not a good policy decision. Right now I'm reading a book following the aftermath of the Bolshevik Revolution in Russia and the thought behind collective farms is that farmers must meet a quota of food produced in order to give that quota to those working the factory producing clothes and such goods. The proletariat gave up their individual goods for the good of the Soviet Union as a whole. However, as quotas increased and had to be met there was less to go around and after a time people could not provide for their own interests, as that happened the amount of goods decreased over time thus causing many towns to suffer. I think this case in history can be applied to universal healthcare, when there are no limits. Today we provide for healthcare from our wages but as demands increase for a few there is less to go around for the many. In economic distress, America does not have the ability to shell out for every medication people need. I do not think it should be restricted, as Maggie mentioned, I think slum rats that bite slum children should even be allowed healthcare. America is built on the notion of justice and quality, after all, Lady Justice is blind to the options and simply weighs the situations. If there was no cap on the amount of money the government should spend, then more would not be demanded of the public to the extent that deductibles and taxes would be so high people would not be able to function or have even the most basic cost-affective healthcare coverage. Furthermore, with healthcare for all but capped to a specific amount (in affect rationing) healthcare would be equal and unbiased for everyone. I also like Paul's point that if we focus more on preventative medicine and less on paying for every medication regardless of the price, that merely allows for a small window of added life but not save the life, that should not be funded by the government. Now it is too lofty to establish healthcare for all, rationing will just have to do for now, but one day when the bugs are worked out this concept of medicare for all will be an actuality.

    -Lauren C

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  17. I personally am very torn about where I stand on this issue. To me, this issue is strongly centralized around a debate about classical liberalism’s principle of natural equality and the idea that living in America means freedom of opportunity.

    On the one hand, having universal health care with rationing and caps limits our freedom of opportunity by limiting the ability of a person to get all the care that they need. Like earlier posts stated, you can’t compare one person’s life to another, and it is unfair to tell someone that their life can no longer be prolonged and fought for anymore because they have exceeded the amount of money the government has allotted them to receive for health care. The time people have with their loved ones is worth way more than anything a government could spend. In regards to an earlier post, yes the white house needs to start asking people to make sacrifices in these tough economic times (and I believe they already have) and the government does need to start making sacrifices and cut backs (some of which were visible in the new budget plans) but these sacrifices should not come at the expense of the health and well-being, or even the life, of a person. Also, we trust in our doctors to fight for our lives and do everything they can for our health and well-being.

    However, on that note, universal health care would help allow others to receive care when they might not otherwise be able to. There have been plenty of stories in the news for years about emergency room’s turning patients away because they don’t have insurance and hospitals can’t afford to treat them. If there was some sort of government-provided health care system, maybe we would no longer hear about people not having the opportunity to receive care. I think that voters that are low-income and of low socio-economic status will support universal health care because it could work to their benefit in situations such as this and give them the opportunity to receive care they might not otherwise be able to receive because they either can’t afford it or don’t have insurance, or both.

    Realistically, some sort of universal health care system will eventually be provided. I agree with Kurt E.’s ideas that perhaps care should not continue to be given if that person is not going to have a comfortable quality of life and only be given care if there is a good chance that that person’s life will be saved and that maybe there isn’t a single perfect solution to the health care problem. But again, this brings up the argument that people should be given the opportunity to live and the chance to see a turn around and be one of the many medical miracles we hear about. After all, there is so much about medicine and the human body that we do not understand.

    Maybe if we did have universal health care and there was a minimum standard of coverage or spending cap given to each U.S. citizen, as seen in other countries, then eventually our government would have enough funding to set an increasingly higher minimum standard or cap.

    - Leslie W.

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  18. When I think about health care, I do not see it as a debate over health – I consider it a battle between the privileged and the unprivileged. Throughout the course of my internship, I have read and listened to the cries of America and the things people are going through just to survive. The privileged fear the effects the public option would have on their outstanding care where the unprivileged just simply want to be seen. This debate reminds me of a movie called “John Q” starring Denzel Washington. According to Internet Movie Database, Washington plays John Quincy Archibald whose “son Michael collapses while playing baseball as a result of heart failure. John rushes Michael to a hospital emergency room where he is informed that Michael's only hope is a transplant. Unfortunately, John's insurance won't cover his son's transplant. Out of options, John Q. takes the emergency room staff and patients hostage until hospital doctors agree to do the transplant.” The movie makes such a powerful statement because Washington’s character is willing to go to jail just so his son can receive the gift of life. Nobody, regardless if you’re privileged or not, should have to result to extremes just to be heard.

    When did Americans become so selfish? I listen to those in opposition of the public option have concerns about long lines in the doctor’s office and whether or not they will be able to continue services with their outstanding physician. Meanwhile we have fellow citizens across this country dying everyday just because they could not afford to see a doctor. As a child, I watched my grandmother die from a disease that could’ve been prevented if she was not blocked because she did not have insurance. My grandmother died when I was 5-years-old. There used to be a time when every American was apart of the same struggle. During the Great Depression, the used to be rich and poor were contemporaries and everyone genuinely looked out for each other. Now our country is designed for rich to get richer and the poor, poorer. There are just too many personal agendas and not enough love. If everyone was willing to sacrifice just a little bit of the privileges they have, the playing field would soon level and many of the problems our nation faces today will soon fade away. The privilege of being able to see a physician regularly is not just a health thing. People are educated about healthy living, conditions that can arise from unhealthy living, and how to sustain personal health. Also, much of the public forgets about the unborn. The health care debate sparks a lot of attention regarding those who are on their death bed. Pregnant women who are uninsured are subject to having complicated pregnancies and birth defects within their newborn. This cycle thus re-creates another generation that will always be a couple steps behind the privileged.

    In response to Prof. Franklin’s question, I think rationalized health care depends more on the constituency than the candidate. Candidates should asses the majority of their constituency and then determine if they should run on this platform. Employees who work for the State of Wisconsin are primarily insured by Unity Health Insurance and this company has limitations. I would consider a majority of insurance companies to be already rationalized with policies that outline limitations.

    Overall, I think every American can stand a little sacrifice. Health care should not be wedge used to divide the privileged against the unprivileged. One life is not greater in value than another.

    Ashley B.

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  19. I have to agree with many of the comments in that to put a monetary amount on the worth of a human life seems outrageous. This however is the way that our healthcare system works to a certain extent. All one has to do is look at the HMOs operating and the difficulty in finding and recieving care that is covered by the plan. By making it as difficult as possible for members to receive care these companies are putting the bottom line ahead of the lives of people.

    I am not convinced though that a healthcare system that resembles those of Canada or France for example is the answer for the U.S. It seems as though these systems would stretch the government budget even further in these tough economic times. Reform over a period of time would be alright, and is necessary, but must occur over time. The problem of healthcare did not spring up overnight and will not be fixed in that manner either.

    -Kris G

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