Let fat people die? WTH did this strawman come from. In Carson’s plan, and all the other GOP plans (and the vast vast majority of cases of sick people since 1986 when the EMTALA law was passed) the person with diabetes gets extensive and expensive treatment to try and save their foot from amputation etc, regardless of what the cause of diabetes, genes or steady diet of McDonalds and beer.
There is no debate that these people get treatment, none. The only questions are how much do they pay for the treatment? What type of systems do we put in place to help control costs? and do we differentiate between cost caused by bad luck and costs caused by choices?
Education sounds wonderful, but every insurance company and HMO is searching desperately for the magic education bullet. I’ve seen proposals from dozens of companies, that make apps, Fitbit’s, website, youtube video, and a zillion games educating their customers in health choices. For the most part, they fail badly. One of the patients in the study, spoke very limited English, was illiterate, and only watched Tagalog TV, good luck educating her with Candy Crush games with health messages.
The American health care system was never designed, it has evolved. It is a myth that in the old days most American worked for big corporations with healthcare and pension. It is also a myth that more people are self-employed it has decreased in the last 25 years. Healthcare evolving into right in America is pretty much a 21st-century phenomenon.
Oghier
6303
The EMTLA merely requires hospitals to provide care in the emergency room until the acute crisis is stabilized. As soon as you won’t die, suffer liver failure or lose a limb right after discharge, they can send you home. Then, you get the emergency room bill and declare bankruptcy. They get acute care treatment. They get nothing for chronic conditions, until those conditions progress to the next acute episode. It’s a terrible system for outcomes and costs.
As for the efficacy of education, it’s clearly mixed. It worked for smoking. It has not for obesity. When 2/3 of the US population is either overweight or obese, there’s clearly no ready solution.
magnet
6304
And how exactly are you supposed to distinguish between the two?
If we are talking about the costs of mesothelioma, then it’s simple: it’s a rare cancer that is pretty much always caused by asbestos.
Otherwise, the honest answer is always “We don’t know.” Obesity, smoking, and physical activities risk factors for disease. They don’t create risk - they increase existing risk. Without them, the risk is still there. An obese smoker who has a heart attack at 50 certainly could certainly have had that heart attack anyway after weight control and smoking cessation. And how about a 60 year old who has a stroke with moderately well controlled diabetes, slightly elevated blood pressure, and moderate alcohol use? By the way, is moderate alcohol use a risk factor or is it protective in stroke? We don’t even know.
Doctors are trained to prevent disease. But once disease happens, the very last thing they want to do is dissect the proximate cause. It’s almost always a futile investigation.
Timex
6305
And how exactly are you supposed to distinguish between the two?
You can look at their behavior?
Oghier
6306
That may be a good example. But it may be the only good example, or one of a very small number. Smoking, heroin/ meth use, maybe binge drinking are all behavioral issues with well known and tremendously detrimental health effects. Of course, that leads us into the “How Best To Handle Addiction” discussion, but we all know how that goes already.
magnet
6307
Ok. Tell me about a 60 year old has a stroke with moderately well controlled diabetes, slightly elevated blood pressure, and moderate alcohol use. Bad luck or choices?
I’ll make it easier for you: obese 50 year old who has a heart attack, and you can assume that obesity in this demographic increases the annual risk of heart attack by 50%: from 1% to 1.5%. Bad luck or choices?
Let’s forget the election for a while.
Does anyone have any thoughts on healthcare they’d care to share?
Timex
6309
But it’s the road you need to go down if you want to have the government get involved in Healthcare.
And to be clear, I already wrote earlier why I think government involvement is the correct move here.
But we need to deal with it like adults, and rationally. We cannot be like stupid children who think things are powered by pixie dust and rainbows. This isn’t a problem that is going to be solved with emotions.
Timex
6311
The second guy was bad choices. His actions contributed to his problems. He made things worse. His actions were bad.
Oghier
6312
You realize we have a whole world of examples, systems that work, right? And some few right here in the US (e.g., Romneycare). None of these, as far as I am aware, were designed by stupid children or necessitate the use of pixies.
When everyone is dead then all will be well.
Yeah, Timex, your attitude is very Randian. One might even say dystopian.
It is not however consistent with how society has chosen to address the problem. Not even consistent with the stated goals of the GOP people who may in fact agree with you. Consider for example the hippocratic oath and the way that emergency rooms don’t turn people away because they may have made bad choices to get there. Even those criminals who somehow survive their encounters with police are treated in the hospital, much less extreme skiers, who apparently deserve whatever happens to them.
And then of course there’s religious morality, not that I suppose that matters much to either of us, but in theory a substantial percentage of the population believes in the judeo-christian obligation to help those who are in need even if they may not have led perfect lives. Anyway as Nesrie points out there is no reasonable way to determine causes of health problems in most cases, and if there were, various rights to privacy would prohibit access to the information. So the whole question is pointless except inasmuch as existing conditions may not be covered at all for many people regardless of their athletic perfection and lack of bad habits.
magnet
6315
But more likely than not, his heart attack was unrelated to obesity. In other words, for every three obese people who get a heart attack, only one could have been prevented by weight reduction.
I hate this thread so much right now. You gonna start a debate thread or what? I’m on mobile or I would.
Timex
6317
What system do you believe works?
Massachusetts clearly doesn’t work as a model, since it depended upon outside funding from federal sources. Unless you are going to find some other external super nation willing to give us money.
Other nations tend to have similarly increasing costs of their Healthcare that point to unsustainability in the long term. Are there nations similar to the US which have Healthcare expenditures that are growing at less than the growth rate of their GDP?
But more likely than not, his heart attack was unrelated to obesity. In other words, for every three obese people who get a heart attack, only one could have been prevented by weight reduction.
But if the government is got to play the bills, then it is going to have to start trying to reduce those risks.
How about a panel that decides if a patient lived a proper lifestyle and deserves healthcare or chose poorly and should be resigned to death? I don’t think conservatives would make a fuss since it emphasizes personal responsibility.
Oghier
6319
Sorry. I’ll stop. Not a discussion that will go anywhere useful, anyway.
magnet
6320
Then you’re not talking about taking responsibility for your health outcomes. You’re talking about taking responsibility for other people’s health outcomes.
Back to the race, so if the rumors turn out to be true about creating a brokered convention and going with Romney over Trump. What happens to the party? Does it break in two and the angry base goes a third party route? Or does the base just stay home and they lose the next few elections?
