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About Me
- dsm
- Biostatistician, Biology and Philosophy Faculty, Lacrosse Addict
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13 comments:
I feel that the author makes a good case for rationing, for the simple fact this is costing me more. My co-pays have gone up and monthly premiums have risen in order to support the next person. Does that mean I have to go to the doctors less so they can go to the doctors more? That’s not fair. I went from paying $10-$15 dollar co-pay to $20-$35 and my premiums continue to increase.
I do not think public health insurance should put a dollar amount on a treatment that would extend a patient life for a year or so, especially if a person has put into the system and because of some life changing situation is in need of public heath insurance, or if you where born into a situation where you need government health.
I do have a problem when you have never put in, and you have no intentions of ever contributing. If you are satisfied with living a minimal life style you should receive health coverage and yes there should be a dollar amount the public heath insurance should pay for treatment that would extend a patients life for a year or so.
I don’t mind helping, because everyone needs help, but you have to help yourself or at least be trying to help yourself.
I agree with Singer in that health care must be rationed. Even if government chooses universal health care, there is still a limit on which can be spent. It sounds immoral putting monetary value upon life, but it must be done. If the person can’t afford the treatment, then I’m sorry, but they simply don’t get the treatment. Society can’t afford to pick up the bill for everyone it’s just not possible or financially sound. It’s not that bureaucrats are sentencing anyone to die (unless one is on death row) death is inevitable for all life, but unfortunately finances are not. Although one might live an additional six months, it is the living that is suck with the bill after that person expires. I completely agree with the statement “If the U.S. system spent less on expensive treatments for those who, with or without the drugs, have at most a few months to live, it would be better able to save the lives of more people who, if they get the treatment they need, might live for several decades (Peter Singer).” The best scenario would include the combination of free national health insurance for those in need with the option of private insurance.
Rationing of health care is it ethical. No way! It’s unfair to put a price on someone’s head and claim at birth they are worth X amount of dollars and has you age your value decreases proportionally. Unless of course you happen to obtain a deadly disease or some disability that leaves you useless to society, then you must check out early and waive all rights to health care. Miracles happen, I think we all need to keep this in mind. I heard a story a while back; a 100 year old woman had a bad heart and was in need of a pacemaker. One doctor declined the surgery, another decided to do it. He visited with her and saw that her quality of life was still very high, she was surrounded by a loving family and still functioned at a high level. Guess what that was over 5 years ago. This is something that is impossible to gauge and set a price simply by looking at a chart with preset values, expiration dates and liabilities. It’s impossible to actually say that if we give you this drug you will only live X days, weeks, months..Etc… My grandfather recently passed away, they gave him 6 months to live, and that was over 6 years ago. Should he have been cut off and left to die simply because he was old and lived a full life? Absolutely not. It’s unfair and unethical to put a price on everyone’s head at certain times in their lives. All 60 year olds are worth X; all 70 year olds are worth Y. ……Everyone is not the same, I’m in good shape I plan I keeping it that way, is it fair to bundle me up in the same class as those that don’t take care of themselves? Medically speaking should I be treated the same as someone who has abused their body for however long they live?
Singer has some valid points in regards to rationing when someone else is paying; I just feel that it would be far too difficult to determine a price scale. QALY is one system that I would not be in favor of at all. How is it ethical to tell someone that although they paid into this system of health care their entire life and now when you need it the most they are cutting you off simply due to some economic calculations? It just doesn’t make sense ethically and frankly it’s kind of inhumane. Strictly from a financial standpoint, sure, rationing sounds good. But healthcare is more than that; it needs to be kept on an individual basis. No two people are the same therefore their medical care should reflect that.
The author does make a good case for health care rationing. He plainly states the facts about the current costs of medication and treatment in the US. Patients only expected to live for a few extra months versus someone that would expect to live several years is an easy choice for who to treat when looking at just plain cost and out-come. Yet, who puts the dollar value on someone’s life? I may want to spend as much money as I can to let my child live another 6 months. However, should I expect everyone else to burden those expenses? The US has one of the most expensive health care systems. Sickness and death are huge money makers in this country. Unfortunately, something has got to change before only the rich can afford treatment and the remaining people are left to die.
We spend an enormous amount of money on patients in their last 6 months of life. Granted some of it is for life saving measures for accidental injuries, but a lot of it is for last ditch efforts to extend someone’s life a little longer. I can not accept or reject this desire to live but who burdens the expense? Someone has to pay for it in the long run…one way or another we all pay for the care. Palliative care is another issue, but I feel keeping someone comfortable before they die is a valid expense. The author does point out there is no one size fits all health care system. Currently in the US there are more deaths due to lack of insurance than any disease. Many people don’t think about it unless they are faced with a medical bill they can not afford because they don’t have insurance or are unable to make the co-pays required for medication or treatment. I think the idea of rationing out health care could cause pharmaceutical companies to have to compete with each other making drug prices come down to a normal cost level. It will not happen over night and it will cause problems when there is only one brand/type of medication available for a condition. In those cases the medication will probably remain expensive and I’m not sure how the cost would be considered.
Regardless of the system we adapt to, something has to change. I’m in agreement with making Medicare/Medicade available to everyone with supplemental private insurance options. I think our emergency rooms would be less crowded with cold symptom patients and resources would be more available for true life threatening emergencies. At first the costs to tax payers would be larger but eventually would flatten out compared to what the average person currently pays out of pocket for health insurance. The transition is not going to please everyone and will have problems that will have to be addressed as they arise but I think ultimately some things need to change.
I think Singer makes a good point for rationing Health Care. I don't agree with everything that he's saying because some of us do pay taxes and things like that. Some people may work jobs that don't have affordable insurance packages or don't offer insurance. I happen to be one of those people single mother and can't afford the insurance my job offers so I have to be on Public health care that other people may be helping me be able to get. I do agree with his argument that some peoples premiums go up to help others. I feel if thats the case then the people who pay these extra premiums should be the ones to decide if the money should go to helping someone live six months longer, older terminal ill people recieve treatment or if the younger not terminal people.
I also would like to add regardless of how people feel about helping others live for six months or longer have they ever took into consideration that the person who may need treatment. may have a family memeber or children that have had their premiums go up as well they may feel like their family cotributed for them as well not just you.
I can't say what's right or wrong in this situation because I don't pay high premiums or premiums at all so I can't say their wrong for being upset I don't know how they feel I have Public Health Insurance. I also can't say it's right or wrong for them not to want to do these things for others because I'm not terminally ill or need treatment for anything right now but what if I did I might feel regardless of me dying anyway I might want six extra months I don't know Cause I'm not in that situation.
I just say on this issue maybe people should take the if the shoe was on the other foot approach. Etheir way you look at it we can't just let people be sick without tyring to treat or help this Health Care situation is completely out of control. We need to figure out a way to make all parties happy and satisfied.
Singer makes an effective case for health care rationing to this reader, as he points out we already ration health care but in more extremes ways. People forgo healthcare altogether because of cost or ration medication because of high co-payments. At 35 years of age I have been paying taxes and paying into Medicare for 17 years. Since the age of 18 I have gone without healthcare for 4 years. For me it is frustrating to be apart of the working class who cannot afford healthcare. Last year I lost my healthcare benefits because of reduced work hours. I weighed my options at the time, if I wanted to participate in Cobra I had to pay premiums starting the month my benefits were cancelled through the cut off date in August to be able to participate in the program, that cost was nearly $1500. I also looked into the cost of private insurance which ran anywhere between $1700 and $2500 per year. I chose to go without health insurance and negotiate costs with my doctor’s office, only going to the doctor for absolutely necessary procedures. I looked into ACCHSS but did not qualify because I made and still make too much money per month and year. The costs of medications or treatments and the outcomes should be weighed carefully. Unfortunately, the healthcare system in this country is a business. Medications and procedures are far more costly in this country than many others. People who do not have insurance receive lesser treatments than those with insurance. When I did have insurance I noticed that my costs were going up, which was puzzling since I rarely have needed to use my healthcare benefits. I realized I paying higher premiums for individuals with chronic conditions who were receiving constant treatment. This country pays $147 million in healthcare for obese individuals. That’s all of the medications for various disease and conditions associated with obesity. In many cases diet and exercise is much less expensive. My grandmother is hundreds of thousands of dollars in credit card debt because my aunt’s Medicare co-pays for cancer medications were very high or the medications were not covered at all. Healthcare should be rationed because we have too many dying due to lack of treatment and many disproportionate care being given because of high costs.
I think Peter makes a real good case in rationing money spent by the government on healthcare, especially if it is hundreds of thousands of dollars spent to prolong life a month longer. Peter states that rationing already occurs with private health insurance, they determine how much they are going to spend on you and what drugs and treatment they will cover. I love the idea of Medicare for all but with provisions on how much they will spend. I can relate to the economics stated in the article that it is not worth prolonging a life just a little longer for so many thousands. The government already puts a price tag on how much they are willing to spend for public safety on roadways (millions) in order to save lives. I think this figure the government applies to public safety is too high, and I think they should adjust it and allocate more money for this Medicare for all. I would hate to be the physician who has to tell the patient that they have exceeded their limit but this must happen all the time with private insurance, Peter mentions how this goes on quietly without being brought to attention. It seems like we got it to good for a government to pick up healthcare tabs for any amount and at the same time put the nation in more debt. Peter makes a point about how many Americans are without health insurance (45 mil.). I think the Medicare for all plan would indeed help a lot more Americans out even with caps on spending (utilitarianism approach). I think Peter makes a good point about if there were caps on how much the government would spend that it would make drugs more affordable and pharmaceutical companies less profitable. I think Peters mention of the study that was done in 2007 that determined 60% of bankruptcy was caused by illness, most of which was medical bills weighs heavy in his argument. I think even though it is cruel how Peter’s thought are on how we should value life, a older person being saved has less value than a younger person saved especially if the old person does not contribute to society any more is a good point. It is not very respectful and thinking this way one has to consider that the older person has contributed and put in to the system for many years already and now it is time for them to collect. All in all, Peter has made some good analogies and points to consider, but no matter what something needs to be done about healthcare, it is not going to fix itself.
Human life should not have a price tag on it.There is nothing in this world leave alone money that can substitute the value of life.The government should not ration health care and should not be the one to decide who lives and who dies.
Nobody on this planet likes to be sick,ill or even die.For God's sake its a terrible feeling when you catch a flu leave alone a life threatening illness like cancer or stroke.By rationing health care,it is like to suggest that too bad you got sick,you got yourself in the mess you are in,sorry but we have to let you go,dude.People contribute a lot of money through taxes and other means to ensure that the government functions the way it is supposed to.People pay health insurance premiums to insurance companies not because they are sick or they will be sick but for the "if" in life,should it happen one day,so the government and the insurance companies should in return fulfill their end of the bargain.
However,much emphasis should be encouraged to quality of life rather than quantity.Life as precious as it is also has an end.No one after all is immortal and we all gonna die,its not a question of how and why,but when?To ration health care or put a price tag on human life would mean that the weakest or poorest of the society will be on the loosing end.The government instead, should put in place control measures as to which procedures and treatment are really necessary for the quality of life.
I agree and at the same time disagree with the author on the sense that people should not be left to die because they can not afford health care and the government or the public would not pay for it.However,it makes no sense to put some one who is brain dead and has multi-system failure on a life supporting machine and with no chance of ever living a normal life again for one year with a monthly cost of lets say $100000.If the treatment is really expensive but saves lives and maintains the quality of life,at all means people should have it.The author makes some really good points but also some mean ones too.
I do agree with Singer’s argument because with health care we have a limited amount of money to help save lives. If we had unlimited money, we could help anybody who had any kind of problem, but we don’t have unlimited money, and we cannot pay for every medical service for all people, even if we wanted to. Therefore I think that the author made a point about rationing healthcare, because we have to ration it, and if that is the case we should ration the money to put it to the best use possible. I like how Singer said that we should focus on getting the most quality years of life, not simply saving the most number of lives. Consider an 85 year old patient versus a 20 year old patient; suppose we only have $50,000 dollars to spend and they each require a medical intervention costing $50,000 in order for their lives to be saved. Since we have a limited amount of money, $50,000, we can’t save both of them. Therefore, we should put the money to the best use, and I agree that we should factor in how many quality years of life could be had as a result of one spending option over another to decide which treatment plan to pay for. Using the money to save the 20 year old would be better because saving his life would probably result in a larger number of quality life years than saving the 85 year old patient. The 85 year old may only live 5 to 10 more years if given the treatment (and the quality of years may not be so good), but the 20 year old could live potentially 50 to 75 more years (and for the sake of argument have at least as high or higher quality than the older saved life would have). Those are the kinds of choices that I think rationing our health care spending would make. Singer is right because we do not have an unlimited supply of money. If we did we could save everybody and do anything. Since we do not have unlimited funds, we must ration them, and the best way to do that is to make sure that the money is spent to get the greatest amount of life years with the best quality possible.
I think that Peter Singer makes a good argument in his article for rationing Healthcare but in some arguments I totally disagree. The author makes good points on the fact that current health care system is becoming increasingly costly and something has to be done. The author suggests that the way health care should be rationing is by prize. Meaning putting limits on which treatments should be paid from the public. I believe that he makes a good point but I can't agree with putting a prize on people’s life by setting a standard that would put people of scarce resource in disadvantage. If this happens people of low-income who get sick may not be able to pay some of the costly treatments for them to live a good quality of life. People of low-income need the help from other sources to be able to get some of the expensive treatments that they might need if they get ill or God for vides a horrible disease. I myself included as I was growing up I had to overcome several surgeries and had to be in treatments that were costly and my parents could not paid from their own pockets. Without the help of the public I will not be able to get my treatments and right now I will be deft without hearing or I will be having respiratory problems, who know. I also see that it will raise the premiums significantly and will continue if something is not done. I believe people who are in need of some of the costly treatments and they have a better chance to live a good quality of life should be granted the opportunity for them to receive help from other sources or the public, if they are unable to pay from their own pockets. I believe all people severely seek or with a deadly disease as well as the not so seek should be granted the opportunity to receive treatments but all weights down to what the vast majority of the people are willing to give or to pay to help those in need.
I agree with most of what the others say. We need to use the little funds that we have for the health care on people who will live after treatment longer than a few months. I don’t think it is really that they are saying that one life is better than the rest, but that some have more potential to live on. In a dream world we could save more people but we have to be realistic, there just aren’t the funds. I really feel bad that we cant do more, its hard to think that we have to choose which life is better to save. Hopefully more doctors will pull together to help those who are turned away, if possible. The government need to look out for the majority as much as possible.
The author makes a good case for rationing health care. It is reasonable to make the case for rationing health care with sky rocketing co-pays. Does the cost of prolonging a sick patients life for 6 months out weigh the interests of the healthy patient? No I believe the problem is the outrageous amounts being paid for such short term extensions of life. As the author stated if drugs are being prescribed to every one what cost should be the limit. Rationing can reduce costs for healthy patients as well as citizens who with taxes subsidize premiums companies pay for employees. A sick patients short term extension of life should not be the burden put on the whole. The individual who doesn't take care of themselves needs more health care they do not honor their social contract which in my eyes should put responsibility on their well being. The healthy are basically paying more for these irresponsible patients.
I think that is should be rationed. I think that its only in the prospective in terms of our own life that is shouldn't be for the most case. I think that there should be a limit to the amount that people receive. The author makes good cases about rationing and think that we should put a price on what is or can be done for medical pricing. I think that there are extremes on both ends that the limit shouldn't be so small but we are at the other extreme that its to much. I think we need a reform our medical system to something that will help the general public a great deal more. When we think of life everyone wants to keep living and will pay most any cost to keep themselves alive. I think that it should be to reason. Reason is hart to determine in most cases that's why its important to get a price guide that would help us judge what the cost is.
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