This might actually be a problem that politics just fails monumentally as a tool for fixing. Like trying to repair an MG with a herring.
There will come a time when technology will make it possible to keep someone alive indefinitely so long as you spend exponentially more money to do so. Everyone has been conditioned to think that they deserve the best healthcare regardless of what choices they've made in their lives. They will not accept that someone that has more money lives longer.
The only option is rationing. Either the naked market does it or the government does it. The perceived (and often genuine) inequality of the market practically guarantees that the voting public will demand the latter. This means that someone steps in and essentially decides who lives and dies. Some agency will perform the brutal calculus that decides that a Nobel winning scientist is a better investment to keep alive than a retired truck driver. Historically this has a terrible track record. Anyone willing to wield this power is usually the last person you'd want to actually do so.
Eventually technology will take us through this transitional period into a better time where healthcare, like food, is cheap enough that everyone can have as much as is needed and the only shortages will be caused by politics as is the case for food now.
It seems the best thing we can do as a species is knuckle down and drive through this transitional period as fast as we can. I'm kind of hoping that this current recession produces a few more of the "knuckle down and drive through" types as they seem to be in short supply these days.
As I see it the major problems of our current healthcare regime have very little to do with radical life extension and any perceived unfairness in end-of-life care.
The major problem is that we are in the hands of a criminal syndicate that is structured around extracting money from people when they are at their most weak, vulnerable and uncertain. That this criminal syndicate, which spans the health insurance, legal and financial industries and for which health care is merely the bordello on which the operations cash flow depends; is regarded as a legitimate business is merely one symptom of how corrupt our society really is.
There is an entire industry devoted to extorting money from people under the threat of illness and death. And yet those who run it are considered fine upstanding members of society; always good for a donation to a good cause.
If you go looking it's not too hard to find instances of people who paid in to health insurance for decades, only to be stripped of their coverage when they became ill.
Tying it to jobs makes it even worse, if you know you need medical coverage, you basically can't leave your job; even if it's to start a company that would produce much more value for society than the job left behind.
As it stands now, on average Americans spend twice as much and get worse health outcomes compared to the citizens of any other industrialized nation. It is a disgrace and a crime, and we need to start labeling it a crime and treating it as such.
Well said. I actually took as a given that this system will disintegrate very soon. It was unraveling even in the best of times but the current economic conditions have set it up for the final collapse. I was thinking more about the difficult task of deciding what will take its place.
I'd wager that the only people left who don't think that the entire path that money takes between patients and doctors needs to be demolished and started over from scratch are lobbyists.
At this point, the parasites have more or less killed the host. If, in the unlikely event that we Americans make no real progress on this in the next couple of years, projecting out to 2043 and talking about sustainability is entirely moot. We'll have gone banana republic long before it matters.
Edit: Perhaps I over-emphasized the end-of-life part. Got it on the brain a lot these days. The perceived unfairness will permeate the entire system. Just put the Noble laureate and the truck driver in an accident with only enough resources to save one. Who will decide, and how. If they have the power to choose the scientist, they have the power to choose their roommates cousins nephew or a big campaign donor.
Government rationing seems like the best choice. It still sucks. Bummer.
Can we discuss health care without the science fiction and doomsday scenarios?
I realize that the USA is used to looking inward for solutions, but other governments are solving these problems, better, today.
Every discussion I have with Americans about healthcare leads directly to these imagined totalitarian futures, as if "everybody" knew that this was what happens. I don't understand it. Where did you all learn this narrative? Was there some nursery rhyme about the evils of socialized medicine?
>Every discussion I have with Americans about healthcare leads directly to these imagined totalitarian futures, as if "everybody" knew that this was what happens. I don't understand it. Where did you all learn this narrative?
Pre-WWII footage of Nazi health programs, Aldous Huxley's Brave New World, the movie Soylent Green and pretty much everything William Gibson has written. We've seen just about every distopian outcome imaginable.
Star Trek counters this to some degree, but it's considered "nerdy".
The GOP has already targeted "rationing" as the evil word of the debate. Any talk of it will be demonized. I still have no clue what the answer is, but you are right, at some point we have to make calls at what point in the exponential cost curve do we say, "it is time to die." that is a tough one.
Too true. Especially considering that we ourselves are in many cases not even allowed to make this decision for ourselves.
Right now, I'd settle for just the right to say "I'd like a quadrupal shot of morphine please so that an extended stay in a miserable nursing home won't bankrupt my whole family."
There will come a time when technology will make it possible to keep someone alive indefinitely so long as you spend exponentially more money to do so. Everyone has been conditioned to think that they deserve the best healthcare regardless of what choices they've made in their lives. They will not accept that someone that has more money lives longer.
The only option is rationing. Either the naked market does it or the government does it. The perceived (and often genuine) inequality of the market practically guarantees that the voting public will demand the latter. This means that someone steps in and essentially decides who lives and dies. Some agency will perform the brutal calculus that decides that a Nobel winning scientist is a better investment to keep alive than a retired truck driver. Historically this has a terrible track record. Anyone willing to wield this power is usually the last person you'd want to actually do so.
Eventually technology will take us through this transitional period into a better time where healthcare, like food, is cheap enough that everyone can have as much as is needed and the only shortages will be caused by politics as is the case for food now.
It seems the best thing we can do as a species is knuckle down and drive through this transitional period as fast as we can. I'm kind of hoping that this current recession produces a few more of the "knuckle down and drive through" types as they seem to be in short supply these days.