Is this biased reporting?

[Occhidiangela]

EFFING Windows Key. I pressed it at the 90% reply point and all went blank. Bill Gates must die. Let's try again, goal is now brevity.

the only way to (roughly) ensure equal access to health care is through public funding and administration

.

It is one way, and in some places it has been shown to work for availability concerns, but I am not prepared to say it is "the only way." The German system apparently works, and works well. (Any Germans still with us, please advise.)

Given the 'equal worth' argument that I offered, I intended to defend the notion that the unequal access that is resultant from the privately administered 'fee for service' model in the US is unjust.

The equal worth point needs further clarity. I do not consider a criminal (such as anyone who has entered my nation illegally) to be deserving of any medical care at the expense of The State, a state, or The System. IF there is a policy provision agreed by the electorate to provide such, then so be it. If there are charitable organization willing to provide that care, so much the better. National health care, as a system, is a matter of opportunity cost if we assume even modestly responsible governance (perhaps a bad assumption) and thus finite resources.

We can restrict the conversation to citizens and legal alien residents in the process of earning citizenship and proceed.

Justness is a rather loose consideration for access to care, since even with generally available care it is not uncommon to require a second and third opinion to get the right care versus incorrect care, which can be lethal. Is sloppy care easily available a just condition? I hope that the percentages favor a "good enough" standard, in that misdiagnosis should be rare, but I can't get equal care if the quality of care givers varies widely . . . which it does.

Here's a wrinkle: why do some Canadians come south for medical treatment if social medicine answers their needs? Is it cost or availability? I have heard both.

I know quite a few elderly Texans who go south for their care, to Mexico, due to both cost, cheaper visits, and availability of certain drugs FDA has not approved yet. They find the drive to Nuevo Laredo and back, and treatment by University of Texas Medical School alums who set up shop in Mexico (malpractice insurance premiums down there are much lower than here for example, as are other costs.)

I'm not willing to say that we ought to restrict access for the sake of a few dollars; I stand on principle and say that health care access is a fundamental right in modern society, a right that is tied to an equal right to life.

While your general theory resonates with me via "how the world should work" in an unconstrained environment, the matter of what "rights" are require societal consensus, and the concerns of a given society are a matter of sovereign exercise.

If via sovereign political processes that right is agreed and becomes policy, then amen, Chaer, is indeed a right. In the American case, you cannot overlook the issue of taxation and taxes, a critical concern of American societal structure since the nation's inception.

Since a public system requires tax revenue to support, one needs to get "buy in" from the electorate if a truly "democratic" or "republican" system is to serve its citizens. If the case can be made to show that the tax burden will be "reasonably fair" and the actual costs reduced over the current system, I think such a system would be approved. That case has yet to be made, or made well enough to satisfy the electorate, and those who shoulder the majority of the tax burden.

The deep distrust of what politicians do with the tax dollars once received, and how the funds are allocated, are a powerful disincentive to increasing the tax flow to pay for a system that, once implemented, won't be replaceable and can be, with even moderate PR campaigns, an excuse for an ever increasing tax bill due to "need to afford the health care" for _X_ reason.

Let's peek at the notion that we are equally entitled to a right to life. The self evident truths of the Declaration of Independence did not all make it into the final draft of our Constitution, the operating document for executing "the pursuit of happiness." (Trying to remember which Scottish philosopher came up with that, think it was Reid.)

Under our constitution, the rules of government, we cannot be deprived of life, liberty or property except under due process of law. That does not equal "an equal entitlement to life" irrespective all other factors, as our lawful exercise of the death penalty demonstrates. As a general rule, I think equal protection under the law generally translates to "an equal right to life" but I suspect one can dismantle that notion with a refined argument. Perhaps not.

Here, however, is the key question of free citizens in a free society: who determines the risk decisions of the citizen? The citizen, or "the government" that allegedly serves the citizen's general interest. If a citizen is willing to forgo complete health care coverage in order to afford other options, let the citizen do so. That of course assumes that all citizens will have enough resources to make that decision, rather than having the decision forced on them through paucity of means.

Part of that solution to the latter case is the general practice of "x" percentage of case load being pro bono, as in the practice of law, but such informal standards can result in overload of health resources in a given locale. It is uneven, since the demands are uneven across society.

The answer?

When a system that is 100% public can be envisioned, transitioned to, and presented to the public, particularly those whose shoulders bear the burden of peying for it, as rationally more cost effective in the long run, consensus will be achieved and such a system transitioned to. I think we will get there. I also think it will demand the implementation of "fenced money" in terms of "certain taxes are color coded to that public fund, and that fund alone. If that can't be done, the corruptibility of government will screw the resourcing of the system.

Why do I think we will get there, in time?

The Achilles Heel in the private based system, as I see it, is that layers of profit required to enable any private enterprise to provide health care is at the long term cost of "can't we squeeze another 1/2 % profit out of this operation?"

To achieve that aim, one either eliminates "waste" (whatever that means in Health Care) or one increases price to satisfy share holders. Since shareholders tend to be a "what have you done for me lately" crowd, the long term prospects are for health care costs to rise for that reason (no value added to the care receiver) as well as other reasons, (general costs of any health care system) or for "waste" to be trimmed at the margins continually with the risk that quality of health care continues the leak out of the system.

I appreciate your principles based approach, it appeals to my sense of a good place to allocate resources to strengthen the mimimum standard of quality of life in a socitey, but one cannot ignore the utilitarian factor. In a health care system, you get out of it, in the macro sense, what you put into it. It requires health care resources to run a system and provide the care to people, and those resources are finite. They do not arrive "ex nihilo" because someone needs health care.

There is no free lunch, and there is no free health care, aside from charitable trusts set up explicitly for that purpose.

And by the way, those same multi million and multi billion dollar charitable trusts are typcially funded and supported by those "capitalists" who this thread's self designated foolso disdains. Sweet irony.

Occhi