Do rich people deserve better health care than everyone else?

[WhoCountsTheVotes]

Rich people can afford better health care, does that mean they deserve it? Is refusing health care to someone based on their ability to pay a certain price discrimination? Would it be acceptable to refuse someone health care because they are rich? A Pennsylvania court ruled in the 1980s that a woman has a right to an abortion whether she could afford it or not. Does that count for all kinds of health care?

There's also a question of scale. Some people might want to pay extra for another day in the hospital, or more tests. What about someone like George W. Bush? He can afford more health care than tens of thousands of regular Americans, if not millions. It's not just that he will pay a little extra for some extra service, he is quite literally out of the ballpark of 99% of Americans. Why does the fact that he has more Federal Reserve Notes in his pocket mean he can claim such a large share of health care?

Is this in any way just? Is this the kind of society we want?

What about a health care system where you were charged a percentage of your total wealth, as opposed to a set number of dollars? That would mean that people who wanted to put more into their health could, but the discrimination against the non-rich would be less. Each person would be valued equally and have an equal claim on our nation's health care system. You could call it a "progressive health care market".

What do you think?

[turdinthepunchbowl]

1. Deserve? Nope.

But I would be agreeable to everone having equal access to a good level of care, in that HMO's are becoming socialized more and more anyway. I think people are actually losing "choice" under this type of system.
But, I am an American who would like to do better with hard work. And as such, I would like to be able to "buy up" to a higher level if I could afford it.

[WhoCountsTheVotes]

2. what does that mean exactly?

"But, I am an American who would like to do better with hard work. And as such, I would like to be able to "buy up" to a higher level if I could afford it."

I'm an American too, and I'd like to do better with hard work - who doesn't? That doesn't change the fact that how much money you have has no relation to how much hard work you do.

As I said, "buying up" to better health care is fine, but why should one Americans be able to buy up more than another? If someone wants to spend more on health care, that's fine, as long as everyone had the same claim to health care to start with.

[northzax]

6. so you think

that someone would want to spend more on health care without an increase in return on that expense?

should we also have all housing pegged the same way? I pay more for an identical apartment that my neighbor simply because I make more? and Warren Buffet pays 2 mil a year for the same studio?

[WhoCountsTheVotes]

11. progressive market

"that someone would want to spend more on health care without an increase in return on that expense? "

of course not, someone could spend more and get an increase. The point is we could start with the same amount to spend. Unless there is some compelling reason to allow rich people to claim a greater share of health care, I don't see why that's a problem.

Housing could work the same way I presume, but not necessarily.

[Oracle]

59. Yes, because they can afford it.

If your poor, you don't deserve health insurance...if you can't work move aside and let a healthy person work, until they burn out...that's the beauty of keeping unemployment high...there's alway someone who will work for less and with no costly medical insurance to pay.

Next!

[The Backlash Cometh]

5. Not many are in favor of HMOs as they were operated.

Too much unaccountability.

[Redleg]

24. Everyone should have equal access to good quality and affordable

health care. I agree with you there.

[quilp]

54. No! All Health and Education must be on an equal playing field.

For any democracy to have any meaning.

[Muddleoftheroad]

55. Ridiculous

There will ALWAYS be better schools -- Harvard, Yale, et al -- and better care if you have money. There is no way to eliminate privilige.

[arcane1]

3. this post is begging for a Farmboxer reply... so I'll do it

Of course the rich deserve better health care. To Bush we are subhuman, and must be grateful for any kindness or assistance they can bestow upon us. The best quality health care to them is a divine right, whereas we only need to be healthy enough to continue working...


I like your idea though, but it's much too fair to EVER be accepted by the right. They'll call it something...

[WhoCountsTheVotes]

15. funny, but

what's a farmboxer? pardon my cluelessness.

Glad you like the idea, not really mine of course. I think it's pretty important, help me exand on it!

[DemBones DemBones]

19. Farmboxer is a long-term DUer, though I haven't seen him at DU2 n/t

[northzax]

4. er, 'deserve' isn't really the right word

the fact that you can pay for something better means that you get it. that applies to everything in the world, including health care. Everyone should have basic health care, no doubt. but those that can afford to pay more get more. Just like the State will provide you with a lawyer, but it ain't gonna be Martha Stewart's lawyer.

Think of it this way. If people paid a portion of their net worth for medical care, rich folks would STILL have better care that others. If Bill Gates has to pay $10,000 to get his teeth cleaned, don't you think he's going to have a wider choice of dentists that I can get with my $20? and better service? or are you going to make him pay for the exact same service? then he's just going to leave the system completely, and go private. for that kind of money, he can hire his own personal dentist to live above his garage and clean his teeth every thursday. I don't think people should pay more for a commodity simply because they can. note: government is not a commodity, and taxation is seperate)

[DemocratSinceBirth]

7. All Americans Are Entitled

to a basic level of care. Nobody should be refused necessary medical treatment because of an inability to pay.

After that you are on your own.

[JewelDigger]

8. This is a tough question for at LEAST one reason

In practicality, there are some people who run to the doctor for every little thing...real or imagined. They want every test, vacine, exam, and medical do-dad imaginable.

Then there's the people who won't go to the doctor until they've practically standing at death's door (or feel like it anyway).

Assuming that all health care is equal in quality (which it isn't), I don't even know how you can prevent the hypocondriacs (sp?) in society from using more than their fair-share of medical resources unless you charge them in some way for it. In some ways, I believe (but not sure about this) that's why there's a co-pay for a visit to the doctor's office even when you're insured to prevent some people from running to the doctor for a nose-bleed or a paper cut.

I know you are talking about health care for all the folks (rich & poor) with real medical needs, but somehow you have to consider how you would address the 'overuser' problem.

[Mairead]

12. Many physicians solve that problem neatly

Patients deemed to 'cry wolf' a lot have a little tag on their record, so that the receptionist knows how to book them appropriately.

[WhoCountsTheVotes]

13. not at all, this addresses that exact problem

If someone wants to spend all of their claim on health care for every little thing, I wouldn't want to stop them. The point is that everyone could have an equal claim on health care. How they choose to spend their claim is up to them. Individual choice.

[shimmergal]

17. Yes. Actually at least two reasons.

I just finished a temp job which involved looking at scads of medical records. Know what one of the most common causes for a visit was? Rhinitis. Basically the common cold, with runny or stuffy nose.
The doctors usually prescribed Motrin. The co-pay didn't seem to have deterred this, although long waits for appointments might (this clinic had a walk-in option.)

The second reason. Sometimes the rich and famous get _worse_ care, especially with terminal or end-of-life conditions. The tendency here is to try every procedure with a 1% chance of success, since the person can afford it and relatives/fans etc. may expect as much. Lots of suffering follows and usually it doesn't help the person at all.

[Snow]

18. And here's several more thoughts....

1) Does more expensive medicine mean better medicine?
a) some of the most effective medicine is preventive, and it tends to be the cheapest
sub a) having said that, medicare for the poor folks generally doesn't cover preventive care.
b) some of the really expensive stuff is really ineffective
sub b) for example, a place I worked at was for a while really pushing bone-marrow transplants for breast cancer treatment. It didn't work, I think they knew that, but it made big bucks - and wasn't generally covered by insurance so it was definitely medicine for rich folks.
sub b2) there was a too-doo in calif recently over a large (non-profit & that really makes a difference) HMO refusing to treat a family with 3 san filipi syndrome children with, I think, bone marrow transplant - or something along those lines. Really expensive and of doubtful effectivenesss. After a public fuss, the HMO relented & I think one of the kids got the treatment, which appears not to have worked.
b) However, a posh private hospital is sure a nicer place with more pleasant, competent caregivers than poor people hospitals (duh!). Or at least that's the way it's supposed to work, right? However, the dean of a mid-west medical school in his 50's developed a fast-growing malignant melanoma, and discovered that even med school deans, physicians, do get lousy treatment, incompetence, discourtesy, and all the rest as patients -especially as patients who are on their way to be dead fairly soon. He gave some very interesting talks about it before he died.

2) Having pointed out the difference between poor people's care, which mostly consists of the hospitals who take a lot of medicare patients and the er's attached thereto, I would like topoint out that medicine for old folks, medicaid (I hope I didn't get medicare and medicaid mixed up) has no income qualification, making it, in theory at least, same level of care for all old folks. This therefore at least for its beginning years, worked much better than the poor folks' medical care.

3) Insured standard (allopathic) US medicine, while flashy-blinky, often costs more than non-allopathic medicine (because the non-standard stuff usually isn't covered by insurance) and in some cases is less effective.
a) Case in point (rant warning); electronic fetal monitoring (EFM) during labor & delivery. Standard of care, gotta do it this way, prevent problems, right? BZZZZZZZT! Ding-dong, you're wrong! (to quote Oscar the Grouch, nearly as great a philosopher as Yogi Berra). Numerous studies during the 70's and early 80's, randomized clinical trials of EFM showed no benefit in birth outcomes. Ahh, replied the proponents. Those trials were of normal babies. EFM is most useful in the problem delivery. Okay, so three trials were done of high risk (low estimated birth weight or premature) babies - one in Dublin, one in Boston, and one in Seattle, where I as a lowly grad student did the data analysis. Guess what - no difference! But have you seen EFM disappear and be replaced by good old simple, cheap, stethoscopes? And our study was published 15 years ago!!!!
b) I have problems with chronic sinus infections and mild hypertension. Both are very problematic to treat with allopathic medicine; in fact there've been studies that show treatment of borderline hypertension is among the most expensive and least effective. However, in my personal experience and backed up by some pretty good - not great, methodologically, but pretty good - studies, acupuncture does a much better job with much less side-effects and considerably less cost.

Huff, huff - pause for hand massage - okay, there's just a few of my thoughts in the matter. Complicated, eh?

[Avalux]

9. What is the hippocratic oath?

Rendered irrelevant in today's society.
Everyone should have a right to healthcare regardless of how much money they have and it should not be tied to employment.
As it is right now, the rich and the jobless poor get better healthcare than I do. Those of us in the middle are paying out the ass for shoddy insurance.

[Davis_X_Machina]

10. But, but.......God loves the rich more...

...ergo, they receive more of this world's goods.

Under the perverted Calvinism that is this nation's unofficial official religion, it makes perfect sense that rich people deserve better health care than everyone else.

Welcome to Murka, where the Elect know they're Elect because of their material prosperity. They're not elect because they're rich, they're rich because they're elect. Taxing them at a higher rate than everybody else is to question Divine judgement. That is why a progressive income tax is heresy.

The poor are poor not because they have less money, but because they're the Preterite, damned from before the beginning of time. They're not damned because they're poor, they're poor because they're damned. To help them out is to question Divine judgement.

Reformation extremism meets Social Darwinism.

Welcome to Murka.

[Friar]

23. preterite

Belonging wholly to the past; passed by

Did you mean something else?

[PROGRESSIVE1]

14. Of Course they do!!!

:silly: they are rich, they are better than us.

(satire)

[Wonder]

16. do not get me started

Just as Lieberman suggested trying vouchers as an experiment for 4-5yrs. I say nix that experiment and trying this instead..

Those 1% of the upper crust should give america healthcare on their tab... Healthcare on the House!!

What would Arnold have to say about that I wonder, "What A Bilderberg picking up the tab?"

[pnb]

20. If healthcare (or anything for that matter) were priced by wealth...

...you run into too many problems.

First, why would physicians ever attend to poorer patients? If you're a doctor and you will be paid $100,000 to perform a task for one person and only $10 to perform the same task for someone else, what are you going to do?

Also, who arbitrarily decides on the value of medical procedures in this scenario?

In addition, if the problem is that it is too difficult to provide care to some people, how is it solving anything to make it just as difficult for everyone else? This is not a way to make things "fair" for everyone.

[WhoCountsTheVotes]

29. totally separate issue

In the USA, most people don't go to the doctor and pay cash, now do they? How much a doctor gets *paid* for his service is a separate issue than how much of a claim each person has on health care.

I'm trying to come up with a progressive, fair market solution to health care, not trying to deny anyone anything.

[pnb]

48. I did simplify the situation but it is not separate

Most of us have health insurance who then pays our physician according to the fee schedule they have negotiated for whatever procedures we have done.

If somepeople are going to pay more for healthcare then that would mean, if not directly paying physicians as you pointed out, paying the insurance companies. Those insurance companies would extract more payment from more wealthy people. Those insurance companies with more wealthy people insured will be able to negotiate fee schedules more favorable to the physicians who would then most likely use those companies. If they are going to be performing procedures anyway, they might as well perform those that will pay them the most, regardless of who actually writes them the check.

It would still work out pretty much the way I first said.

[Gringo]

21. An emphatic NO.

This is different from a Lexus or a weekend house in the country. EVERYBODY should have equal access to health care.

The government should provide basic sustenance and shelter for the homeless. I have a problem with the homeless being forced to seek help from religious cults (regardless of how well-meaning their members may be)

[Friar]

22. Health care is not a "commodity"

I don't have to personally buy the stop signs that prevent me from being broadsided at intersections. Some things are not practible from a marketing standpoint.

Health care is a prime example of Adam's "natural monopoly". Maybe that's Keynes. I'm not educated.

[zoidberg]

30. Of course health care is a commodity

You might think it unfair or cruel, but health care is a commodity. That doesn't mean that the government shouldn't step in and provide health care for those who can't afford it. Let markets work for those who can afford it. Provide subsidies of some form to those who can't. But to say that health care is a natural monopoly and should be treated differently than other services is absurd.

[Muddleoftheroad]

25. Actually yes

If I had tons of money, I could pay for any procedure I wanted or needed. Since doctors are free human beings, it is THEIR right (not the state's) to give me that service if I so choose.

I am all for healthcare for everyone, but there is a maximum that society can afford to save a patient. Suppose one tenth of the population got an illness that cost $1 million to cure PER PERSON. Would the remaining 90% of us pay over $100,000 each to save them? Could we?

Life, sad to say, is imperfect and involves tradeoffs. At the high-end (very expensive surgery, elective surgery like implants and such), wealth will always get you better or more treatment.

[WhoCountsTheVotes]

26. I think you're assuming a lot of things here

If you as an individual went to a doctor as an individual, you might have a point here. Most likely you are dealing with a regulated business, and quite possibly a corporation. Since corporations are chartered by the state, they don't have any rights.

[Muddleoftheroad]

28. Wrong again

A business has a right to serve a customer. If I walk into a store and say I want to buy something and another person walks in and outbids me, they have a right to sell the product to the highest bidder.

That corporation you speak of is made up of people who make decisions for the corporation that impact them. They have a right to make legal decisions that are best for them and the corporation.

[WhoCountsTheVotes]

31. you are either wrong, or missing the point

Corporations don't have natural rights like people do. Corporations can be regulated, and their charters can be revoked by the state that granted them. So if by "business" you mean corporation, you are wrong.

What individuals do is a different matter. Health care in this country is almost NEVER a private matter between two individuals.

[Muddleoftheroad]

32. EVERYTHING Can be regulated

So? Is that your point?

But as an individual, becoming corporate doesn't mean you lose your rights. Yes, the government can regulate it, but not to the point of taking away my livelihood. The government, for instance, can't force me to work. Can't force me to do a job.

So, if a medical "corporation" is offered $1 million to perform a surgery or $100, it has the right to choose the highest bidder if it is a non-emergency surgery. (For emergencies, triage should be cost neutral.)

[WhoCountsTheVotes]

34. an individual does not "become corporate"

When a state grants a charter of incorporation to a business, they do not "become" the corporation - the law sees the corporation as a separate, ficticious, legal entity. Saying that these ficticious, legal entities have human rights is, well, something bordering on religious at least.

"So, if a medical "corporation" is offered $1 million to perform a surgery or $100, it has the right to choose the highest bidder if it is a non-emergency surgery."

Absolutely false. A medical corporation has no rights.

[Muddleoftheroad]

35. There we disagree

Fortunately, the law will uphold my side of this.

You can't force people to do work they don't want to. THAT seems to be your goal.

These legal entities are made up of people. The people have rights as both individuals and as a group. I would think all of the pro-union types around here would recognize the desire of some people to act in concert with one another for mutual gain.

[WhoCountsTheVotes]

36. you are talking about something completely different

No one if forcing anyone to do anything. I would challenge you to quote the law that upholds your side.

"These legal entities are made up of people. The people have rights as both individuals and as a group."

Yes, and yes. The corporation itself does not have human rights. No one gives up their personal rights when they become employees, directors, or shareholders. That does NOT mean that the people involved are now the corporation - they are not.

A corporation is a specific type of legal structure. It's important not to confuse a legal structure with human beings, individually or in groups.

[Muddleoftheroad]

38. No need

I would challenge you to find instances of government forcing doctors to ignore the big bucks for the little bucks.

People form corporations for protection against suits and government intrusion. Such an action doesn't give away their rights. I know you are anti-corporate, but I'm not.

And the people ARE the corporation in many cases. A lot of corporations only have a few members. That means, if I bring in $1 million, I see a hell of a lot of that.

[WhoCountsTheVotes]

45. wait a minute

No one has suggested the government force doctors to do anything, where are you getting this from?

People form corporations, but the corporations are separate from the people involved. Humans have specific roles with the corporation, like directors, shareholders, and employees. If I am an employee of a company, that doesn't mean that I own the assets of the company, any more than the directors do. Even shareholders don't have control over the assets of a corporation - they belong to the corporation itself, not any of the individuals involved. None of the people involved in the corporation ARE the corpation.

"And the people ARE the corporation in many cases."

No, that is false.

"A lot of corporations only have a few members."

I have never heard of a corporation having "members" - they have employees, directors, and shareholders, not "members"

I guess this is all semantics, but I'm not saying any of the things you are claiming I am. And while I'm certainly not a corporate lawyer, I'm pretty sure that there is a clear legal distinction between the people involved in a corporation and the corporation itself.

[Muddleoftheroad]

50. Corporations

If you try to force people to treat one patient over another, THAT is forcing them to take a certain action.

The corporations may or may not be separate from the people involved. In a small corporation, the members (Hence the term) of that corporation are both officers and employees. They are stockholders and decisionmakers. They ARE the corporation.

So if I work for and am a part owner of a small medical corporation and you tell me, a private citizen, that my corporation MUST treat a non-emergency $100 patient over a non-emergency $1-million patient, then you are costing me money and intruding in MY life.

[WhoCountsTheVotes]

51. well of course I'm not saying that

In fact, as I stated in a previous response, I don't think the renumeration that a doctor gets should necessarily be tied to the amount of someone claim to health care they want to "spend" either.

The distinction between the officers, employees, and shareholders of a corporation and the corporation itself might seem to be nit-picking, but it has serious implications.

And why exactly is it okay to "force" care for an emergency patient, but not a non-emergency or less-emergency patient? That's doesn't seem consistent.

Another point it that you have *no* right to have a state charter a corporation for you. As an officer of a corporation, you also are not exactly a "private citizen" anymore - the fact you are an officer gives you certain responsibilities that a "private citizen" does not have.

Again, I'm not trying to nit-pick, but the distinctions are important.

[Muddleoftheroad]

52. Lots of stuff

Clearly, the private sector has the capability to pay healthcare folks more than the public one, especially for the best doctors or for high-end services. An officer of a corporation has obligation to the corporation and to himself to do the most lucrative work -- all other things being equal.

Emergency procedures have a societal obgliation attached to them that non-emergency procedures do not. That should be obvious.

An officer of a corporation is ALWAYS still a private citizen. The status as officer is additional, not exclusive. They are no necessarily chosen by the electorate.

[zoidberg]

37. What if it's a private practice?

Say I study medicine and open my own clinic. Could I then be forced to operate on some poor Joe for $100 while I could be operating on Warren Buffet for $1 million?

[Gringo]

49. Valid point

I see no reason the government should install artificial hearts in any 90-year old who wants one.

Decent, basic (especially preventive) health care should be a right.

PS to those who fear monger about nationalized healthcare - you are liars. Living in Japan for 5 years, I can tell you that the service was excellent, the premiums very affordable, no copays, much less wait time, you could go without an appointment, ambulance ride is free, and you don't get socked for using the emergency room. Our system is ultra-expensive for the consumers, and provides a horrible level of service. Don't buy into the fearmongering. It is 100% LIES.

[private_ryan]

27. deserve it or not they get it now and always will

everyone should have decent health care, however you can't expect Bill Gates or George Soros wait 3 hours in the same doctor's office as me. Money talks and if they made the money honestly more power to them.

[bluestateguy]

33. The conservative response to that question:

"YES! And if you can't afford it than you must DIE!!!! Survival of the fittest and if you can't survive than Social Darwinism says you must die (Note how conservatives love Social Darwinism when it comes to economics but hate it when it comes to the creation)!!! Under capitalism those with the money to spend get the goods and those without the money don't get anything."

[turdinthepunchbowl]

40. where does this come from?

When people see this type of post, at least the first part because I agree about the second part, they would surely get the impression that the liberals are the angry people. Comments like that are
ad-hominy, if'n you ask me.
Being in the mid-west, I get to see the conservative side on a daily basis, and have so for 36 years.
It seems that anyone needing medical care can in fact, get it. It may require the indignity of sitting for 3 hours at a hospital that will treat you. In fact, don't all hospitals have to treat you, no matter your ability to pay, if it's an emergency?
Conservative people know this, and as such go on with their lives, knowing that people are not going to die in the street due to the lack of a place to get treated. Cold hearted? Yes. But not like it's made out to be.

[Liberal Veteran]

44. Emercency care is NOT health care....

Or at the very least it is a terrible and expensive substitute for health care.

And people do die because they wait until it really is an emergency because they don't have access to real health care.

I have known people that had no insurance who literally ended up in the hospital with pneumonia because of having ONLY emergency rooms as their primary means of getting health care. That's riduclous and in a country that spends more on "defense" than the next 20 countries combined, it's an obscenity.

[SyracuseDemocrat]

39. They don't deserve it...

I mean, everyone should have the same level of health care in an ideal world. But it wouldn't be right to block people from getting health care if they can afford it and forcing everyone into a gov't health plan like Kucinich's plan offers. We'd just have long wait lines and it would be like Canada. I like Kerry and Dean's health care plans because they are incremental. With regards to the corrupt HMOs, none of this would have been possible had the Congress not passed the 1973 HMO act, which required employers with more than 25 employees to offer at least 1 HMO as an alternative to the standard health insurance plan...

[turdinthepunchbowl]

42. seg-way

and not related to the thread that much.
But I'm old enough to remember my yearly ear-ache.
We went to the doctor and paid for the service.
People used to go to the doctor when they really needed it.
It was affordable.
Then the HMO came along and people went for every little ache, driving up costs, driving up premiums, driving down coverage.

[zoidberg]

47. Wouldn't that be the fault of insurance, not HMOs?

HMOs seem to limit the reasons people go in for medical care. It's basic insurance that divorces price from cost and causes massive over-utilization of the system. I'm not defending HMOs, they have their own set of problems. But I think insurance is more to blame for what you are talking about.

[Liberal Veteran]

41. Deserve? Good lord! Of course not.

What contributions have Jenna and Barbara Bush made to society that they "deserve" better healthcare than anyone else?

So far, their only accomplishment in life is winning the womb lottery and being born into a wealthy family.

[Nederland]

43. Question

Before I answer, I need more information.

Do you think that rich people deserve anything that their money can buy? For example, do you think that rich people deserve better clothes than the rest of us? Better cars? Better houses? Better vacations?

If the answer to the above is no, then you and I have a fundamental difference of opinion on the ideas of property and wealth. If the answer to any of the above is yes, I'm curious how you would justify your response. Why do rich people deserve better housing than the rest of us? Answer that, and then I'll answer your question.

[WhoCountsTheVotes]

46. of course not

"Do you think that rich people deserve anything that their money can buy?" Of course not! How can you say that people *deserve* anything because they have money?

I don't even think this has anything to do with property, for the most part.

[pnb]

53. I disagree

A physician's time and resources can indeed be considered his/her property and for reasons I mentioned above, one way or another, they would need to be infringed upon.

[WhoCountsTheVotes]

56. of course, a physician's labor belongs to the physician

and no one said otherwise. Also no one suggested that anyone was forced to do anything.

[bluestateguy]

57. See the movie "John Q"

It's a wakeup call to the HMO's and politicians.

[JohnKleeb]

58. two words

hell no

[BushHasGotToGo]

60. Comestic care, yes. Real health care, no

But I'm more interested in boosting the care of the poor than lowering the care of the rich.