Baby steps
 

Do we really want the government or insurance companies to get (further) into this sort of analysis? Brave New World, indeed.

Baby steps
 

Well, that's the danger. But we live in a world of finite resources. I've heard too many doctor-war-stories about patients who miss one appointment after another, or who let an obvious problem fester, and then rush into the emergency room demanding immediate, urgent, and very expensive care.

Would you spent taxpayer dollars keeping a 25-yo man on life support, with no help of recovery, when he suffered a head injury in a motorcycle accident that would've been avoided if he'd worn a legally required helmet? I'm not sure I would -- though, like you, I'm also not sure I like governments or insurance carriers making that decision.

(Note: Answering "I'd choose to pull the plug, but only because I'd like to watch the leaders of the Republichrist party go berserk trying to stop it" would constitute fighting the hypo.)

Baby steps
 

I regret having left the impression that I was disagreeing with your point in any significant way.

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No, but the smokers sure as hell should be paying higher premiums. I figure this is the sort of the thing that those invisible hand afficionados would love.

(Actually, they do. HIPAA's portability provision has all sorts of "no denial for preexisting condition" sort of language, like Ah-nold's proposal. Everyone pointedly ignores that though the insurance companies can't deny coverage, they sure as hell can jack up the premiums.)

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Am I on ignore? It strikes me that lots of the poor insurance-less masses smoke. Are you only concerned about the non-smokers getting covered? What does "higher premiums" mean when we're giving everyone insurance for free to make sure the poorest are covered?

Baby steps
 

Probably the same effect as cutting ten percent off a hospital bill that was twice the size of someone's mortgage and calling that a fix.

Baby steps
 

huh?

you guys are in charge now. you can't just complain. we need policy.

Are you saying, under the current system, you would be in favor of increased premiums. But in a payless system, you would forget about the smoker negative incentive?

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I was actually talking about the trend over the last couple of years where uninsured patients were suing hospitals for the size of their medical bills. Frankly, I thought that was a pretty lousy way of fixing the health care system (via lawsuit instead of policy).

I'm not sure what you mean by "payless" system, but I'm all for incentives for better health.

Incidently, the HMO concept was originally designed with the thought that a member would stick with his or her healthplan for decades. The PCP physicians, then would have incentives to educate patients on health, do screenings, get cholesterol down, etc. because they got to pocket the difference between the premiums and what actually went to the patient's healthcare over the course of the patient's lifetime. They had incentives to keep the patient's healty. What ended up happening, though, was that patients would move around from plan to plan and there wouldn't be any real incentive on the physician or the patient side to stay healthy. The HMOs now don't really look, in practice, like the models.

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everyone gets health care- even people who can't pay. in that world how do you increase premiums, or are smokers just not part of everyone?

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Dunno. That's not a system that I think works in this country. Everyone has insurance will be a system that works, but some sort of NHS / Canadian system, as I've said over and over and over again, isn't going to happen.

Supposing that Michigan were to adopt a system like Massachusetts and California have recently announced, the health care that you've been so jealously guarding over this entire debate is going to cost your employer more in premiums than the bottom of the barrel college type plan that covers just the basics a lot of the uninsured are going to get. There's going to be a descrepancy in the premiums because everyone is going to end up in a different risk pool or else the concept of insurance collapses alltogether.

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Exactly. For God's sake.

"Everyone has insurance" or "Everyone gets basic medical care" doesn't have to mean "everyone gets free neurosurgery, or free cardiac care at the Cleveland Clinic."

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Its a slippery slope and you know it. I'd venture a bet that within 3 years of NHS, Hank would be bringing suit to get his penis enlargement paid for. This expectation is what keeps me firmly in the anti-NHS camp, npi.

eta: 2000 columbia winery Chard, David Lake Signature Series, Otis Vinyard, Block 6, Dijon clone. Hi ty!

Partisan Cut N Runners
 

Who is the Congressional Democrats?

Operation Victoury in Iraq!
 

http://z.about.com/d/politicalhumor/...ofwhoopass.jpg

http://www.hetemeel.com/haha/40760.I...ss+on+you!.jpg

http://www.newprophecy.net/Cindy_She...ey_Sheehan.jpg

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You can't use the slippery slope argument, because Spanky sez the ancient Greeks proved it was fallacious.

And what do you mean when you say "NHS"? None of the programs discussed recently are anything like a National Health Service.

S_A_M