Wednesday, July 19, 2017

A new kind of slavery …

… Articles: Charlie Gard Is the Face of Single-Payer.

Even at this late date, with doctors and world leaders lining up to volunteer help for Charlie, the NHS still acts on the basis that it owns the child.  His parents were not allowed to appeal.  Only the hospital had that right.

This conceit is at the center of the single-payer controversy, but no one is willing to actually argue it.  If it were debated, it would show that the "payment" idea is a diversion.  Instead, single-payer advocates have taken the position that the State owns its citizens.
Right now, I have been forced into Medicare.  I don't like it, and I would happily take an alternative, but legally, I cannot.  Further, if Medicare declares that I can't have a particular treatment, I can't even buy it for myself.  That's exactly the same situation Charlie Gard's parents are in.  The federal government owns me through Medicare.
I should note that I promised myself in my college ethics class one day that I would not take any extraordinary means to preserve my life (catholic ethics does not require that I do so). But that's my choice. Not the state's. But unlike many people, I'm not a worshiper of the state.


  1. You know, Frank, what I have been going through with insurance companies. Neither they nor employers who try to save money on what plans they arrange, should have any say in my health care decisions ~~ whatsoever, at all. They cannot be trusted. They are rewarded for getting around the expenses of ethics whenever possible.

    I used to think that it was reverse, that the state paying was the bad thing. It's true, not a good thing. Yet, having stock holders, having businesses who run for profit, for the benefit of its owners, is no way to ensure that anyone in the world gets the very best care. My life and health is no less legitimate than anyone else's in this world.

    The ideal scenario for private pay and privatization is that no claim is paid, and that we let the sickest and poorest people die. People get raises and promotions for saving insurance companies money, not for paying claims.

    We need to decide how to pay doctors and hospitals for the services that they provide. Hospitals giving out good will and getting stiffed by people who cannot pay or refuse to pay their deductibles is not the answer. It's where we've come from, which includes horrendous hospital conditions, people dying in their squalor. Good will and unpaid hospital bills send the hospitals begging for charity and tax exempt status. Many hospitals go belly up for not being able to collect enough money to cover charge offs and good will expenses.

    Everyone needs to get quality health care, and it should have nothing to do with whether you're the POTUS or a 5-year-old whose parents don't have a green cards. Hospitals cannot ethically deny good care to anyone who needs it.

    A connection that was never made in the article, is that it was only the hospital's decision to determine Charlie Gard's destiny -- how that connects to single pay. A single pay system has nothing to do with that. It has to do with a rule that needs to be changed. Also, the fact that the NHS is making decisions that the writer and others disagree with, does not in any way put a halo over the head of insurance companies.

    In Massachusetts, I had the state's insurance plan, Masshealth, and had to sue them using the attorney general's branch of the same government to get a CPAP machine that should have been covered without argument. Okay, so that's not perfect either.

    This past day, I used Medicare to pick up prescriptions, one was for over-the counter, and I had to pay full price because of that. Hey, it was only $20 for probiotics, but it was doctor ordered, just like the other stuff that cost me less than $3 out of pocket. Not perfect either, needs to be changed.

  2. There are arguments to be made both for and against allowing Charlie Gard to die. Difficult as the decision is, Noel gets some key matters wrong:

    1. It is the courts, not the NHS (proxy for Noel's despised single-payer system), which have been called to decide.

    2. Contrary to Noel's assertion that Charlie Gard's parents have not been allowed to appeal, they have in fact already appealed to the Court of Appeals, the Supreme Court, and the European Court of Human Rights.

    And Rus is right that a single-payer system most certainly could be framed to accommodate all manner of decision and appeal protocols.

  3. So far as I know, Medicare does not prevent beneficiaries from getting treatments it disapproves, i.e., meaning that it will not pay for. So long as the beneficiary pays and the doctor agrees, the beneficiary can get the treatment. When Medicare deems something not medically necessary, all this means is that Medicare is not going to foot the bill not that Medicare will somehow prevent a beneficiary from self-paying.

  4. The question here is about who is responsible for Charlie, his parents or the state. I suppose there are arguments to be made on behalf of the state's proprietorship. But you have to have a hell of lot more faith in the state than I do to entertain them. I am not a statist. Period.