No matter who is providing health insurance, the private or the public sector, there is one truth that no one is honestly discussing. That is the fact that everyone dies, regardless of what is done to or for them. At some point, either they just die on their own, or medical help can no longer sustain them.

If some entity is providing health care, at some point, some person will decide that they will no longer provide whatever care is keeping the person alive.

The right-wing hysteria machine calls this decision a "death panel." But in the private sector, the decision is often made way before the end of life period in favor of profit and the withholding of care. So many patients end up suffering and dying much earlier than they would have if they had received relatively "normal" health care.

Remember that in the private sector, the motive is only secondarily providing goods or services, but primarily making a profit. For a health care company, this means taking in as much as possible in premiums, and delivering as little service as possible (to keep profits high). So in this situation, some clerk looking at claim forms acts as the de facto death panel.

Nevertheless, in whatever system of providence of care, someone, somewhere is going to make a decision based on the quality of life, the relatives' wishes, if there are relatives, and yes, the cost. It is not a happy thing, thinking about whether or not to provide care. But the choice is going to be made by some person. Doing nothing, is, by the way, a choice.

A number of years ago, the State of Oregon wisely made a list of all the medical conditions that might be covered and rated them on whether or not they would cover them. I have not been able to find this list. But IIRC, it was something like 804 conditions. Oh, I just found the list here:

http://www.oregon.gov/OHA/OHPR/HSC/current_prior.shtml


The conditions included broken bones, stitches, the usual illnesses, including viruses and cancers. One of the conditions was anecephalia, a baby born, with extensive medical intervention against the will of Nature, with no brain. This was one of the conditions they decided they would not cover.

Curiously, I also remember a piece on the news about a woman (in Florida, I think, but it doesn't really matter), who had an anecephalic baby and was insisting that the baby be kept alive with machinery at the cost of something like $500,000 dollars per year.

The questions that one must consider are whether the baby had any remote hope of anything resembling a normal life, and what were the opportunity health costs of keeping it "alive."

How many broken arms, cases of pneumonia, tonsillectomies, early stage cancers, diabetes, and other conditions would not be able to be treated if this one baby got its half a million dollars a year to keep it "alive" on machines.

I do not know the outcome of this. But someone decided either to sustain the baby and forgo treatment of all the others in need of health care, or someone decided to unplug it and let Nature do what she would have done in the first place if medical science had not intervened.

Now, some may argue that the baby in question was "entitled" to health care because it was "a life." This assertion begs the bigger question of who should get care, and what is the structure that should deliver that care.

Saul