Having questions, I was going to comment on Shannon’s post, but it seemed hijacking. This is just curiosity talking.
First, comment: I’m not that cheerful that decisions about my level of productivity (by then no doubt charmingly redefined as “quality of life”) no longer warranted the expense to keep me alive. Sure, I might make such a choice, but I’d just as soon it was mine. That health care and especially research seems guided by political factions seems important – but maybe I’m wrong about that. I’m curious about others’ opinions.
Question: Something that has gone through my mind a lot in these debates is America’s responsibility (and its future role) in developing techniques and drugs. I know I’m better off than many of my relatives were at this age. (And I’m not sick, just getting old.) So, I’m thankful. Cholesterol, blood pressure, diabetes, by-pass & pace-makers – the list is endless. Indeed, I remember when mental hospitals dotted the landscape of America. Sure, some of the crazies are living on the street, but many take their medication every day and go off to work. Cancer survivors surround me – but also remind me of how terrible the cure can be. And doctors describe advances in those treatments that are still in the trial stage.
So: Am I right to think these made a difference? What policies (public or private) encourage development and innovation? How much is research driven by the greatest good for the greatest number – now? in the future? How much will any of the health plans politicians are coming up with affect these? Won’t they? I assumed we were paying for innovation and that leads to some of the expense. Is that true? Probably, the short question is – what percentage of innovation and discovery in these fields comes from America? If we didn’t do it, would it make much difference world-wide?
It really is only going to be your choice when you are rich enough to self-insure. Any other arrangement will lead to somebody else butting in and saying at some point ‘not with (my|our|the people’s) money. Unless we imitate Canada (unlikely at this point) and ban private medicine, the ultra-rich will have this. No country is rich enough that even the poor could have this choice today.
America has a special responsibility because our free-riding socialized medicine fellow members of the community of nations gave us that role. The medicine is expensive therefore more is developed here under our present legal rules, than is otherwise normal. If we join the socialized medicine crowd, money will flow away from medicine research because of lower rates of return and the rate of improvement will slow.
By my best information about 1/3 of the homeless are mentally ill off their meds and a significant number of them cycle into the justice system as well. This is a tremendous problem that is the worst of both worlds, inhumane and expensive. Perhaps we should reopen those mental hospitals, at least some of them, to improve matters?