Can we talk?

Who needs health care?

    Speaking from the compassionate point of view, I have to ask myself who deserves health care and if there is a priority list. For example, most people will agree with me that elective surgery is not a priority. But even there, when do we draw the line?

    Say someone has skin lesions, which arrive with age. Should insurance be required to cover every non-cancerous mark that offends our personal vanity? Or is there some point, where a spot might be dangerous or pose some threat because of its location, say a place on the neck where a necklace irritates it, that a doctor should treat without the third degree from insurance or the government? What if there are too many spots close together or on a person's face or neck that cause embarrassment? Can the psychological aspect justify insurance or medicaid becoming involved in payment of what might be argued as elective? Or would something like that always be the full burden of the patient?

    Those who can afford any kind of health care will get it, and the best quality in the world. (Those of us who need insurance are going to see the quality of health care go down with time, but let's not talk about the new system just yet.) Those with the financial support will always have what they need.

    Of those that remain, those of us who are not rich (either middle class or impoverished). we cannot deny emergency care to anyone. If someone's been hit by a car or is having a stroke or is bleeding to death, we can't stop and say, "Oh, no insurance. Turn him away." Any person, even homeless or drug addict, in a life and death situation need to have medical access. We cannot be a people of moral conscience otherwise.

      What about the person who needs dialysis for the rest of his life, and it appears he may live another 20 years, if treated properly? Will we take care of him? Or set a limit? Or evaluate his contribution to society (father, employed, etc.)? Do all children under 12 get treatment? How far? Chemotherapy, too? Preventive check-ups? Dental care? Vitamin therapy? Treatment for allergies and hyperactivity included? Since not every child requires all of these things, should they be guaranteed medical treatment when a doctor recommends it?

      Should all elderly get complete health care? Just because a woman is over 65 and has medicare and her late husband's Tricare (military), should she have full coverage for everything she imagines? Is it right to force her out of her own home because she shows certain signs common to senility? Medicare does not cover home care, except in the short term recovery from a surgery, and then, it's only for very brief visits, not daily administration.

      What about diabetics, long term cancer patients, heart patients, recovering stroke victims, arthritis for the rest-of-your-life patients, paraplegics,and so forth? These are people who will never be free from on-going medical costs and treatments, and who cannot afford them without insurance. What is our responsibility to them as a society? Do we say, "We'll all be better off without you. We don't care if you lose your home, can't pay your taxes, or have a personal life after you put every dime into surgeries, medicine, and equipment."?  (Maybe Logan's Run, the movie, comes to mind.)

      And what about prevention? If we make the purchase of insurance a necessity, will tests be mandated next? At a certain age, everyone will be required to do a colonoscopy? Women will be required every two or three years to do a mammogram? Men prostate exams? Blood pressure and cholesterol tests a requirement every six months after age 30?

      We can't afford to treat everyone for everything, so how do we decide? Who do we ignore? Doctors, like everyone else, need incentive. Pharmaceuticals and scientists need incentive. Insurance companies need a moral conscience as well as the high regulation they already have. We need to learn healthier lifestyles at earlier ages. But how can we say, an individual should not have health coverage? How can we turn anyone away? Can we turn away the alcoholic who's killing himself with his habit? Can we turn away the man who weighs over 500 pounds? Can we turn away the wife who keeps going back to an abusive husband? Can we tell an unemployed person he's going to be fined because he can't afford health insurance and still eat and pay rent? Can we refuse to treat the members of a gang who've been wounded by their own violence?

        So how do we give quality health care at the lowest cost to every one who needs it? That has not been addressed by anyone!