re: #5 Sharmuta

I know folks don’t want to hear it, but we DO need reform.

The right should bring some ideas to the table we can get behind.

(1) Incentives for healthy lifestyle. Allow insurance companies to give discounts or rewards for losing weight or maintaining a healthy weight, for not smoking, and so forth.

(2) Disincentives for using the ER for primary care. As, for instance, somebody comes to the ER for poison ivy, give them a voucher for a visit to a clinic. The poison ivy can wait.

(3) Preexisting condition reform. The democrats want this. Agree to it already. Make their day.

(4) Tort reform. Much of the cost of medicine is the cost of keeping the lawyers at bay.

(5) Mistake-reform. Hospitals need to have a way to own up to mistakes or bad practices and fix them without getting pilloried. We have this now with air traffic control.

(6) Admit that some things have to be rationed. There are only so many hearts out there available for transplant. Some way or other, somehow or other, one person gets it and the other doesn’t.

(7) Admit that some causes are hopeless. Extreme and heroic efforts on behalf of those who have nil or next to nil prospects should be available only upon payment by the patient or a proxy. If we really have to cut costs, or cap the growth of costs, when a woman just 20 weeks along goes into labor and delivers a (barely) alive baby, the poor kid should be let die. It is doomed. The doctors can try. They can prolong its agony. But they cannot nurse it through to where it can live to see any birthdays. [At any rate, no one has ever succeeded in the attempt. Not even once.]

At the other end, if/when yours truly has exhausted the arsenal of treatment and nothing has worked, should it come to that, another surgery on top of the other, scraping for another week in the ICU before the inevitable end comes, is just not reasonable. There is a time for living, and a time for dying.