Facebook Challenge -- No One Dies, Really?

Well, we need something to talk about here after a months-long hiatus, especially since it will be kinda lame if all we do is live-blog Steelers games.

The innundation of status updates on Facebook yesterday about health care, including by fellow Nerdy Wonk DanNation, opened my eyes a little more on the health care debate, namely that I might be disagreeing with one of the left’s basic premises. Here’s the line: “No one should die because they cannot afford health care, and no one should go broke because they get sick.”

First, I guess I should say that I agree with the second part, that no one should go broke because they got sick. I think even staunch Republicans agree with that, at least the way it’s phrased. There’s some other things we can argue about its premise, though – does this mean that all health care should be free? That there should be an income-based cap on how much you can be charged? We’ll leave this for another post.

But I think I absolutely disagree with the first part of the argument – that no one should die because they cannot afford health care. In fact, I think that adherence to this argument will actually prevent any kind of government-sponsored health system from being implemented. End-of-life care, like basically every other medical cost, is spiraling out of control. If I was not at a new job, I might actually take some time and provide some statistics. But I think it’s fairly uncontentious statement. And then you get to crazy heart transplants and the like.
I think everyone is entitled to basic health care. And basic can include a lot of things. You get check-ups and preventive care (that only makes economic sense, after all). You get a broken bone fixed. You get catastrophic care after a car accident. You get treatment for your diseases and illnesses to either help you get better or to maintain a reasonable standard of health and life: dialysis, heart pills, chemotherapy, etc. But I think we bankrupt the system before it even starts if we say that you are entitled to every last procedure that someone with a billion dollars could pay for. Do we pay for multiple kidney transplants when dialysis isn’t working? Do we pay for hip replacement surgery for the 95-year old in poor health (or even, at all)? Do we pay for a liver transplant for an alcoholic? Do we pay for a heart transplant for someone over, say 60? I think the answer is no. If you have the money (or the private insurance), then fine. But I do not think that these advanced procedures are an entitlement. If you don’t have the money (or the private insurance) in these situations, well, then, you’re going to die. I think we have to be very up front about this. Long-shot surgeries, or procedures that merely delay death for a few weeks should not be a part of mandatory health care. We’ve got to face it that, even with a public option, some (or even a lot of) people are going to die because they cannot afford (better) health care.