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The Pro-Choice Party
Posted by: Jon Henke on Sunday, September 02, 2007

John Edwards says the "right to choose and the right to privacy are fundamental constitutional rights". On the other hand, he also says you're going to go see the doctor when he tells you to see the damned doctor if you know what's good for you...
Democratic presidential hopeful John Edwards said on Sunday that his universal health care proposal would require that Americans go to the doctor for preventive care.
Which one of John Edwards' two Americas gets a freedom of choice and privacy that extends beyond the uterus?

[Note: disclosure]
 
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and they finally figure it out. Next up, illegal to eat fast food, illegal to smoke, drink or drive your motorcycle.
 
Written By: josh b
URL: http://
How will he enforce this "requirement"? Sigh. The GOP leads us into wars and an interventionist foreign policy I can’t support, while the Democrats want to expand government bureaucracy and limit our choices. Is there a viable third party candidate out there??
 
Written By: Scott Erb
URL: http://faculty.umf.maine.edu/~erb/blog.htm
Why is "right to privacy" and "IRS audit" never in the same sentence?
 
Written By: Morris
URL: http://
The left believes in the "right to privacy" when they download tons of sick child dismemberment snuff porn on their computers. And um... good for them?

But they don’t want us to own property. We can’t have a home to seclude ourselves in because that land belongs to "the people" and not me.
 
Written By: jows
URL: http://
Funny, isn’t it?

Replace capitalism (i.e. you’re sickly or have bad habits, go to doctor more, pay more) with "social capitalism" (i.e. we decided you’re sickly and have bad habits, pay a premium tax).

It’s like they constantly strive to replace a system that works PERFECTLY with a system that could possibly work at 75% ideal after it’s been tweaked through a hundred years of screwups.

 
Written By: FisherOfMen
URL: http://
Let’s assume for a moment that universal healthcare is coming.

What is the main cost advantage of people having health insurance?

Preventative care!

The uninsured cost TAXPAYERS so much now because they don’t seek care until medical conditions are advanced and acute. Regular checkups and seeking early treatment for ailments are a huge part of keeping costs down.

So reconsider the idea of people being legally required to have regular checkups under threat of government force as this thread is interpreting it, and consider in the context of eligibility for this universal healthcare.

While people will not be able to opt of out paying for it (like public education), they will be able to opt of using it, preferring some private plan or pay as you go system. If someone wants to be eligible for universal healthcare, they will need to have an annual physical exam.

Of course then it’s not exactly universal healthcare, but you folks don’t want universal healthcare anyway, so I’m surprised you’re not happy about this potential development.

In this very blog I have ready many posters decrying having to pay for healthcare for people that don’t take care of themselves, some suggesting that smokers and obese people be ineligible. Well, this is a chance to move universal healthcare in this is direction.

I know it’s John Edwards, not my favorite candidate, and there are a bunch of partisans in here, but try some objectivity and gain some perspective.
and they finally figure it out. Next up, illegal to eat fast food, illegal to smoke, drink or drive your motorcycle.
No, not illegal, but it will cost you, either in additional premiums, or potentially ineligibility fot universal healthcare.

At least I hope not illegal, otherwise we’ll be adding some new laws that I’ll be breaking. I went camping this weekend and broke every one of those rules... except the fast food.

Cap
 
Written By: Captin Sarcastic
URL: http://
Cap,

NEJM did a study on this - there’s essential no statistical difference on receipt of preventative (or chronic for that matter) for the uninsured vs. those with private health insurance or government insurance.

So forcing people to go may indeed cut down on costs - but then again you’re forcing people to do something they’re not doing of their own accord - and if you’re going to force people to do things they don’t want to do, there’s much more efficient ways of bring about positive health outcomes (mandatory exercise, stomach staples).
No, not illegal, but it will cost you, either in additional premiums, or potentially ineligibility fot universal healthcare
While life insurers are allowed to charge based on medical history, other than pre-existing conditions, I don’t think private health insurers aren’t allowed to charge premiums based on BMI, history of smoking, "dangerous activities", etc. I assume this is because of a notion of "fairness" that lobbied against it. But you support differentiated pricing as long as the gov’t is "paying" for it?
 
Written By: m.jed
URL: http://
My trackback did not post
 
Written By: Don Singketon
URL: http://donsingleton.blogspot.com/
"John Edwards. He knows what’s best for you."

... or how ’bout:

"John Edwards. ’Cause he’s a trial lawyer, that’s why."
 
Written By: RC
URL: http://
NEJM did a study on this - there’s essential no statistical difference on receipt of preventative (or chronic for that matter) for the uninsured vs. those with private health insurance or government insurance.
I could find no such study in NEJM archives, so I can’t comment on it. However, I can point to studies that show that the insured are healthier than the uninsured. The uninsured are twice as likely to be in poor health, and 30% more likely to be fair health (compared to excellent health) and 20% less likely to be in excellent health.

I can’t say definitively that prevantative or early care is the difference, but logic would seem indicate it contributes significantly.
but then again you’re forcing people to do something they’re not doing of their own accord
No! You keep making this false assertion of force.

If you smoke, you pay MORE for life insurance, you are not FORCED to stop smoking, but if you want to pay less, you would need to quit smoking.

I have not made any conclusions about how unhealthy actions should be addressed in healthcare policy, I have just mentioned some ideas, and if we are going to have universal healthcare, the additional costs of these behaviors should be considered. Perhaps it’s appropriate to make no differentiation.

But asking that a person that wishes to be covered by a universal health insurance policy have a physical exam each year does not seem to be the obtrusive mandate that you all are making it out to be. Let’s say for example for the a person who chooses not to have a physical exam once a year would have a higher deductible, or some other kind of penalizing cost. This would be a choice, just as it is today.
But you support differentiated pricing as long as the gov’t is "paying" for it?


I’m not sure how I would like to address it, and you are probably right that it cannot be addressed fairly. Who’s to say that one unhealthy activity (smoking for example) should be penalized, while another unhealthy activity (no carb dieting, or any of a million other unhealthy activities) is not penalized.


Cap
 
Written By: Captin Sarcastic
URL: http://
To me, the whole "universal health care" debate is just nuts! I’ve been through anti-poverty/welfare programs that didn’t end poverty, education programs that don’t eliminate test gaps, Ponzi schemes like Social Security and Medicare sucking wind because of all the fiscally responsible devils in charge, Medicaid costs going through the roof, and now I’m supposed to believe that this is going to work? And all for a measly $120 billion dollars? Is that all? Incredible how Edwards can budget for demand like that.
Sorry my friends, but I just don’t buy it anymore. I guess Government can pull off the infrastructure game ok, and pay for Military, Police and Fire Protection, but brother, when they get into the realm of personal choices and trying to equalize everything, I just throw up my hands.
With my hands up, I guess it makes it easier to pick my pockets.
 
Written By: autot
URL: http://
I could find no such study in NEJM archives,
http://content.nejm.org/cgi/content/full/354/11/1147/T3
I can point to studies that show that the insured are healthier than the uninsured. The uninsured are twice as likely to be in poor health, and 30% more likely to be fair health (compared to excellent health) and 20% less likely to be in excellent health.
Do these studies control for behavioral factors like diet and exercise, or demographic, socioeconomic, or cultural factors? IIRC, something like a third of the uninsured have immigrated within a year, a good percentage are uninsured for 4 months or less, another good chunk are young and employed. To the extent that large sub-populations of the uninsured have similar characteristics or behaviors, changing them from "uninsured" to "insured" isn’t likely to change their health.
If you smoke, you pay MORE for life insurance, you are not FORCED to stop smoking, but if you want to pay less, you would need to quit smoking.
I understand this. As far as I know, private HEALTH insurers are prevented by law from asking these questions at any time during the application process - and if they’re not on individual policies I can speak from experience that I’ve never answered such questions for any of the providers my private health insurance - even upon enrolling, let alone once annually. Life insurers are not allowed to change the terms of their policies either, so if you’re a non-smoking, non-sky diving applicant at age 35 and pick up both habits/hobbies at age 37 and have a 20-year term policy, the chance of early death has increased, but the life insurer can’t change the terms of the policy. If you gave this option to private health insurance (and removed many of the other mandatory coverages forced on them by the State), private health insurance would be much less expensive for a basic policy.
 
Written By: m.jed
URL: http://
I understand this. As far as I know, private HEALTH insurers are prevented by law from asking these questions at any time during the application process
Woah! I never said that the answers to health questions had to be provided to the insurance company. I am talking about a standard physical performed by a doctor (or qualified practitioner) who would be required to keep the results as any doctor does today. I am just suggesting that having a record of having a physical exam once a year, not insurance companies having the individual results.

So back to the question....


But asking that a person that wishes to be covered by a universal health insurance policy have a physical exam each year does not seem to be the obtrusive mandate that you all are making it out to be. Let’s say for example for the a person who chooses not to have a physical exam once a year would have a higher deductible, or some other kind of penalizing cost. This would be a choice, just as it is today.
 
Written By: Captin Sarcastic
URL: http://
What’s so surprising about this turn of events? It’s merely the next logical step in the infantilization of Americans.

We didn’t stop it when the government took over responsibility for our retirement, and took our money to do it whether we liked it or not. We didn’t stop it when the government took over responsibility for our healthcare after we turned 65, same financial deal. We didn’t stop it when government started taking money from our employers to pay those who lose a job. It’s all for our own good, right?

We didn’t stop it when government decided what medicines we could and could not take. "Oh, you’re dying and would like to try this experimental drug? Sorry, Charlie. We have not made sure it’s safe yet! So you can’t take it, and we’ll prosecute your doctor if he helps you get it."

We didn’t stop it when the government decided we all had to wear seatbelts. They didn’t just advise us, oh no. They TOLD us. And then reinforce it all the time with smarmy commercials. The ones here in Tennessee has the usual "click it or ticket" blather, and then finishes with a stern sounding fellow waying "Tennessee is serious; we’re going to save lives!"

If/when nationalized healthcare is adopted, it’s then just a matter of time until something like Edward’s plan is also adopted. I believe that it’s inevitable. The politicians will become desperate to try anything that’s supposed to save money in healthcare. Preventative care is an obvious choice. So, liberal/left friends who support nationalized healthcare, are you ready for mandatory checkups and treatment?

And, when that happens, they can dust off those seatbelt commercial scripts and update them for the new world: "Check up or pay up! We’re serious; we’re going to save lives!"
 
Written By: Billy Hollis
URL: http://
Cap,


You’ve said both:
I never said that the answers to health questions had to be provided to the insurance company.
and
No, not illegal, but it will cost you, either in additional premiums, or potentially ineligibility fot universal healthcare.
How are unhealthy behaviors such as smoking, obesity, or participation in the X-games supposed to cost more or inhibit eligibility to universal care, if the provider can’t ask about them?

Assuming you come up with some suitable excuse for the prior self-contradiction,
I am talking about a standard physical performed by a doctor (or qualified practitioner) who would be required to keep the results as any doctor does today.
If the only behavior modification you prescribe is that of an annual physical, while still denying freedom, it’s less intrusive than what said in your initial comment.

In searching for just how much something like this would cost - not an easy task, which itself is an indication of just how screwed up our healthcare services are though not an argument for socialization - and associated benefits, I came across:

*"Standard tests rarely uncover disease and have not been proven to prolong life."

*"Health planning experts can’t find any evidence that annual physical exams benefit healthy adults."

*"I read with great interest the recent article in the ARCHIVES by Dr Gordon et al1 questioning the use of the annual complete physical examination (CPE). In 3 years of practice since completing my internal medicine residency, I have begun to suspect what Gordon et al suggest in their well-referenced article, namely, the lack of medical justification for the CPE in many cases. . .

"Gordon et al conclude with the suggestion that perhaps as many as 11 million unnecessary office visits for CPEs are made in this country each year at great expense to the health care system."


*"When subjected to careful scrutiny, a comprehensive annual physical examination with laboratory testing in unselected healthy adults has not been proven as a means for disease detection and prevention. . .In 1996, the U.S. Preventive Services Task Force changed its policy regarding annual physical exams, stating that there was insufficient clinical evidence to support the practice. The American Medical Association and other large health groups have also abandoned the notion of an annual physical, calling, instead, for testing to be performed based on individual risk factors for disease."

Regarding costs, I was unable to find any useful sources for the cost of a comprehensive physical exam [CPE]. From the NEJM article, roughly 45% of the population (135 million people) aren’t receiving recommended care. Since annual physical exams aren’t recommended for healthy people under the age of 50, the total cost, at $200 per CPE would be at least $28 bn more than the current aggregate cost of healthcare. That’s roughly 1.5% of healthcare expenditures. I don’t think it’s unreasonable to assume that in the short-run we could save 1.5% of healthcare costs due to early detection of disease, but (1) as the quotes above show, there’s no indication that an annual physical does this, (2) we’re really just deferring costs until the individual ages and the costs catch up with them, (3) there’s no guarantee that simply because a doctor tells someone to stop smoking, eat right, and exercise more that they’ll do it - and assuming I now understand your amended recommendation, there’s nothing that the healthcare financing provider (i.e., U.S. taxpayer) can do about failure to comply with doctor’s recommendations.

 
Written By: m.jed
URL: http://
Assuming you come up with some suitable excuse for the prior self-contradiction
No excuse, it was ill considered idea and far, far too intrusive. I would oppose anything more than a benefit (or lack of penalization) for those who take an annual physical exam.
as the quotes above show, there’s no indication that an annual physical does this,
If the science indicated that annual physical exams do not improve results, then I would abandon support for that position. However, I suspect that there is a way to develop a battery that provides optimal results versus costs. Consider the battery that life insurance companies used to underwrite individuals. It is inexpensive and effective for determining health risks. Consider the 30 year old guy with bad cholesterol around 210. If he doesn’t have a test until he is 44 and his bad cholesterol is 320, the cost of his treatment would be dramatically higher than the cost of the 14 blood/urine tests he had during those years, unless of course he has a fatal heart attack, in which he’ll be cheap to care for.
and assuming I now understand your amended recommendation, there’s nothing that the healthcare financing provider (i.e., U.S. taxpayer) can do about failure to comply with doctor’s recommendations.
Correct.
 
Written By: Captin Sarcastic
URL: http://

 
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