[link|http://www.tpmcafe.com/blog/warrenreports/2007/jul/26/no_medical_bankruptcies_a_fact_free_analysis|TPM Cafe] has a few interesting comments on recent testimony before Congress and a rebuttal OpEd in the Washington Times. I thought one of the responses to Warren's article was quite articulate:

There was no discussion of whether a different health care system could solve Ms Smith's family's problem and how much it would cost - for example, in a state run program, would her husband have been treated at the distant Mayo Clinic, as he was in real life? No assessment of how much it would cost to give everyone in the US equal treatment and how it would be funded and then to decide if anyone is going to propose such a plan and if not whether we should put on testimony about a problem that is not going to be solved. There is also the very hard question to pose, but policymakers should pose it, to be honest with us as opposed to being liked by us: Ms Smith's testimony culminates at the point where she has to move in with a child because they are broke. The hard question is, at what point do we as a society say an individual / family can shift their costs to everyone else or conversely, what contribution does each individual/family have to make to those costs? If exhaustion of personal means is not required, what is the point we'll select, what are the principles to decide that and what is the cost of that decision?

Of course, this type of top-down analysis and thinking should be applied to just about every problem that is attacked by our government. It's a little naive to think that it would come up in detail in a short Congressional hearing, but it certainly should be part of the debate. Unfortunately, developing a consensus on grand strategies can take decades, so we end up with incremental approaches to most problems. While I agree with many of Mt57's points in principle - especially that the questions need to be asked and answered, [link|http://en.wikiquote.org/wiki/Voltaire|the perfect is the enemy of the good].

I'm reminded of a bit of a speech I heard by Mitt Romney yesterday evening on C-SPAN. It apparently was in [link|http://www.ottumwacourier.com/local/local_story_208230447.html|Ottumwa, Iowa]. He talked about how people without insurance were getting "free" care at hospital emergency rooms and how this "free" care was really costing everyone else a lot of money (though increased overhead for those with insurance, etc.). If Romney had ever been poor and experienced having little or no health insurance, (not likely, coming from a famous [link|http://www.amxfiles.com/amc/romney.html|political and industrial family] and [link|http://www.nytimes.com/2007/06/04/us/politics/04bain.html?ex=1185768000&en=a550f3b73fa16580&ei=5070|having a little money of his own]), he would know that he's telling whitewashed falsehoods. While it is true that hospital emergency rooms generally have to treat everyone they see whether they have insurance or not, they also have collections departments and collection agencies that will hound people for months and years to be paid. The idea that care is free if you can't afford to pay is ludicrous. Romney's (and many Bush Republicans's) mantra that private insurance will take care of all the problems is dangerously [link|http://www.townonline.com/hudson/homepage/x117549322|naive]. But as What's the Matter with Kansas? points out, the politics of the backlash isn't about addressing problems, it's about getting voters riled up.

Cheers,
Scott.

[link|http://www.askmehelpdesk.com/advice/t-14467.html|Help! They garnished my checking account!] And paying [link|http://www.askmehelpdesk.com/small-claims/medical-garnishment-33451.html|$10/month didn't help.]. Often people have little choice in how much they pay toward their medical bills.

Showing up without ID might work in an emergency situation like being bitten by a spider, ;-), but it won't do any good for treatment of chronic conditions - the situations where most of the expense lies.

Cheers,
Scott.