You mean the "end of life care provisions" that the 'right wing' (allegedly) falsely claimed existed? And how was that going to provide "cost savings" again, Jake? Not rationing certainly.

Wasn't the Left's claim (And yes, there's danger in trying to summarize the voice of a crowd in one line, but I'm trying to take what I see as the most reasonable counter-argument) essentially that the "end of life care provisions" weren't "death panels" as Palin had asserted?

Admittedly, Johnny Isakson(R) has pushed back in terms of having the end of life counseling sessions that he proposed in the wake of the Terri Schavio case equated with what's in the House bill. The house bill devotes 10 pages to the topic and Isakson's original bill was 2 pages. But the basic concept as Isakson originally proposed it seems sound; most expenses are run up in the last 60 days of life when the person isn't competent to represent themselves. By encouraging people to describe their wishes and appoint a person with durable power of attorney to act on their behalf if they are incompetent, considerable expenses could be avoided without rationing or government coercion.

I haven't had the time to read more deeply into this. I'm mentioning it because I think addressing this line of argument and any objections Isakson might have would improve the quality of the discussion.

Also, there are quite a few expenses in the current medical system which could be legitimately cut away. For starters; those without insurance tend to use the emergency room for routine doctors visits, which is not a cost effective way to do things. (And which essentially amounts to an unfunded mandate borne by hospitals, in many ways. How is that not socialism?)

Also, because there's no 'national health registry' or similar, if a patient doesn't have their previous lab results a doctor will often have the test re-run in order to cover themselves legally. This is another source of waste in the current system.

P.S. It's possible that Obama/the house bill may have wanted some outright rationing of end of life care in excess of what Isakson proposed. So long as a person wasn't prevented by law from purchasing their own insurance, I'd have been fine with that. I could be misinterpreting things, but I think the Democrats might have been unwilling to defend their desired reductions openly, though it's odd that those groups opposed to new socialism seemed to be staunchly defending established social programs.

Ryan!

...yes, there's danger in trying to summarize the voice of a crowd in one line...

Yes, there is. Might as well say "the right" and then lump the CAFTA conspiracists in with Sowell and Krauthammer. But generalizations are essential to dialog and learning...

By encouraging people to describe their wishes and appoint a person with durable power of attorney...

I think the problem isn't so much with Isakson's bill (haven't read it, admittedly), but more with the concern a single (governmental) entity will end up controlling care, with the obvious budget pressures which are being created by the present administration. Isakson's bill may be wrongly conflated with that (though perhaps understandable, given what you've said), but it doesn't mean the underlying concern is invalid.

But thanks for the heads-up!

Also, there are quite a few expenses in the current medical system which could be legitimately cut away...

Oh, undoubtedly! No disagreement at all. I would point to over-insurance as a huge problem, a need for tort reform, as well as the "let's use the ER" dynamic you highlight above.

Decoupling healthcare from employment seems reasonable. Another thing I heard proposed by "W", though I don't know what became of it, was that, instead of expenses above a deductible being paid for 100%, that they be paid for, perhaps 90%. Then people would see some cost for a particular procedure.

I'm just sad that I don't see more balance in the dialog.

Makes sense.

Part of the reason quacks aren't identified is because there is effectively NO DEMAND for such a system.

I would think that somehow getting people to be able to evaluate the quality of care they receive, by whatever means, and choose accordingly would be critical to having a market?

Also, I'll acknowledge that the US market is probably the engine that drives international drug development, and most proponents of price controls fail to acknowledge this. However, I also think the bans on re-importing drugs from Canada, which claim that Canadian drugs may be harmful, are ridiculous. If America has to compete economically with other countries, disproportionately high drug costs are an impediment to this. Yes, re-importation or similar practices would have a price in terms of the development of new drugs. But the disproportionately high cost of US drugs, relative to other nations also has a price.

On a related note, I'd like to see the FDA be a little quicker to approve drugs developed in Europe based on the data used there, or at least allow them for terminally ill patients. I don't know enough about the politics of the issue to be able to say why this doesn't happen now. But the FDA sometimes seems reluctant to grant approval to drugs which compete with existing drugs, which seems problematic to me.

...the US market is probably the engine that drives international drug development, and most proponents of price controls fail to acknowledge this.

Indeed: to kick a dead horse (I'm pretty sure I've said this here before, and you certainly just did) part of the reason Canadian or UK healthcare "works" is because US consumers indirectly subsidize these systems. Most people look at the cheap deals that these countries get from drug-makers and say: "Hey, why don't WE do that?" Yet if we did, and removed one of the final remaining free markets for such, such drugs would stop being developed.

However, I also think the bans on re-importing drugs from Canada, which claim that Canadian drugs may be harmful, are ridiculous.

The argument you cite certainly is. I'm in favor of the same thing because, among other effects, it would force drug companies to stop giving in to these deals with other nations, and let Canadians and Brits (and others) bear more of the real cost of their policies.

On the other hand, it might cause real havoc with humanitarian efforts to combat AIDS in Africa, creating a perfectly legal (not merely black) market for re-selling these drugs back to first-world nations, and probably ultimately making them impossible to obtain for poorer nations.

On a related note, I'd like to see the FDA be a little quicker to approve drugs developed in Europe... I don't know enough about the politics of the issue.. the FDA sometimes seems reluctant to grant approval to drugs which compete with existing drugs, which seems problematic to me.

Well, this is the old conservative point about how it's easier to control (or corrupt) something at its pivot point. Those in favor of more state control think that more regulation solves everything, but, of course, it is the wealthy who will always have the most access and clout with the regulators, legally or otherwise. When regulation fails to eliminate the human propensity towards greed, we just call for more of it, exacerbating the cycle. Russia was, for nearly a century, one of the most heavily "regulated" countries on earth. So it's not surprising (to me, anyway) that today it's also one of the most kleptocratic.

Drug companies (and other large companies) can *love* regulations, and this is a prime example of why they should.

On the other hand, it might cause real havoc with humanitarian efforts to combat AIDS in Africa

Perhaps, but the utility of such treatments are questionable even now. I'm not sure that America re-importing from Canada will have an impact on Africa, with Europe much closer by.