tag:blogger.com,1999:blog-11034229.post1411823159198131081..comments2023-07-14T02:53:40.719-07:00Comments on retired doc's thoughts: Basis of Quality Adjusted life years is a fiction Ask Jeremy Benthamjames gaultehttp://www.blogger.com/profile/05537303135780186926noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-11034229.post-89827434354464255092012-08-14T23:31:34.421-07:002012-08-14T23:31:34.421-07:00(continued from above)
Another bad part of ObamaC...(continued from above)<br /><br />Another bad part of ObamaCare is to limit the choices of people both inside and outside of the system. A free market in health care is likely to provide some less expensive options, including catastrophic care plans for much less money. Government needs to keep everyone in a standard and expensive insurance contract so it can extract artificially large insurance payments from the young to provide cash for delivering health care to the old. This is a stealth tax administered by the insurance companies, applied to the young. This is how the young will be robbed. Maybe they will figure this out when they become old.<br /><br />Our Democrat politicians have found a durable principle to cement a bond between the generations. Current producers will pay taxes to support the old. In return, they will gain the right to tax their children to support them. The enduring principle is inter-generational theft under the color of law.<br /><br /><a href="http://easyopinions.blogspot.com/2009/09/obamacare-bails-out-medicare.html" rel="nofollow">Obamacare Bails Out Medicare</a><br />Andrew_M_Garlandhttps://www.blogger.com/profile/02855052302054611917noreply@blogger.comtag:blogger.com,1999:blog-11034229.post-3144474668199861332012-08-14T23:31:07.190-07:002012-08-14T23:31:07.190-07:00Our politicians have maintained themselves in powe...Our politicians have maintained themselves in power by making promises, essentially buying votes. The promises had to be dramatic and simple. The medical care promise has been "pay into the system, and we will do everything possible to keep you alive and functioning as you become old and sick".<br /><br />"Everything possible" used to be quite limited for almost everyone. Now, expensive treatments produce some extension of an enjoyable life. More of a problem, some very expensive treatments cure a few percent of people who would have died, but we can't tell in advance who will benefit. The politicians can't keep their promise, yet that promise is essential to remaining in power.<br /><br />Politicians can't keep their promise because they did not collect and save enough money (resources) to provide the promised future medical care, either at past or current costs. They didn't save anything; they immediately spent all available cash on their own incomes and on other vote buying. Any care now for the old must be pay-as-you-go by the current working population. The government told the now-old that the government was saving for their future care, but it actually saved nothing. The old were robbed when they were young, and they will be quite angry if they ever figure this out.<br /><br />The political solution must be complicated, sly, and involve middlemen to take the blame instead of the politicians.<br /><br />The first principle of government is to continue buying votes. Quality Adjusted Life Years (QALY) is better understood as Quality Adjusted Voting Years (QAVY). There is just so much money available to be spent on people who can supply votes. If the money runs out at $10,000 per QAVY, then $30,000 is too expensive and will be denied.<br /><br />When "everything possible" was limited, the collectivist (Marxist) nature of government healthcare was tolerable to most people. The program was costly and complicated, but everything possible would be done in the end. Now, it is clear that most people will die sooner for lack of funds, sooner than "everything possible". People may complain that this was not the deal they made. If they are going to be sick or die anyway, maybe they could have enjoyed their money rather than contribute it to this scheme. Maybe they could have done better. Maybe they could have saved their money and apply it now to options that the government does not see as QAVY effective.<br /><br />A bad part of ObamaCare is its control of all insurance contracts, other than those for elite politicians and union members. All health insurance must provide a list of services specified by government. Strangely, coverage limits for these may vary according to the cost of the insurance. These broad requirements make the insurance expensive. Government subsidies are supposed to make the insurance less expensive. Where are the subsidies supposed to come from?<br /><br /><a href="http://www.hoover.org/publications/defining-ideas/article/125431" rel="nofollow"><b>Richard Epstein</b></a>:<br />=== ===<br />[edited] Extensive federal regulations specify the kinds of coverage that any health insurance carrier has to supply: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, chronic disease management, and pediatric services.<br />=== ===<br /><br />There is a strong bias toward supplying insured services that a person might use in their young life, and away from providing a cheaper coverage only for catastrophic care. People will pay a large amount each year and will want a large amount of almost-free services in response. They may regard this as a good deal while they are young, as they collect a stream of moderate-cost services. They will see QAVY restrictions when they become old and expensive.<br />(continued)Andrew_M_Garlandhttps://www.blogger.com/profile/02855052302054611917noreply@blogger.com