What defines the "value" of a person to the government?

You must have free medical care for all Americans

By H

Age and productivity.

My 76 year old father lives in England and recently needed hand surgery because his fingers were "clawing". The specialist told him there was no chance whatsoever that the National Health Service would pay for the operation. He had to pay out of pocket at a private facility.

Had he been a 35 year old worker the op would have been free on the NHS.

Richard

Retired people have usually put in over 30 years of federal and social security deductions...people who are working now and paying taxes and deductions are of value because that is how the government gets money without borrowing from some other country. Yes, we should lay off giving any money to other countries, especially if we are borrowing from China to pay our own bills. Until we can get our own debts under control as a nation, we really have no business helping anyone but our own people.

We can't pay for every medical intervention anyone asks for. I'd say the fairest way to allocate scarce healthcare resources is on the basis of maximizing Quality Adjusted Life Years.

EDIT:

As I understand it, Quality Adjusted Life Years are determined by asking people how many years of good health they would trade to avoid a given disability. If people say that they would as soon have five years of perfect health as ten years with a given disability, then one year with that disability is equivalent to one-half a quality adjusted life year.

Currently, the NHS generally will not fund any medical intervention that costs more than a certain amount (I believe it is something like 50,000 pounds, but I'm not sure) per Quality Adjusted Life Year. That strikes me as the fairest way to allocate scarce medical resources. Certainly better than our hodge-podge of a system. It's true that every once in a while I read some sob story abut someone in the UK being denied some intervention that may or may not tack on a few extra weeks at the end of life, but at least there you won't get stuck with a $20,000 bill after giving birth to a healthy baby. And that strikes me as more important.

I've been to two town hall meetings and listened to people's paranoid ramblings about "death panels" and "pulling the plug on Grandma," ignoring the fact that life expectancy at 65 is GREATER in the UK than it is here. If the object of the NHS is to kill off old people, they're doing a lousy job of it.

We're already past the point of diminishing returns in terms of medical interventions at the end of life. A study published in Archives of Internal Medicine compared patients with terminal cancer who had end-of-life discussions with their physicians, with those who did not. It found that the patients who did not have end-of-life discussions received more expensive and invasive treatments, suffered more, and had a poorer quality of death than those patients who had such discussions. And here's the punchline: they didn't even live any longer.

And since you bring my mother into the argument, let's talk about her. At the age of 76, my mother was out riding her bicycle and a woman in an SUV barreled past a stop sign and slammed into her, She was dead before she hit the ground. She died out in the world, doing something she loved, and taking a risk, because she knew there are more important things than clinging to life at all costs.

In regard to "pulling the plug on Grandma," I do not see what is so compelling about this vision of elderly people hooked up to respirators that people act as if it should be the central organizing principle of society.

And it may surprise you to learn that I am against physician-assisted suicide.I don't want our doctors to get in the habit of killing us. But there comes a time in everyone's life when it is time to let go. We all have a duty to die and get the Hell out of the way of the next generation.

EDIT:

I was wrong about one point. Life expectancy at 65 is slightly higher in the US. But life expectancy at birth is higher in the UK.