But this is the question being posed.

When are end of life decisions made and by whom? That is what will change. For instance can a 100 year old woman get a pacemaker? Obama said she probably should have been given some pills instead of the procedure. Should be noted that woman is 105 today. This happened at one of the President's recent town halls.

This is your clever attempt to get me to say that Obama is personally going to go around, Logan's Run style, personally exterminating those who he sees as past their expiration date. While completely adsurd, you still expect me to answer.

I don't support someone else deciding that someone is past their prime enough to let them die. All I'm saying is that if people think that now patients who face the terminal stage of chronic illness are usually counciled by their physicians to do anything other than manage pain you're sorely mistaken.

Wow. Did this really happen?

Wow.

Will he manage healthcare the same way that he was able to make the decision to fire CEOs of private sector. Does he or some other bureaucrat get the say on pulling the plug?

I was being sarcastic. That's how conservatives are making it sound, so I thought I'd try it on.

@Pale: Good for her. In all honesty if I was 100 I wouldn't want extraordinaty treatment, but that's me. Obama obviously has an opinion also. This lady's was different. But Obama is essentially saying she should have been denied treatment solely based on her age. Not only is that age discrimination, who are we to pass a law restricting treatment based on age?

The thing is that rationing is happening now. When I was diagnosed with sleep apnea, my doctor said before my sleep study that he knew I had apnea just by looking at my throat, but the insurance company wouldn't put the cost of the machine towards my deductable (I have a high-deductable insurance plan) unless I had money spent on a sleep study. $2600 later, the insurance company approved the machine. If I hadn't had insurance, I would have passed on the study and the machine altogether. But I'm sure that by the time I was in my late 40's or early 50's I would have had a catastrophic situation such as an enlarged heart that would probably have lead to my untimely demise, because I didn't have insurance and self-rationed care. That is not rationing, that is a prudent business practice. Insurance companies also may require you to get a second opinion on a procedure they think is borderline or questionable. Often this is because the doctor did a poor job providing the justification on the pre-approval.

Have you ever skipped on a procedure because the insurance pre-approval didn't go through? I'd call that rationing. Nope, never had this problem. But i wouldn't call this rationing. Rationing is when the isurance company says "well, we only allow 15 procedures of X type per month, and we've exceeded that limit.

I was being sarcastic. That's how conservatives are making it sound, so I thought I'd try it on.

@Pale: Good for her. In all honesty if I was 100 I wouldn't want extraordinaty treatment, but that's me. Obama obviously has an opinion also. This lady's was different.

So if I just replace "prudent business practice" for "rationing" then you'd be ok with it?

...

@Pale: Good for her. In all honesty if I was 100 I wouldn't want extraordinaty treatment, but that's me. Obama obviously has an opinion also. This lady's was different.

But what makes me sad about that is that I know that we are switching insurance companies AGAIN here this year because of cost. We have less than 25 employees and are paying nearly 100k annually for employee health coverage. We're also talking about dropping dental coverage to make up for rising health costs

Yes it should. From the beginning I said that I don't think that someone other than you or your doctor should be party to a medical decision.

I don't have the fear in my head that a government bureaucrat will review every medical decision that's being made. I guess that's just me though. When people talk about rationing in places like Canada (which isn't even an adequate example because what's being proposed in Congress isn't a single payer system) they're talking about non-medically necessary surgeries placed at the back of the line while life-threatening conditions that require treatment are moved towards the front.

But in all honesty, I think conservatives are going to "win" the debate on healthcare. I said a week ago or so that I thought there was only a 50-50 shot something would get passed. I think there's a 25% shot now. Congress is going to go home, get yelled at by both sides and there won't be enough support to pass anything but something watered down will pass that will run up the deficit and cover a handful more people. We'll still be in the same boat with healthcare in 5 years. I can almost guarantee it.

But what makes me sad about that is that I know that we are switching insurance companies AGAIN here this year because of cost. We have less than 25 employees and are paying nearly 100k annually for employee health coverage. We're also talking about dropping dental coverage to make up for rising health costs. My dad, a small business owner, has 8 employees. He pays for the entirety of all their healthcare- has since he's owned the business. He doesn't know how much longer he can do it because it costs so much. He told me it would be personally disgraceful if he couldn't pay premiums for everyone that works for him- he knows that it's not standard practice anymore but he likes to take care of the people he relies on.

I don't know what the answer is anymore. What's being proposed is so watered down I don't think it can change anything. On the flip side I don't think that free markets are a good approach to healthcare because in a free market there is rational choice, but the nature of the goods on offer and the actors in the market make it an irrational market. There isn't an adequate supply in my area to make a market truly competitive, and I imagine it's the same in a lot of other places.

people talk about rationing in places like Canada (which isn't even an adequate example because what's being proposed in Congress isn't a single payer system) they're talking about non-medically necessary surgeries placed at the back of the line

But what makes me sad about that is that I know that we are switching insurance companies AGAIN here this year because of cost. We have less than 25 employees and are paying nearly 100k annually for employee health coverage. We're also talking about dropping dental coverage to make up for rising health costs. My dad, a small business owner, has 8 employees. He pays for the entirety of all their healthcare- has since he's owned the business. He doesn't know how much longer he can do it because it costs so much. He told me it would be personally disgraceful if he couldn't pay premiums for everyone that works for him- he knows that it's not standard practice anymore but he likes to take care of the people he relies on.