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Health Care, Budgets & AZ's "Death Panel"

We look at state budget pressures and the new pressure to say “no” on health care.

Francisco Felix and his wife Flor Felix (AP)

Francisco Felix and his wife Flor Felix. Felix is one of dozens of Arizona patients who need liver transplants but can't get them because of moneysaving budget cuts to the state's Medicaid system. (AP)

States all around the country are scrambling to deal with gaping holes in their budgets. There are big obligations and not enough money. Many are looking hard at their Medicaid commitments.

Arizona has acted. Its governor, Jan Brewer, and state legislature, have cut off procedures that supporters say save lives. Critics now charge: “death panel.” Take your damaged heart and go. Arizona says, “What should we do?”

Other states have other problems: pulling the teeth of the poor instead of fixing them; weighing more cuts.

We look at the Arizona story, and rationing health care by budget cut.

-Tom Ashbrook

Guests:

Jocelyn Guyer, Co-Executive Director, Georgetown University Health Policy Institute’s Center for Family and Children.

Kim Vega, sister of Douglas Gravagna, who in 2006 was diagnosed with cardiomyopathy and this summer qualified for a heart transplant. In October Douglas learned that Arizona would not fund his transplant. He is hoping to raise $300,000 through the National Transplant Assistance Fund – or NTAF – so he can get on a list to get a new heart.

Monica Coury, Assistant Director, Office of Intergovernmental Relations, Arizona Health Care Cost Containment System, which is Arizona’s Medicaid Agency.

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  • geffe

    The sheer meanness of the Arizona Republican legislators denying care to save a 100 million dollars is astounding. At the same time they invoked this they cut taxes.

    This is the Republicans answer to health care. Cut taxes and if you’re not rich enough to afford that operation, too bad.

    What I find amazing is how the media was constantly reporting on the “death panel” nonsense during the health care debate last summer and now you don’t hear much about this shameful approach to health care that has been perpetrated by Republicans!

  • cory

    “Death panels” are part of our future, whether you are a lefty or rightie. We are declining and going broke, and that means telling the 95 year old with CHF that a double knee replacement just doesn’t make any sense.

    Welcome to the Brave (ugly) new world.

    Leftfield, Wisconsin

  • Lynne from Quincy

    My brother is on a transplant list here in MA. This means that (should he survive) his health will improve dramatically and he can go back to work and be a productive member of society again. Good health care is an ECONOMIC issue as much as it is a HUMANE issue.

  • Brett Earle

    The term, “Death Panels” coined by Governor Palin–and adopted by Republicans as a battlecry against
    ‘ObamaCare’–should not be ascribed to this potential tragedy, looming in Arizona.

    The phrase should not be used, here–because, in one way or another, the “Republican Attack Machine” will find a way, on the air waves, to twist this Medicaid funding matter around, and place the blame, erroneously, on the White House and the Democratic Majority in Washington.

    It is a tragic hypocrisy perpetrated by Republicans everywhere–and that would include, of course, members of the G.O.P. in Arizona–to opt for tax cuts for the wealthy…..while, at the same time, deny such life-or-death measures for medicaid recipients.

  • http://lacrosse98 sbanicki

    The single largest reason for health care costs being so high is oligopolies.

    “”Consumer advocates fear that the health care law could worsen some of the very problems it was meant to solve — by reducing competition, driving up costs and creating incentives for doctors and hospitals to stint on care, in order to retain their cost-saving bonuses.
    “The new law is already encouraging a wave of mergers, joint ventures and alliances in the health care industry,” said Prof. Thomas L. Greaney, an expert on health and antitrust law at St. Louis University. “The risk that dominant providers and dominant insurers may exercise their market power, individually or jointly, has never been greater.”””

    The above quote is from the November 21, issue of the New York Times.
    More

  • Pancake, a relative of doctors, in NC

    It’s not only a matter of access to medical services. When you get to see the “specialist” he or she turns out to be a salesperson for drugs, tests and procedures you may not need, and a recruiter for commercially framed disease categories in which you may not belong.

    I have even suspected several times, here in backward old North Carolina where ignorance is bliss, that people I knew were treated after false positives or even experimented on just to enhance revenue. I went with a relative to a cardiologist where the office ran like a mill. Every older person with good coverage was immediately scheduled for a heart catheterization.(a dangerous procedure) This dangerous diagnosis usually treated nothing, and if it caused problems, so much the better for business.

    You can talk about transplants, but organs have to be harvested from another person, and the drug regimen to prevent rejection is debilitating in itself. Most of the hearts go to wealthy men who expect to remain alpha parasites forever. I do not begrudge a young person another chance at life but escalation in the number of transplants at the present crude level of technology is barbaric. Instead of preventive and regenerative medicine I expect the next step will be robot butchery. The percentage of competent humane physicians is dropping all the time.

    So you see, even singlepayer for all would not solve the attitudinal and educational perversities inherent in predatory corporate capitalism. It would take many years to clear out the quacks. A doctor today is as brainwashed and servile to the Oligarchy as any newly minted economics doctorate. A good doctor today will be driven insane and cannot keep working. They might become a medical missionary in Haiti if they are really tough.

  • William

    Too many people chasing too few tax dollars. The economist Robert Reich has endorsed the idea of death panels so they will become more popular in the coming years.

  • geffe

    It our dysfunctional health care system. This is what causes out comes like the one looming in Arizona.

    The health care discussion should also include end of life care. To call things death panels is an interesting semantic scare tactic. However it does not deal with the real issues of how we move forward with creating a good solid decent health care system. The one we have now is broken, period.

  • Ellen Dibble, Northampton, MA

    Try to inflict reason on the non-Medicare/Medicaid health-care/health insurance industry. The profit motive doesn’t improve things AT ALL.

  • Mark

    The future of health care in America! HMO – Healthy Members Only!

  • Dan H.

    I’d like to commend the BBC reporter for asking Gov. Brewer the only question that needs to be asked (“How many people need to die before you reverse course?”) I’ve known a ton of small-market American reporters who wouldn’t have a problem with a question like that, but the large-market, Capital M Media seem to avoid confrontation like this. Cowards.

  • Ellen Dibble, Northampton, MA

    You can be denied a transplant by your primary care physician, in a well-established HMO. You’re not a viable candidate? Not worth my time? Dare you to go find a second and third and fourth opinion? Where are your lawyers? Where are your clamorous family members? There is always preferred service to some.
    But by some perversity certain services that are not that curative, mainly time-consuming and a hassle, those treatments seem to get pushed; you have to do 6 months of X before you get to Y. And maybe Y is a waste of money too.
    The privacy laws are making it MORE difficult for consumers (people) to figure out among themselves where to go or what to do to be well.

  • http://bruceguindon.com bruce guindon

    death panels are a creation of the Republican party and they will only continue to exist
    as long as the people vote against their own self interest and the only way you can have true reform in the healthcare system is to embrace a single payer plan anything short of that goal is more profit for the Insurance/ pharmaceutical mega business

  • Roer Yagonas

    On Point,

    Great show! When we allow someone else to run health care choices, which is what the last Congress desperately wanted with a single payer plan (i.e. the Government), this is where you end up.

    The Affordable Care Act comes with no funding which means someone else will decide who gets the limited funds. In the backdrop of a harsh recession, that means many people in need will have someone else decide what type and how much of the limited health care resources you will receive. You can couch this in many ways, but it is rationing by any other name.

    How have we come to this awful state in our Health Care?

    – R (Ithaca, NY)

  • Mark Durant

    Rationing is not new – and to think it is is intellectually lazy. Whether it is a stuffed shirt in a cubby at an insurance company call center, a hospital doctor, or someone in a state or federal government department making these decisions, they are all rationing. When those decisions are made in the public sector people are answerable and the process is open – in the private sector, it goes on day in and day out and is unreported. But, hey, this is THE (big, scary) GOVERNMENT. Woooo! Come on! I am British and would trust the National Health Service over Blue Cross Blue Shield any day of the week.

    Mark Durant,
    Walpole, MA

  • WINSTON SMITH

    60 Minutes had a segment on Sunday night on the “Day Of Reckoning” that is coming regarding the fact that so many of our state goverments are basically bankrupt and not paying their bill. I guess that the reason is that taxes are not high enough and need to be raised. NOT. A big part of the problem is that the stinking unions (state employees workers, federal employees, postal unions, teachers unions, etc.), in bed with the Democrats, used their political muscle to get our spineless legistlators to approve rediculously general pay/benefit/retirement packages that we can’t afford. The answer is to renegotiate these contracts or simply wait until we are broke and can’t issue the checks as they will bounce.

    Notice the common thread here. The federal goverment is broke (actually $14 trillion in debt). Medicare is bankrupt. Most of the states are broke. But we need bigger and bigger government to solve our problems.

  • Mark Durant

    …just an addendum
    So, rationing happens all the time. The lack of political will to make a system work (and pay for it) is what makes rationing fail – not the concept of rationing itself. I would rather there was a system where people didn’t die for lack of care (private or public)….period.Arizona is just as wrong as private insurance companies doing their pretzel-like contortions to avoid paying out.

    Mark Durant
    Walpole, MA

  • Jeff Rosenow

    message from Manhattan Kansas

    Arizona’s “low tax Nirvana” has been siphoning people from the midwest (and weakening our economies) for decades. Now that life has proven to be not so cheap, Arizona, RAISE YOUR TAXES. You created your own mess. You fix it!!!!

  • Josh Fieldhouse

    Politics aside, has it occurred to anyone that capitalism and a person’s health are incompatible? When one business profits from an individual’s poor health and another business from one’s good health, who’s the winner?

    OH yeah, I’m living here in Nashville, TN

  • Jim from Vermont

    The Docs have got to step up and quit milking the insurance system. My wife had fairly straightforward hand surgery. We had 3 preliminary meetings about the deal and a 20 page questionnaire to complete 2 weeks before the 1st meeting only to discover that the Doc hadn’t even read it yet. Just another billable appointment. Get to the medicine. I gave the Doc my cell number and told him we’d be back when he was ready to practice medicine.

  • SteveV

    Caller from Cambridge, Mass: Right on!!!!! But of course few people want to discuss this so…..another can kicked down the road.

    SteveV from Swanton, Vt.

  • geffe

    Mark so would I. I lived in Scotland for many years and my ex’s mother had two liver transplants on the NH system.
    She had rare disease and would have died over 20 years ago in this country due to having a preexisting condition.

    The real story here is the dysfunctional health care system.

    What the Republican governor and it’s legislators are doing here is starving the beast which is their agenda.
    The Arizona state law makers are cutting taxes at the same time! The argument is so hollow, cruel and inhuman.

  • Rick Evans

    Are lifer inmates in Arizona entitled to transplants as they are in California?

  • Mary Lou, Quincy, MA

    These horrific healthcare problems could be solved fairly easily with (1) ending the wars and taking a fraction of the money to bolster Medicaid AND Medicare. (2) Expanding Medicare downward to people who are 40 and older and requiring anyone paid through Medicare (e.g., medical equipment suppliers, etc., to document the existence and condition of the person on whose behalf the payment is being made–e.g., no payments for people “receiving services” after they’ve died or recovered. No payments to PO Boxes, etc. So cut the fraud. And (3) RAISE TAXES ON THE WEALTHY. Arizona cries “poor,” but refuses to ask those with several mansions (e.g., Ariz. Sen. John McCain) to kick in a few extra bucks to save people’s lives IN HIS OWN STATE! The blood is on the hands of those who refuse to face the political music. Higher taxes don’t kill people, but these death panels do.

  • Susan

    Lake Charles, LA – A sad situation that has no easy answer. Once again it appears that the basic problem is “who pays for it?” I would trade the 20 billion dollars wasted on foreign aid and put it into funding cases like this but would Mrs. Clinton agree? I think not.

  • jack

    Tom,

    Those in the Reactionary Party claim they support a “Culture of Life” when it comes to abortion. However, once a person is actually born, they don’t care about that same life, because health-care is too expensive to provide.

  • Craig Reisser

    The obvious solution is creating a revenue stream to support Medicare and Medicaid. We have a Federal excise tax of 30 some cents a gallon on beer, so why not institute a Federal excise tax of a nickel a gallon on carbonated soft drinks and 15 cents per gallon on “energy drinks” and dedicate all of the revenue to Medicare/Medicaid — just as the gasoline tax revenues are dedicated to the transportation sector.

    Given the link between sugar and diabetes (where the USA has a greater incidence than most other wealthy countries) such an excise tax would be appropriate. Given the price fluctuation in soft drinks at grocery stores and their automatic inclusion in fast food “combos”, a small excise tax should have little impact on consumer prices and would encourage citizens to make healthier choices.

  • http://NPROnPoint Paula

    The very wealthy in this country are not “sharing the pain” of this economic down turn.

    If the taxes on the multimillionaires were raised that would begin to help preserve some programs that are being cut.

  • Ellen Dibble, Northampton, MA

    Next time you shell out your health insurance monthly bill of say $650 (which doesn’t cover lab tests and has a $2,000 deductible), think about how that money will assist an 80-year-old who may need a transplant and many months of increasingly costly treatments all to no avail, as the person ends up dying after a couple of years of “heroic efforts,” paid for by yours truly. Meanwhile yours truly is forgoing lots of needed care until she gets into Medicare range at which point said care will begin to be affordable.
    Medicare/Medicaid has to make decisions. So does for-profit insurance. Think of the cost of AIDS medicine here versus the cost in, say, Nigeria. Think and feel confused.

  • Josh

    Tampa – I think the government needs to have a “death panel” on it’s spending programs. The President is bragging about a 4 billion dollar school lunch program and this guy is dying.

  • Rick Stewart

    The caller would like us to spend money we don’t have, because it is a ‘human need.’

    This is a recipe for eliminating all humans. I imagine the last one alive will spend his/her final moments looking for someone else to help him/her do something s/he ‘can’t do alone.’

    When hard choices need to be made, the government is not the place to look for courage.

  • Toby Burleson

    Single-payer health insurance would have eliminated the problem of people losinging their health insurance when they lose their jobs. I would be willing to bet that Gov. Brewer and the majority of residents of Arizona vigorously opposed single-payer during the health care legislative debate. When will people in this country learn to analyze policy issues rather than emotionally reacting to misinformation.

    Toby Burleson
    Columbia, SC

  • Yar from Somerset, KY

    @Winston Smith,
    If only the rich could afford medicine, doctors wouldn’t get much practice. Do you want your doctor to only operate on those that can afford it, or do you want a doctor that has a lot of experience?

    Any nation that controls its own currency is not broke, only poor in spirit.

    We have great wealth, it is controlled by a very few, until civil breakdown reorganizes the people into a much worse system.

    Yes, we must raise taxes. I think medical care should be paid for with a VAT. I am for a single payer system
    We need to work together to preserve our democracy, that means lifting up the poor through taxing those who are more affluent.
    It is better than the alternatives.

  • Margaret

    Omaha,
    The cost is due to Patents w/o obligation to provide a generic or cost adjustments until such Patent has reached end date. The medical equipment and pharma companies spend years in court trying to extend patents.
    New medical procedures and pharmaceuticals actually provide better care and more efficient cost effective. The greatest cost is to those who cannot get care receive crisis care only.
    Having Heart Disease as well as other medical disabilities I have seen procedures that are more efficient and pharmaceuticals that protect and prolong quality life.

  • Derek

    This discussion of health care and citizen health misses the point once again. It is a simple mass balance problem. The cost of healthcare imposed on the US citizenry has been unchecked as a capitalistic enterprise with a captive market, and the cost has risen unchecked. Wages and tax revenue has stayed constant. The only way to make it sustainable is to control costs as the rest of the world has. 1 – 1 = 0, and 1 – 2 = -1, and 1 – 3 = -2…

  • Erin in Cedar Rapids

    No wonder the world is turning against us! We don’t even treat our own people with dignity and respect. Tax cuts for the super wealthy and the rest of you are on your own! Shameful.

  • Joseph More, MD

    When my grandfather graduated from medical school in 1901, there was very little useful medical technology. When my father graduated from medical school in 1932, medical technology was ten times more powerful. But still very poor by current standards. When I graduated Medical school in 1958, the power of medical interventions increased another 10-fold. Now, useful medical interventions have again increased immensely, with a disproportionate increase in cost. If we continue to encourage the growth of medical technology, we shall all be eventually bankrupt.

  • Jenny

    How much money could be saved by instead cutting the number of tests that are covered? When my mom first had ALS, doctors ordered the same test 3 times, and it was totally pointless–just to confirm her diagnosis, which was a given. It seems to me that more money could be saved by just cutting coverage of repeat tests.

  • John Falcone

    Here is a simple and elegant solution: raise TAXES.

  • Martine from MA

    Here’s a suggestion to the family of Douglas who needs the heart transplant. The family should be able to take out a no interest 30 year loan from the federal government to pay back the costs of the treatment. There’s no reason for the treatment to be free. If they want the heart transplant so much, then be willing to pay for it.

  • Joe Rice

    Before Medicare existed no one ever talked about government “denying” health care to anyone. Then when the government starts to provide health care for the elderly, any restrictions come to be seen as a denial of care. Government provided health care comes to be seen as a right rather than a privilege.

  • tony p

    To say there is a death panel is a distortion of fact.

    There are panels that control the public purse strings (which are the same purse strings every tax payer in the US controls). Denying coverage is not a death sentence only a denial of payment.

    If you are on the public dole then you have little say in what is given, and should be thankful for everything you have already received.

  • Andrea

    Why does a transplant cost over a million dollars? What is the break down of those expenses? It seems the “elephant in the room” is the amount of money being charged by the medical community. Why are hospitals, doctors, etc. so costly in this country?

  • Michael Shapiro

    What is perverse in this argument is to ignore the fact that it’s about choices. I hold my fellow citizens to blame for not thinking we need to pay taxes. But even within these limited budgets choices are made. Apparently Arizona has plenty of money to arrest Mexicans and hold them in for-profit jails. Is that the choice we want?

  • geffe

    One of the issues not being discussed here is how we spend our tax dollars. The US is going to spend $84 billion upgrading our nuclear weapons and we can’t find the money to give some people health care?

    We have spent trillions on two wars that are being waged in the name of our nation and yet we can’t find the money to help the sickest people in our country. Why?

  • Kate Van Demark

    This is a tension between resources for population health and individual health. Arizona may be on the line now, but this is a conversation that the nation needs to have more of. It has surfaced in the past in Oregon in the late 70′s when its Medicaid program was stressed and in NY and the US when feeding tubes for end-stage Alzheimer’s patients were controversial. Whether government or privately paid, the more we spend on one individual, the less there is for the many across a variety of services.

  • http://www.etcr.biz Dennis

    They are cutting everything from health care to state programs with health care, even freezing pay raises in government but have they cut any of congresses pay or health insurance?

  • gretchan

    It’s easy. If we would stop going to war , we could take care of our citizens. The idea that we should not have available the latest technology is crazy. A healthy populus is a productive populus
    We could pay for everyone’s healthcare if we had the money we have wasted ,by being in Iraq.

  • Mike S

    This financial reality of paying for health care has always existed. At one time we could only blame ourselves and our position in life for our lack of affordability. Later we were able to point the finger to the big profitable insurance companies… Now that the state and soon to be federal government is responsible for paying the bills, we can blame them for our own lack of medical purchasing power.

  • John West

    Tom,
    I would suggest to the gentleman caller from Murfreesboro regarding..WWJD, that Jesus would most likely oppose the entire system of privatized medical care. I believe He would be thinking more along the lines of a system of care by the people and for the people without profits for a few wealthy doctors or corporate stockholders. I fail to understand why those who would ask “WWJD”, would be opposed to a move toward a nation free-access medical system for all.
    John West
    Cookeville, TN

  • Mark Durant

    Oh, and an error in your program. The interview with Channel 4′s reporter… Channel 4 News is NOT made by the BBC, but ITN.

  • Sharon

    This is an outrage. This country bails out reckless

  • Jenny from Cedar Rapids

    Wait a minute–Monica is saying that it’s the CITIZENRY who decides to raise taxes? It’s the LEADERSHIP. It’s time for the leadership to lead, and say “We know no one likes to pay more taxes, but people’s lives are at stake, so everyone can give a little more for the common good.”

  • B Shore

    We’re already making decisions every day, in a thousand ways, about the value we place on life.

    When you decide whether or not a particular safety feature should be on cars, or in a factory – we place a clearly identifiable value on the cost of a human life.

    The real question is whether we are being consistent in the way the tradeoffs are made. For example, are the years and quality of life saved with the tremendous end-of-life expenditures we make valued in the same way as these other procedures and treatments?

    That’s the real question, it’s a shame you never really discussed it.

  • Veronica Soell

    Please do not say my last name on air.

    My daughter lives in England and is being treated for cancer under the National Health. Her doctors are planning a stem cell transplant.

    At no time has any limitation been put on her treatment because of cost. Her treatment is at least equivalent to any treatment available in the US.

    The answer to the problem in the US is twofold. We need a single payer plan to save vast amounts of administrative cost. We need to pay more taxes.

  • Sharon

    This country bails out reckless companies, and they are going to let people die because they won’t because they

  • John

    I listened to a few minutes of your show as I drive to the library this morning and was struck by how much this story is an example of a real “death panel”. This one is the product of a state government that I’m guessing opposed the new law in general and provisions for “end of life” services in particular. Oh, the irony.

  • Peter Auster

    Our current health care insurance system is a tragedy and national embarassment. That people do not want to pay more taxes or do not sorry about the care of their fellow citizens if they have health insurance is a red herring. It is easy to look at the issue solely from a budget perspective when addressed in the abstract. However, politicians and policy makers have done a terrible job of putting a face on the problem. Like the guest on this show, who wants to tell their neighbor they will die because when a cure exists but no one wants to share in the costs of care? My wife and I have outstanding medical insurance, and I am willing to pay higher taxes to insure my fellow citizens have the same care. Most of our friends are willing to share in the costs as well. A loud and vocal minority are keeping the status quo.

  • Sadie Deppa

    I had a friend who moved from Iowa to Scottsdale, AZ after she inherited a lot of money. The money was sheltered in trust accounts, etc. She was about 50. She decided her Blue Cross/Blue Shield Ins. was too expensive and dropped it. She got breast cancer and because she had no employment income she received medicaid cancer treatment for years. She died with millions of dollars in her estate.

  • Rushton Bowen

    I agree with the caller asking “what would Jesus do” when he spoke about the influence of cost. However, this is capitalism. The bottom line is the dollar bill. This is very unfortunate, but Arizona isn’t deciding who lives and who dies. The dollar bill holds the power.

  • Ellen Dibble, Northampton, MA

    I agree with health care costs heading for the ceiling that we in both Medicare/Medicaid and paid insurance have to start with What Can Be Afforded with the Money We are Willing to Pay?
    We know the alternative. This reminds me of those mortgage plans that start at 2 percent and then the sky’s the limit. Eventually the cliff looms ahead.
    Decisions have to be made. I’ve seen plenty of people say they see death coming along, and skip the costly treatments, I’m going where I’m going. I’ll join the crowd.

  • Steve T

    The movie Sicko seems to have not been watched by a majority of posters here.
    I mean, you knew this was coming right?

  • Byron Simms

    I know that these situations are very difficult for all involved, but we need to be realistic about the entire life-death issue. Not everyone can live to be 100 years old, in perfect health, pain-free. Just because we have the technology to transplant organs and other body tissue from one person to another, does NOT mean that we are entitled to this treatment on the government’s dime.
    I’m sorry for people that are up against this dilemma, but we must come to grips with the fact that we will all die at some point, and there is no absolute right to live forever any set lifespan, at any cost.

  • Ross Fields

    I know we have heard alot about European Health Care…there are different programs for different countries…bottom line is that no one really worries about receiving healthcare…they also pay higher taxes in order to receive the services…they encourage large government but they expect good government. I feel very much for the guests brother, if he had the money or the right job it would not be an issue. Rencently my daughter had to have an emergency operation…she was one month from receiving medical insurance from her company but since it had not kicked in she is saddled with a $25,000.00 bill plus student loans. We need to really look at being a true community in this country when it comes to medical care, education and just plain taking care of each other. Thanks for listening. Ross

  • Martine from MA

    I wanted to add to my last comment. $250K is in the same price range as buying a condo or house. If a family is willing to pull together to buy a house then they should all be willing to pay for a heart transplant for a loved one.

    Another option for Douglas’ family is to hold their own fundraisers. Stop whining for a free (to them) heart transplant.

    I don’t believe in free health care. Human life is precious, but not that rare. There are almost 7 billion human beings on this planet. We can’t fix all of them at no cost to those that are sick. If they want extraordinary medical care, then they have to pay for it.

  • Rick Stewart

    It’s so easy – spend other people’s money, without limit.

    Oh yea – don’t buy insurance, but ask for compassion when the ‘unexpected’ happens.

    If a person works one 11 hour shift each weekend, at McDonald’s, they can buy their own health insurance (that’s what I do).

    Anyone who refuses to do this does not deserve our help. Our sympathy, of course, but we should not bail them out. Let’s make it clear – you should get off your butt and buy health insurance, because it sucks when you don’t.

  • Scott B

    I literally just came from having to sign DNR (do not resuscitate) and palliative care orders for my Mom. But I do so with a clear conscience because we had this conversation with her and her Dr. years ago on my Mom’s dime. Yes, it’s going to save the state some money (she’s on Medicare), but people like Sarah Palin seem to think that spending the few dollars so everyone can discuss end of life care is a gov’t “Death Panel”.

    But my mom is also almost 80, and she knew that the decisions she made about her life then were going to be different than the ones she’d have made at 40.

    There seems to be this thinking that there are a bunch of kindly old doctor making decisions at the insurance companies. Bean-counters are making many of the decisions as much as medical professional . I can’t be the only one that ever read or watched Grissam’s “The Rain Maker”.

  • Archie

    With all due respect, will the female call-in guest (not Monica…her name escapes me) please stop preceding her comments with the expression, “You know what?”

  • Archie

    Re: “With all due respect, will the female call-in guest (not Monica…her name escapes me) please stop preceding her comments with the expression, ‘You know what?’”

    It’s Kim.

  • Mark in Cambridge, MA

    We go back to taxes here. Sometime during the late 70s and early 80s, when there was still this quaint word, “stagflation”, kicking around, it was decided to address the various problems of paying for a grotesquely expensive Cold War with the boondoggles of deregulation of the financial markets, and radically reducing taxes on the richest.

    This inflated bubble after bubble, allowed the creation of false wealth by pushing little pieces of paper around, and saw the beginning of the great Outsourcing we’re now reaping the fruits of.

    We’re living in a country where a banker makes more than a doctor. That’s a problem. And it’s only been that way for thirty years. Re-regulate the markets, let the bankers and super rich wail and moan for a few years, and squeeze them for the good of the rest of us. After the last ten years, how about we have a Progressive Decade to balance things out a little.

  • Derek

    I agree with Rushton, and I’ll tell you what Jesus would do. Nothing! He’s gone. Done. Over with. Kaput. If anyone cared, the world would be a different place. In this world the good ol’ boy would be hanging out with lepers having a gal of ill-repute wash his feet raking in the cash from the water he turned into wine. Capitalism and WWJD don’t mix. Wake up and smell the oligarchy.

  • User Loser

    Medicare works? Arizona can’t do something as well as the rest of the country so they should quit trying? I’m inarticulate but at least I try to tell the truth. It’s a race to the bottom with a lot of people who are criminally incompetent making bad excuses for being mean.

  • Adrian from R.I.

    By now, should we not have learned that centrally planned health care did not work in the USSR, in China, and in Castro’s Cuba; and ObamaCare cannot and will not work either because at root it is a viciously immoral government intrusion in people’s lives. Obamacare requires violating my Inalienable Rights.
    Tom, one of your guests should have been a ruthlessly honest doctor like Dr. Hendricks who quit the medical profession. Dr. Hendricks is a famous brain surgeon in the book “Atlas Shrugged” (page 683).

    “I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”

    I wish all doctors would follow the example of Dr. Hendricks. It would then immediately become clear to all who favor socialized medicine that a gun in the hands of a brute government enforcer is no substitute for a scalpel in the hands of a skilled doctor. Doctors are not the servants of their patients. No free man is a ‘servant’ of those he deals with. Doctors are traders, like everyone else in a free society—and they should bear that title proudly, considering the crucial importance of the services they offer. However, most doctors are not capable of defending their inalienable rights on moral grounds because they subscribe to the morality of altruism (otherism). It is this code of altruism, of self-sacrifice that gives Obama such power because most of us, explicitly or implicitly, accept that the needs of some people constitute a morale claim on the ability, resources, freedom, even the lives of others. Doctors, as well as their patients, must come to understand that it is immoral to enslave doctors. Therefore, it is on moral grounds that Health Care Is Not A Right and neither is a haircut.

  • AJ North

    And so, the worm, as it were, has turned in a spectacular way. From the absurd chants about “Death Panels” in the health care “reform” that was finally passed and signed into law (along with interminable court challenges), which was, in fact, only little more than a profit-protection plan for the health “care” cartel, we are now witnessing the spectacle of actual Death Panels – here in the United States of America. Perhaps this will serve as a dramatic “wake-up call” and useful instructional moment.

    When the discussion on health care reform began, thoughtful, well-informed, reasonable and decent people argued eloquently for a single-payer system of health care delivery in the U.S., similar – but by no means identical – to systems that have been successfully employed in other nations for generations. At the very least, they argued for a “public option” Their voices were drowned out by those representing the greed of their corporate masters comprising the health care cartel and uninformed – and purposefully misinformed – people whipped into a frenzy by money-grubbing misanthropes (and perverts who believe in a profoundly warped world view that if your health is failing and you have no resources available, it not only YOUR fault, but [their] god hates you).

    Health insurance is manifestly NOT Health Care. It is long past time to give every American the right of access to health care, and the way to do that is simple, obvious and efficient: eliminate the antiquated behemoths called health insurance companies by enacting a plan similar to Medicare that covers everyone.

    As Arnold Relman, M.D. and Marcia Angell, M.D., two former Editors-In-Chief of the New England Journal of Medicine have long advocated (among many others), profit must be removed from health-care delivery in this country. Concomitant to that is what has become popularly referred to as Medicare for All – single-payer coverage (see, for example this piece by Dr. Relman: http://www.nybooks.com/articles/22798).

    Indeed, the solution is quite simpler — merely lower the eligibility age for Medicare to birth. Medicare has an overhead of 4%; the for-profit health insurance companies have an overhead greater than 25% (of course, with the U.S. placing so far down on the list of math skills of nations, that fact may be hollow).

    The absolute minimum that should be acceptable in any future legislation is a “public option.” Far and away the best overall system would be to place each and every American into a single risk pool – “Medicare for All.” On an actuarial basis, this would provide THE lowest premiums across the population; this is a fact which cannot be disputed.

    By adding the huge number of new – and generally very healthy – young people to Medicare, its trust fund will finally be solvent in the long term, and there will be no more worries for seniors about inadequate funding – nor for anyone else. Furthermore, we will save the well over 800 billion per year now wasted by insurance companies on processing and paperwork alone – not to mention the billions siphoned-off for “administration” – and as staggering profits. The fine details will always be an evolving dynamic set. But, a system created to serve the public’s interest – We, the People – and managed by professionals who operate under transparent oversight, and who ultimately answer to us through our elected representatives in response to changing needs, is how a democratic republic works – or should.

  • http://Thequestionisfairness Bob

    Modern healthcare is a gift not a tragety.

    It’s also expensive and will get more expensive as healthcare improves.

    The question is how we spread the good of modern healthcare with fairness.

    It’s only a tragety if we can’t answer this question.

    Bob
    Lancaster, MA

  • Paul

    Everyone talks about how the poor need to accept it that there are certain expensive procedures the government is unable to provide for people in certain conditions or at certain ages. Nobody ever says such things when a person of means has such procedures performed, however. Richard Cheney, for example, who had either government-funded health care or privately insured health care through a private corporation that benefited primarily with our tax dollars had many expensive heart procedures performed. I’m glad the former vice president was able to prolong his life to enjoy more time with his children and family. But why should other people be denied the same thing, simply because they lost their health insurance through a job eliminated by a recession? Where is the compassion in this country?

  • Jason

    I’m appalled that Monica Coury, who is in a position of authority with regards to Medicaid, does not sound like an advocate of the sick in her state. Instead, she sounds as though she is indifferent toward those who would benefit from the transplants that they are being denied, while at the same time bragging that Arizona provides care to people that they are not required to. As an advocate for sick people, I would much rather hear her push to find the money to care for the people she is supposed to be concerned with.

  • gefffe

    The Martine from MA and the Rick Stewart’s of the world are the real problem. Their lack of compassion is off the charts and is based on nothing more than the idea that it’s all about them. This attitude and ideology is why our nation is going down the tubes. Imagine it’s Christmas week and people like Rick Steven’s can’t even find one ounce of compassion. Amazing.

  • Ellen Dibble, Northampton, MA

    To some extent, compassion in this country is “getting religion,” is facing up to capitalist realities. Cynicism may seem sacrilegious but it needs to be deployed if health care is going to be fair to the patients as well as to the providers.
    A lot will never be fair. If you have a disease that many have, and where a profitable cure exists, you may receive lifelong supports. Insurance money will flow towards you, even if your condition is to some extent a lifestyle choice. I’m thinking of obesity and alcoholism. But I’m thinking of the mega mega costs of statin drugs that, to my very limited knowledge, are used IN ORDER TO ALLOW people to eat chocolate, eat hotdogs, bacon, cake, cream, cheese… The cost of that medication is high, yet is distributed over those who avoid those foods and therefore don’t need the drug, as well as over those who seize the opportunity to take the pill and indulge themselves. My source on the cost of the statins was an AARP monthly journal. If you are lucky enough to have cholesterol problems, you will be cured, even pampered. If you have another set of as-yet-unprofitable health problems (“no, this is not the year 2100, Virginia”), you will be paying for the care on behalf of the others.
    Single payer would not even out this inequity, that science has not caught up to utopia. But it will create more economic equity.

  • Maggie Holt

    No matter what we legislate, no matter what expenditures we allow, no matter what incentives we create or competition we encourage, humanity will continue to be subject to biological realities of life, the passage of time, the circumstances of genetics and fate, and eventually death. Sometimes I think that the “health care debate” is a childish lashing out against a sad but undeniable certainty: there is suffering, there is death. We are all finding someone else to blame for those facts of life and insisting that there is a system we can invent to improve on it.

    I pity the officials having to parse out scant resources. I pity the people waiting for transplants. I pity the advocate so certain that there is a solution without knowing the repurcussions that some other source of funding will have. Face it people! We are all pitiful…that’s bad news and good news. We are all in this together. Despite his cardiomyopathy and the holy grail of surgical transplant that he seeks, I hope that Doug can appreciate the time he does have and that he does not squander it with anger and sadness. When it comes right down to it, none of us are guaranteed a minute of the life we live. Not one breath is a right. It is a gift. It is not forever. Let’s live our best life and let’s not fight about these difficult decisions. Be glad and gracious for what we have, and trust those who govern who see a bigger picture than any one of us can see.

    What would Jesus do? Remember that Jesus was able to work miracles becuase people had faith in him. They came to Him humbly, not with a loud sense of entitlement and insistance that they had a right to new organs.

  • ThresherK

    Adrian from RI is invited to go to a free society such as Somalia or Brazil—low taxes! no crippling government!—and see what he can buy as a septugenarian cancer patient.

  • Rick Evans

    Posted by gefffe
    –”Rick Steven’s can’t even find one ounce of compassion. Amazing.”


    Hmm.
    No one named Rick Steven so were you referring to Rick Evans? If so how is it lacking compassion to ask if AZ covers the transplants of lifer felons while leaving law abiding poor people to fend for themselves? Think about it.

  • geffe

    The amount of sanctimonious dribble on this forum is outstanding. The last comment by Maggie Holt is a good example. The nerve of people telling this man to just suck it up and die. And these people seem to be Christians.

  • Richard Jay

    To help address the national problem of insuffcient financial resources to deliver substantially unlimited healthcare services ( regardless of success rates ), I suggest that each voter and each member of state and federal legislatures ask themselves this question:

    “If I am 80 years old and am suffering from a form of luekemia for which the sucess rate of treatment is only about 10% to extend life by 6 months at a cost of $100,000, and there are very young children awaiting heart transplants that for which an operation would extend life on average by 30 years with a success rate of 80% and a cost of $100,000 each, would I choose to have federal or state money spent on myself or these children?” I’m almost 75 and the answer to me is very clear.

    I suspect that relatives of older people such as me, choose to make choices largely dependent on what they ( the spouse or offspring ) want as opposed to what the person with the illness would elect, if they had their full mental faculties. Adults would be well advised to be sure they have a living will that directs healthcare providers on what they ( the patient ) want so that the right care will be provided.

    Richard, from Connecticut

    Ref. On Point Show 12/21/10

  • geffe

    I meant Rick Stevens. However your question is an interesting one. I don’t think inmates get to many heart transplants.

  • Gerald Fnord

    Yes, rationing has always been there: it’s just that when it’s rationed on the basis of who can pay enough, we don’t call it that. You may be fine with that if you believe that the Market is fundamentally normative—that people with more money deserve more because they (or an ancestor) are more useful to more people—but don’t pretend it’s not rationing.

    But if you do want a truly free market without State interference, let’s start by abolishing patents, copyrights, and artificial (State-created!) persons.

  • Don A.

    I think we can all agree that a procedure costing $1 million with a 1% chance of success ($100 million/success) can not be done. Therefore, we really should be only discussing what we (the country) can afford, not whether we can afford everything. The idea that there can NOT be rationing is ridiculous. The idea that there can NOT be a cap on heathcare costs (as in the present healthcare law) is ridiculous.

  • Rick Evans

    geffe posted ,–”I meant Rick Stevens. However your question is an interesting one. I don’t think inmates get to many heart transplants.” –

    Thanks.

  • William

    Not a very merry Christmas for this couple. It is a sad situation they and many other people find themselves in these days. Best of luck to you.

  • Don A.

    A problem with the Obama healthcare law is that it it does not limit the amount spent on healthcare, i.e. no rationing. There must be some form of rationing. There is not enough money in the world to pay for EVERYTHING that could be done to prolong the life of EVERYONE if only for a few days. If an individual wants to pay for their own healthcare, either through insurance or their own funds, let them, but don’t expect the government (the taxpayers) to pay for everything for those who receive subsidized benefits.

  • Sam

    This is what happens when capitalism becomes bastardized…

    In the stead of indulging in a healthy debate of health care availability and affordability, the repubs turned this to a travesty – spewing lies and deceiving their ignorant base of followers with phrases like; ‘death panels’, ‘you will loose
    your doctors’, ‘rationing’,’Obamacare’…..

    The issue is not with politicians misrepresenting truth but with the % of highly uneducated denizens of the land who can and are herded by a selfish greedy bund of brigands!

    It is unwise to have sympathy for these proletariats who came out swinging against a cause which would have helped them significantly…and I dont.

  • Jennifer

    Why isn’t anyone discussing the idea that AZ has the ability to look to other states for policy and budget ideas. Considering the fact that people’s lives are on the line, it would be worth it to do things like standardizing procedure costs state wide, as they have in other states. This would prevent unnecessary high costs of routine procedures, while freeing up money for the critically ill.

  • Jim in Omaha

    Doctors consider your need for their care a “right” when it is sought (the Hippocratic oath and all that) but a “commodity” when it comes time for being paid for that care. The two views are incompatible. Especially when the people who provide the care literally have no idea what they will charge you for it. If you don’t believe that, just ask whoever you deal with at a doctor’s office or hospital to tell you in advance what the cost of your procedure will be. They usually have no idea.

    If we want to give doctors the authority to control when you get the care you have a right to, then we should make them responsible for deciding how they get paid for it. Either they give it away, at their own personal expense, to those they deem worthy, or they deny it and those people suffer the consequences. Isn’t that how a free market would work?

  • George Williams

    The caller from Tenessee asked what Jesus would do. He appeared to have knowledge of Biblical texts but could not answer his own question. Of course Jesus would have performed a miracle and healed the sick person.

  • Mark S.

    The future of Tea Party, Repugnant Party Amerika:

    With apologies to Alan Grayson:

    1.) “Don’t get sick. If you get sick, die quickly.”

    2.) “Don’t become disabled. If you become disabled, see point no. 1 above.

    3.) “Don’t retire. If you do retire, die quickly.”

    Easy, isn’t it? Say, wouldn’t it make things a whole lot easier if we simply established euthanasia centers? Humane, cost-effective and profitable for the private contractors we would hire to run the system. Let’s just cut to the chase and do it.

  • Craig Reisser

    As for Adrian in R.I. – he suffers from the far right wing delusion that is Libertarianism — rugged individualism and ambitious greed from Ayn Rand’s ‘Objectivist’ philosophy. First of all, Ayn Rand is the pen name for Alisa Zinoyenia Rosenbaum, a Russian emigre novelist of bourgeios who fled St. Petersburg in 1925. Her brand of Libertarianism is to the right as Karl Marx’s Communism is to the left. Her major works, The Fountainhead and Atlas Shrugged are best sellers, but so was The Communist Manifesto and Das Kapital. We humans are by definition societal creatures — Marxist/Lenninist communism rejects individualism just as Rand’s ‘Objectivist’ philosophy or Libertarianism rejects the societal context of human experience in favor of a distorted, egotistical individualism.

    The happy medium is the humane capitalism or Social Democracy of Western Europe. Look to contemporary Germany with its relatively low unemployment, trade surplus, broad & prosperious middle class as a model. In Germany, health insurance companies (Krankenkassen) are government regulated non-profit corporations. The emphasis is on preventative medicine — per capita medical expenditures are less than half than in the USA, and average life expectancy is now longer. Originally Blue Cross/Blue Shield were patterned after this model, but now many Blue Cross providers have been bought up by for-profit corporations such as Well Point.

    Craig in Omaha

    The way forward is

  • rob nisch

    We have gone insane!Waging two needless wars,and we can not take care of our own!USA is so far behind the rest of the world on health care.Shame on us.

  • Bob Letcher from Columbus, OH

    What troubles me most is the readiness of supporters of the Arizona’s Governor’s approach to government to look back into history ONLY AS FAR back in time as 2007, when the Director of Arizona’s “medicare” program, blaming the “economic downturn”, stated that they had started to draw attention to the $1 BILLION problem in 2007; AND, at the same time fervently avoid accepting responsibility for G.W. BUSH’s hard-headed economic policy, imperialist wars, and that same “economic downturn”, which they caused and which Mr. Bush’s leadership, back in 2001.

    Also, the size of the pot (of money) is not at all like he weather blowing into
    Tucson; rather, it’s a direct reflection of the ideology that suits “the haves” at the expense of “the have-nots” (much as a certain K. Marx wrote a century and a half ago).

  • http://www.pretirement.blogetery.com Dan Wilson

    The group that is left out in the cold are those baby boomers with health needs who were laid off and lost their insurance, insurance companies won’t have them and their is no chance they will be able to resume a career. They are the pretired. Check out my blog at http://www.pretirement.blogetery.com and leave your comments.

  • http://n/a Kristina

    I live in central Ohio.
    I found this morning’s broadcast to be disturbing by its lack of setting clear definitions. The host should be embarrassed, repeatedly demanding the AZ spokeswoman to talk about “how it feels.” Our lack of leadership is showing in so many ways:
    1) We need an honest debate on whether or not we are going to care for all Americans, or whether we continue the current patchwork of profitable health businesses. We have never had a comprehensive system, only private medical practices with a few public programs for carefully defined subgroups.
    2) We need to acknowledge that there are different levels of health care. The AZ family agonizing about a heart transplant should not be allowed to squash discussion of the less dramatic needs that have long term impact, such as nutrition regulations for schools. A program that does not generate emotional hysteria may actually offer excellent payback in terms of overall public and individual health.
    3) Just because the politicians and their fanatical supporters are using labels as excuses not to have serious discussions doesn’t mean the rest of us have to follow suit. That includes media workers, who should be leading the charge for careful research and responsible discussion, balanced with both good information and emotion–not just interviewing people in an extreme state of distress.

    Thank you for listening.
    Kristina from Ohio

  • Gretl

    As an arizona resident, I am becoming more and more ashamed if my state. I’m a school teacher at a”failing school”which now describes many public schools in the state. Our hispanic students are becoming disengaged because of the attacks on their legality. Our governor has no solutions except to attack democrats, and our aging populations don’t vote to fund public services.

  • Jennifer

    from Massachusetts: I can’t even believe that denying critical care is even up for discussion. Anyone ok with that here lets see what you say if and when you are faced with the issue. the lack of empathy is astounding. and furthermore, I can’t believe that anyone is just accepting that money runs out and people die? So let me get this straight, blame is not on the state, these things just happen? NO other states are taking away lives because of their in competencies. What is wrong with people? this is just insane.
    I LOVE what Craig wrote about libertarianism. Thank you!
    This form of conservatism doesn’t work. It proves to us over and over that it doesn’t, yet people cling hard to it’s claims. Dogma

  • Jean

    As a resident of Tucson Arizona, I am embarrassed by the behavior of the politicians in charge of the state.
    They have created a death panel in the Medicaide program at the same time they are proposing lowering taxes for the wealthy.
    They are just pretending that their hands are tied–no one’s hands are tied. This death panel is the will of the Republicans in charge of the state legislature and governor’s office. Now the AZ governor is trying to get permission from the federal government to decimate the state’s Medicaide program in order to reward the wealthy of the state once again. AZ State Sen. Russell Pearce wants to opt out of Federal Medicaide dollars. The final goal of this administration in AZ is to get rid of Medicaide entirely.

  • Kara

    I did not like this discussion.

    The opening BBC sound bite set a poor one-sided tone for the overall program. The BBC reporter cornered Jan Brewer into giving a fumbling defensive answer by posing a question that was a thinly veiled insult. This is not a way to start a “discussion”.

    That was followed with endless “I know there are budget cuts, BUUUUUUUUT here’s a tragic personal story. And, by the way, you’re a bad person if you support this program cut.”

    Seriously?! All complaints and no thanks to AHCCCS that supports soooooooo many other programs that people take advantage of every day! As an Arizona resident, I see the hardships facing our state. It’s time for people to stop vilifying government agencies that are doing the best they can with the limited resources they have.

    I appreciate Monica Coury for coming on the show and think she did a good job not taking personally the mud being thrown at her. Thank you Monica for plainly explaining the state’s decisions and know that you do have some supporters that value and understand the difficult choices that you have to make on our behalf every day.

  • http://rlkuykens@comcast.net ron kuykendall

    the issue seems to be $100,000,000–how many elected politicians, their staff members, and support staffs have taken a cut in income–(our taxes)–all the rest of us have taken cuts,layoffs,unemployment- why not politicians? would not a 10% decrease in all these relatively non essential positions enable those approved for transplants to live- and maybe help to keep a few essential police or firemen on the street-to where has our sense of priorities disappeared ?

  • Paul

    I’ve seen opinions that the cuts are pure “meanness”.

    This mentality reminds me of “crazy cat lady” who, feeling sorry for starving cats, adopts all that she can find. Laudable. But before you know it she has 200 of them in a two bedroom apartment. And we know the rest of the story…they suffer more as a result.

    I feel for those who can’t afford all that this country offers, but there IS a breaking point. Unless you WANT an ineffective, oppressive, and incompetent gov’t (e.g. Communism), inequality is a FACT OF LIFE. And even under Communism, it’s still a FACT OF LIFE.

    When there isn’t enough to go around, there isn’t enough to go around. And lying to oneself doesn’t change that.

  • Marc

    We really love to put things in simplistic terms. It’s the evil insurance companies, or the greedy rich, or the bad republicans. Of course, outside of public radio, they pick on the illegal immigrants, sleazy lawyers and over-regulation. A system this complex where the same group determines supply and demand is bound to become unsustainable. Add the emotional factor that people’s lives are at stake and “you can’t put a price on a life” and you have the system we have today.

    So, I’m with Kristina in her suggestions of honest debate rather than over-relying on our feelings or simply throwing labels around. We need to define policy based on data not heart-wrenching anecdotes. We got into this mess when HMOs were vilified for trying to control costs, so they stopped and simply let premium’s rise (according to a This American Life show). Single payer (which I’m for) won’t change things, just hide it by taking money from the taxpayers until we have a much bigger problem.

    I give Coury credit for having the guts to give some tough love to an audience that thinks more with their hearts.

  • Ellen Dibble, Northampton, MA

    I think OnPoint was right to get the bleeding hearts part of the debate right up front and specific to one individual with a life at stake.
    This approach is much simpler than making callers or theorists hypothesize this or that times the millions of people whose health would be improved or lives would be saved with greater health care provisions. It gets to the heart of the problem, it seems to me, which is that 20 years ago, individuals might be able to afford their own care even without insurance. Nowadays, the care available for the same rather common conditions cost many multiples. Decisions have to be made. There are political decisions and personal decisions and medical decisions. I think they managed to sort of nail down the Help-Me-I’m-Dying corner of the debate with exactly the example we had. There are at least three other corners.

  • peter nelson

    “The term, “Death Panels” coined by Governor Palin–and adopted by Republicans as a battlecry against
    ‘ObamaCare’–should not be ascribed to this potential tragedy, looming in Arizona.”

    By that argument we shouldn’t say anything because the conservatives will twist it.

    We need to grow some cojones and take the lexical battle to the conservatives. In this case they’ve done all the hard work of putting “death panels” in the lexicon and we can ride that big stinking bull right into their livingrooms. “Death panels” is exactly what this is and progressives need to be plastering the image of poor people dying, or living in misery because they can’t afford needed medical care while rich fat cats schedule their surgery at their convenience.

  • William

    “Death Panels” is tied to Obama like “Neo-Cons” is tied to President Bush. Both sides have their little play on words to obtain certain results.

  • http://www.beccar.wordpress.com Eugenia Renskoff, Brooklyn, NY

    Hi, Tom, Why not just have health care, period? No death panels, no nothing except being able to go to the doctor when you need to? Or is this idea just too simple? Eugenia Renskoff

  • http://www.metaphysics-for-life.com Ilana

    How much will it take to convince people that the question is not “do we have the money for this?”, but rather “do we have the resources for this?” The answer is “yes, yes we do have the technology, skills, people, etc. etc. etc.” It’s not Arizona’s fault – it’s not anyone’s fault. We are addicted to a money-based economy and that is the only reason why this crisis exists.

    Maybe this financial crisis will at last motivate humanity to move beyond money to a resource-based economy. I can only wish and hope!

  • Bush’s fault

    Great forum, as always, right cory? As usual, the utopian dreamers want to confiscate the wealth of the rich to finance their impossible dreams. This bolshevik attitude is counter to the basic instincts of Americans and has proved a failure with Hillarycare, Obamacare, and any other socialized “care” you wish to invent, AND, in the tradition of unintended consequences, enabled the creation of the successful Tea Party movement. Besides, the rich don’t get mad, they get even…take it from someone who isn’t rich.

    I agree that there was never an attempt at real health care reform, only a money grab by the amateur bolshevik thugs who failed.

    To conclude on a positive note: there is always Germany for those of you who think the grass is greener.

  • Bush’s fault

    PS: Bottom line of this forum for the past three or four years seems to be that the Republicans can’t be beaten. Republicans have apparently created a national and global disaster in every realm, but the democrats can’t seem to make a difference. I’m all ears.

  • david

    President Obama recess appointment of Dr. Donald Berwick has some answers.
    Berwick will run the Centers for Medicare and Medicaid Services (CMS)
    In his own words:
    “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”

    “Even the New York Times has taken notice of Berwick’s controversial nomination. Robert Pear reported last month: “Long before the uproar over ‘death panels’ last year, Dr. Berwick was urging health care providers to ‘reduce the use of unwanted and ineffective medical procedures at the end of life.’”

    I hope he was just thinking out loud!

  • Tim G

    The root of this problem is our wildly out of control healthcare system. If our legislators would have REALLY fixed this problem with a meaningful healthcare reform bill, this discussion would not be taking place

  • http://www.healthcare4allpa.org Cindy

    Your show was absurd! I was the lead researcher in a study in 2009 that showed all the public employers (municipalities, school districts, counties, state government) in Pennsylvania would save $2.3 BILLION per year on employeee health care costs with a Single Payer system. The state of Arizonia is disingenuis when they say they have looked at all options.

    The study include the 501 school districts, over 2,500 municipalities, 67 counties. Why not have a show on what would happen to all budgets if a single payer system were adopted?

    I live in Erie, PA

  • Lloyd Parlee

    Why does a heart transplant cost $250,000!! Who is cashing in on healthcare?!? The costs are out of control.

  • George Potts

    Its easy, just force doctors to work for free or else they lose their license. If that doesn’t work, at gunpoint.

  • barbara jaksa

    whidbey island, washington
    i am one of those people who had a brain tumor and had to declare medical bankruptcy and it changed my life…probably will never be able to buy a home. you have not addressed the people who are getting (obscenely) rich off of the medical industry, doctors, pharmeciutical (sp) companies and insurance companies….costs? why are we not talking about getting the paperwork costs in control, limiting the obnoxious amount of profit that is being made off of people who are ill. you want to charge obscene prices for plastic surgery/elective surgery fine…but to gouge someone who needs a heart transplant??? this is a major part of the problem that our congress and the medical industry refuses to address…

  • http://challenginglachesis.blogspot.com Dave Eger

    I thought the death panels weren’t going to start until they rounded up all of the Mexicans into concentration camps…

    Wait a minute now, was that caller just saying that the Republicans were hypocritical with calling out ? What shocks me is that he’s only realizing this now?! It’s been their strategy for quite a while to call out their own desires as absurd, so that when they follow through with them, no one believes that they even happened. Look at Glen Beck mocking revolutionaries while calling for revolution.

    Can we afford health care at all if there are so many vampires sucking blood out of every vien that they can sink their teeth into? What good are budgets when they aren’t going to the things that we need them to do.

    I like that caller who said that the Great Physician works for free! I bet you Jesus would be working with someone like Doctors Without Borders.

  • Joseph

    I do believe it was Tea Party pin-up girl Sarah Palin who first coined the term “death panel.” Not that Governor Brewer and Arizona Republicans are being accused of forming a death panel I can’t help but think “what goes around comes around.”

    Though when Palin talked about death panels she was trying to raise fears that a public health care system if instituted would make health care decisions based on medical efficacy and quality of life issues, actually the sort of “triage” one caller stated Arizona was just implementing. It is quite evident from the arguments put forth by Arizona for implementing just such a “triage” is that it is not the “triage” that is objectionable to them, it is just that it should only be applied on the basis of the patient’s ability to pay for the medical treatment. This is consistent with the general philosophy of conservatives and Tea Party types like Palin that as a society we should just toss everyone into deep water and force them to sink or swim on their own.

  • http://www.greenlocaljobs.com Michael Long

    Wow, this is a really horrible situation for these people. That story is really depressing and I’m very sorry for everyone that is effected. You should look at this other great article about how well the health care system is working for some Republicans.

    http://www.ama-assn.org/amednews/2010/12/06/bisa1206.htm

    RECORD PROFITS!!!!
    The recession is over for the Republicans!!!!

    Of course we don’t need a government options for health insurance.

  • http://rapplet3@aol.com Rod Appleton

    I think that one of the ‘elephants in the room’ is being ignored when discussing health care and the costs.
    Why did the hospital my mother stayed in for 10 days(colon surgery and recovery) charge $7200/day for the room she stayed in…with another patient in the room, as well, which means the hospital was charging over $14,000 for a 12′ x 20′ room per day. This hospital charge did not include the cost of surgery or the doctor’s costs.
    Even with the expenses of round the clock nurses and utilities, the profit for the hospital is shameful.

    Additionally, where does it say that doctors should make 10 to 50 times what the medium average income for the worker in the country. Why do we continue to ignore their lack of sympathy and contribution to the people of this country. They seem no better than greedy plunderers taking advantage of a people and a situation for their own excessive gains.
    Sincerely,
    Rod

  • http://rapplet3@aol.com Rod Appleton

    Just an afterthought to my previous statement (tirade?).
    It came to mind that the woman on the On Point show whose loved one has been denied medicaid for a heart transplant stated that it would cost over $250,000 for the transplant. This is what incensed me to write my comment, although I’ve had this thought about doctors and hospitals charging far more than they should be, and we all just seem to accept it, including the government sponsored insurance Medicaid, who I think should be investigating these doctors and hospitals.
    So, how does an operation that takes a few hours and some recovery time cost a quarter of a million dollars…why is everyone accepting this? Why aren’t we demanding that hospital budget statements be investigated and be transparent for the public to see.
    If there was a way to boycott doctors or hospitals, we would have done so…However, one of the problems is that we need theirs services and this demand allows them to abuse this need of ours and charge whatever they want for their services.
    Rise up and speak against overcharging hospitals and outrageous incomes these doctors think they deserve…while they rest of us struggle to keep our jobs and inadequate or unreliable health insurance for which we have to pay so dearly.
    Rod

  • http://rapplet3@aol.com Rod Appleton

    Just to be clear, when I stated, …” Why did the hospital my mother stayed in for 10 days(colon surgery and recovery) charge $7200/day for the room she stayed in…with another patient in the room, as well, which means the hospital was charging over $14,000 for a 12′ x 20′ room per day?”,…I wanted to be sure it’s noticed the figures are per day…my mother’s overall hospital bill for the bed and room was over $72,000 dollars for 10 days. I can only assume the same was true for the other patient that she shared the room with. Thus, for that small room with a single TV in it and an adjoining bathroom, the 10 day stay cost over $140,000. The majority of this cost, however, was covered by medicaid(or medicaire?).
    Not even Donald Trump or Bill Gates or Warren Buffet has ever paid $14,000/day for a hotel…do you think?
    Same as it ever was…but certainly think it will change once our voices are raised, not against government but against the sickening greed this health care situation exemplifies!
    Rod

  • John Lewis

    It’s time for this country to get serious about allowing elective euthenasia. A huge part of our country’s medical costs are expended for services that have very little potential for positive outcomes.

  • Roger

    This program is so disingenuous. Canada rations health, Britian rations health care. Every system rations health care. Our system past current and future will ration health care. If we are honest we know we will have to ration health care. We spend over $2 TRILLION per year in the US. It is unsustainable. We must try to be humane about how it is rationed. The old will get less health care. It is inevitable. Dr. Donald Berwick, the Obama appointee who will run the Centers for Medicare and Medicaid Services, said “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”

  • peter nelson

    This program is so disingenuous. Canada rations health, Britian rations health care. Every system rations health care. Our system past current and future will ration health care. If we are honest we know we will have to ration health care. We spend over $2 TRILLION per year in the US. It is unsustainable. We must try to be humane about how it is rationed. The old will get less health care.

    No, the poor will get less health care. We’re already rationing health care. Plenty of published research in major journals (e.g., heart disease in NEJM, cancer in Lancet, etc) have shown unequivocally that poor and uninsured people in the US have poorer outcomes WRT survival than affluent or insured people. According to a recent Lancet study the disparity for cancer survival WITHIN the US between socioeconomic groups is the greater than the disparity BETWEEN major developed nations.

    People talk about the inevitability of rationing but it’s not true – it’s only inevitable for people without money. When conservatives talk about a “right to life” they mean for rich people.

  • Edward Owens

    Once again I wasted another hour on NPR hoping to hear the obvious. I cheered when Tom pointed out that the first confirmed Death Panel is from a Republican state. Not in so many words of course. Then I waited for the guests or Tom to ask the guest from Arizona the obvious question.

    The guest said that they had tried every cut they could find. Really? Did they cut all government employees off from tax payer funded health insurance? And make them pay for their own like the people who work for a living in this country.

    The very next thing we should force, and I mean force, our government to do is end all tax payer funded free rides in health care for government employees.

  • geffe

    I wonder if people know that Cuba has a better health care system than we do. That everyone gets treated and that they spend about $400 a year per person. Of course they do not have the level of technology that we do, but the average Cuban lives as long as the we Americans do.

    Of course I’ll be waiting for all the comments on how they are Communist, but still it’s embarrassing that we can’t even do better than Cuba.

  • Fr. Andrew Rogers

    …And I’ve just been reading about two state-of-the-art hospitals in India started by Sai Baba where all services are free to the poor. Even if you can afford to pay, they don’t accept. They also have a large number of doctors who volunteer their services, and a bus – a hospital on wheels – that goes to remote areas. Look what’s possible!

  • Mark

    First the jobs. Now the health care. Guess where you end up next? Where they want the poor!

  • ThresherK

    Canada rations health, Britian rations health care. Every system rations health care.

    Yes, and our system has mastered the knack of paying more and getting less of it.

    So if Canada wants to improve something for their healtcare, they have the option of spending a fraction of that difference, and that gets them better outcomes. We don’t have that luxury here.

  • Pancake is meatless, in Belmont, NC and everywhere

    Craig Reisser: A tax on sugar is OK, as on anything else if the revenue is used well and people are alerted to start watching calories. But, research shows that greasy meat is a more proximate cause of type two diabetes than sugar. Overweight is an indicator, but sausage biscuits and barbeque are the culprit.

    Yar has it right that our government can issue as much currency, for whatever purposes, that it wishes. Medical services seem a good reason to issue currency. Our population is unhealthy because it is neglected. The only reason our government can’t take care of us is the crony capitalist system of profit for the elite few: Oligarchy.

    My new friend Eugenia Renskoff has it exactly right. Put physicians on salary and let them do the work they trained for. Forget about guaranteeing profit to parasitic businesses. Medical care and the profit system are incompatible. Corporate capitalism results in human flesh sold by the pound. (It would cause diabetes too.)

    “Honest Debate” is a coded phrase used in billionare financed training sessions for proto-fascists. It means, don’t give an inch in discussion, insist on your set of “facts”, and define your opponent as a communist, or communist dupe. Don’t indulge those throwing around this phrase insincerely. They are verbal thugs.

  • Ellen Dibble, Northampton, MA

    On the rich getting to live much longer and healthier. I think that was the opposite of the truth at the point food was universally available in the USA but the medicines and treatments to clear the arteries and so on were NOT universally available. Throw in all the costly developments following on genetic engineering, and it seems that with enough money you can cheat death. I think it’s inevitable. Call it death panels, call it triage. Call it Unfair. But if someone with their million dollars lives twice as long as I do, I think that’s okay. They will be paying taxes twice as long as I do, and they will be paying estate taxes where I do not. And they will be paying for the medical care which will nudge research and development ahead in ways that will benefit the poor as well as the rich along the way. (Polio, hepatitis B, malaria, tuberculosis…)
    Amazingly, there is an issue of getting the right to die nowadays. If you are plumping up the profits of the medical industry, you can be kept alive on a series of tubes literally until your insurance is exhausted, your savings are exhausted, and your relatives are exhausted.
    After a certain suicide locally, someone found out from the local sources that plenty of people exercise the right to die (intervening, not letting death using its own sickle), and that it is reported as — well, there are a few expressions that are pretty good clues. From the point of view of economics as well as from the point of view of quality of life, both the issue of access to health care and the issue of forgoing health care are on the table. And both are terribly tough to address, both emotionally and politically — and economically.

  • Marcia Lieberman

    The point, or question, I’d like to raise pertains to Arizona’s uniquely low transplant success rate. This data was gathered, if I have it right, on patients insured by Medicare or Medicaid. As we know, reimbursement rates for these programs are lower than with private insurance, and, therefore, some physicians do not accept these patients.

    Maybe the high death rate is due to less skilled surgeons.

    Also, what a dreadful statement Arizona is making to the country about the quality of their healthcare.

  • Marcia Lieberman

    My previous comment was made from my home in Lexington, MA

  • Mark S.

    Peter Nelson, your 12-21 post at 10:19 p.m. pretty much says it all. Thank you for distilling this debate down to its essence.

    As we continue to devolve this society down to the take-no-prisoners, Social-Darwinist, laissez-faire, Ayn-Rand-devil-take-the-hindmost character that Tea Partiers and fellow traveler Libertarians want, we will be able to reduce our medical costs simply by creating more and more poor people ineligible for healthcare. Hey, whatever works, right?

    Those elective euthanasia centers suggested by one poster are sounding better all the time. I’m not sure I will want to live in the kind of America I see down the road in 15-20 years. Might want that easy out…

  • Caroline

    Top ten ideas (combined) to pay for a special AZ transplant fund:

    10. Every AZ resident /tax filer donates $1 via tax return (pop. 6 million)
    9. Cut salary of all AZ state government workers by 1% and designate this for transplant fund.
    8. Add 1% tax to golf resorts.
    7. Set up a website with transplant patients’ stories and people from all over will send $ to save a life.
    6. Raise AZ income tax 1%
    5. Ask the Udalls (aren;t there a lot of them?)to donate to transplant fund
    4. Ask owners of Cardinals, Diamondbacks, Coyotes and Suns to donate $5 from every ticket sale.
    3. Cindy & John McCain can sell one of their houses and donate $ to transplant fund.
    2. John McCain donates his salary to transplant fund.
    1. Ask Cindy McCain to fund an endowed transplant fund.

  • Rob

    @Caroline – very clever ideas. Unfortunately, all but #10 rely on favorite source of revenue for everyone shocked and appalled by a budget cut….SEM. SEM (Somebody Else’s Money) always seems like such a convenient solution. After all, SEM is a virtually bottomless well, right?

    No, it’s not. SEM (aka, tax revenue) is limited by the abilities of politicians to convince voters that such money ought to be turned over to the government. When voters balk (as they clearly have in AZ), politicians need to explain the need for hard choices. Seems to me that’s what the Govenor was trying to do.

    This program, BTW, was a naked attempt to sandbag the poor lady from AZ who had to deliver the bad news…every time she made her point, Tom took it right back to the emotional appeal of a specific case, with a family member on the line. What a set-up!

    Here’s an idea….how about we start auctioning off the state and national parks to the highest bidder, and use the proceeds to fund health care? That’ll work…for awhile. And then we’ll be right back where we are, confronting hard choices.

  • Kelly

    We need to be clear that this is rationing of life saving care exclusively for poor people– what is next –rationing of: cancer treatment? heart surgery? This is the thin edge of a very dangerous wedge that violates everything that Medicaid represents.

  • Rob in Seattle

    There’s a long-running joke in business about the “expense account lunch” – where none of the parties at the lunch are footing the bill, so they’re free to order whatever they like. Now obviously no one wants a transplant. But think of it from the doctor and hospital’s point of view. They basically name their price, and expect the taxpayer or insurance company to pay it. There’s no pressure on the other side to hold down costs. No wonder we pay 2-3x what other modern countries pay for health care with similar to worse results.

    You wont see the hospital administrators offering to cut their salaries to pay for transplants. They just keep writing a bigger number on the bill each year, let the insurance companies discount it by 50% so it looks like everyone’s bargaining hard, and pass the cost onto the businesses and taxpayers around the country.

  • http://yahoo SCOTT MERRITT PUYALLUP WA.

    “”TAK INTERFACE”” We alloud this to happen and we can fix it. Remember this is our contry “STAND UP”Were the boss not them you say united we stand a true soldier will pick up there conrad and put them back in line or order or in heath. This ship is getting real sloppy and is loosing back bone I see it you see it dont just say or avertize united we stand regain back bone it’s there I have faith and will stand strong take a look at a ant pile thy know there job there direction there dutey’s “COME ON” We come along way and ben let down so it’s time to stand tuff and march hard and unite and not let that flag down it’s a very simple. JUST FORM THE C.C.E HUBE .Every one has a peace of the puzzel or the answer we can work it out all together are comon ground the same ship Im on your on were all on and there not enoff hummans to keep up for the job ahead so time is at the essant’s the longer we stall the farther behind. So here the answer .

  • geffe

    Merry Christmas to you too Rob from Seattle.
    Your views are skewed and so off base.
    We spent billions on the war in Iraq and Afghanistan and we can’t afford to give Americans decent health care?

    Not many people in this country can a heart transplant on their own. My guess is that surgery of this type would bankrupt most millionaires.

    Your views are not only based on a false premise that we can’t afford this it’s also based on the idea of every man, women and child for themselves. I hope you don’t find yourself in need like this poor man does.

    As for Monica Coury, she dug her own ditch in here as did the state of Arizona.

  • Sam Wilson

    Why doesnt the state of AZ increases the Traffic Tickets or increase the every single fine / penalty that it collects from its Law Enforcement to meet the gap.

    Sure its a Tax Increase, but you dont have to pay unless you have violated the law, its that simple.

    Did they even try?

  • Jed

    Well, Arizonans certainly give truth to the idea that your Republican neighbor would rather see you die than have their taxes raised by even $1. Remind me not to retire there….

  • Janet

    Why can’t AZ cut welfare payments to the illegal immigrants to help that American citizen out with this heart transplant? Why do illegals immigrants get free medical care and this guy is tossed under the bus?

  • G LaShoto

    This is what people mean when they talk about “Austerity” and “Shared Sacrifice”. Given the choice between raising taxes to help the poor or keeping taxes low and cutting off vital services to those who rely on them, governments will always preserve the status quo and serve the rich.

    “Shared sacrifice” means that those who can afford to continue to live as they want, and those who cannot afford to pay the price, in this case with their lives.

ONPOINT
TODAY
Jul 31, 2014
Russian President Vladimir Putin heads the Cabinet meeting in the Novo-Ogaryovo residence, outside Moscow, Russia, Wednesday, July 30, 2014.  (AP)

The US and Europe face off against Russia. Are we looking at Cold War II? Something hotter?

Jul 31, 2014
A comical sign suggest the modern workplace is anything but collegial . (KW Reinsch / Flickr)

When the boss is a bad apple. How some pretty dark traits can push some to the top.

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Jul 30, 2014
Janitta Swain, Writer/Exec. Producer/Co-Director Dinesh D'Souza, John Koopman, Caroline Granger and Don Taylor seen at the World Premiere of 'America: Imagine The World Without Her' at Regal Cinemas LA Live on Monday, June 30, 2014, in Los Angeles, CA. (AP)

Conservative firebrand Dinesh D’Souza says he wants an America without apologies. He’s also facing jail time. We’ll hear him out.

 
Jul 30, 2014
Smoke and fire from the explosion of an Israeli strike rises over Gaza City, Tuesday, July 29, 2014. Israel escalated its military campaign against Hamas on Tuesday, striking symbols of the group's control in Gaza and firing tank shells that shut down the strip's only power plant in the heaviest bombardment in the fighting so far. (AP)

Social media is changing how the world sees and talks about Israel and Gaza, Israelis and Palestinians. We’ll look at the impact.

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