When dialysis was invented in the 1960’s Congress decided that it would be too expensive for insurance companies, so they decided to cover the care of chronic renal disease for any age – basically the government became a single payer for this one disease! But other chronic diseases have not fared so well. There are favored classes of people with basically free care – the Military and the VA Hospital System. Native American clinics and hospital are also federally funded. Even under Medicare there is “original” or “advantage.” Medicaid is our “safety system” which is chronically underfunded. This article from the University of Pennsylvania argues that the best current approach is to improve Obama care. What are your thoughts in the current “ethical mess?”
It is a patchwork that covers some people and some diseases but not others. We can improve it by bolstering Obamacare.
By Amy Gutmann and Jonathan D. Moreno. Ms. Gutmann is the president of the University of Pennsylvania, where Mr. Moreno is a professor of bioethics. Published in the NYT.
The recent Democratic primary debates in Detroit made at least one thing clear: The party exclusively responsible for passing the Affordable Care Act is now waging political warfare over whether to reform it or eliminate it. Senator Bernie Sanders was loud but not lonely in advocating “Medicare for all,” which would supplant the A.C.A. with a single-payer system and virtually abolish private employer-based health insurance. His predictable answer to who will fund its high price is apparently the 1 percent who need to pay their fair share.
But there is another 1 percent, and they are not the privileged ones you’re thinking of. They are the roughly 1 percent of Medicare patients who have end-stage renal disease and cost the system $34 billion every year. No matter how rich or poor, young or old, Medicare kidney patients are guaranteed treatment mostly paid for by American taxpayers. (continued)