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Originally Posted by jorgelito
On responsibility, I mean people who "hurt themselves" and thus putting unnecessary strin on the system and/or endangering other people. I realize this is a bit vague and even slippery slopish, but I find it very relevant to the discussion because it implies that extra "unnecessary cost could be placed ona unversal system needlessly. EX: in LA, many ERs were shut down in part because gangbangers keep shooting each other only to get patched up by the ER and then they are back at it again shooting each other only to end back up in the ER only to get patched up and then they are back at it again..... Or drug users that refuse to get help but then end up in the ER. Recover, then end back up in the ER. Or many people who can't afford to have children, do so anyways and go to the ER then keep on having kids and going to the ER. Or smokers who get sick and then end up in the hospital. I am not so sure I like the idea of a smoker getting free (costly) health care to treat something that they caused themselves. In that sense, it would feel like I am paying for someone elses irresponsible behavior. To put another twist on it: imagine free abortions courtesy of the state. So on and so forth.
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I think that in a good universal care situation, you could hope that some of this would even out. Emergency Departments aren't swamped because of people getting shot, giving birth, etc. They are swamped because too many people use them in place of primary care - for sore throats, etc. The ED can't really turn those folks away without doing a workup, or else they'd be exposing themselves to horrible lawsuits - remember the little boy whose toothache became a lethal brain infection?
The good thing about universal care, if it were implemented well, is that people would go to their primary care physician for things and get them taken care of before they developed into costly, acute conditions. Not only that, but since people would have access to preventive care (think about heart monitoring, physicals, weight management, diabetic counseling) you could reduce the incidence of serious problems. I'm not imagining utopia, because I realize that laziness is a significant factor in poor health, just as cost of care is. However, if this hypothetical system were well implemented, it might restore balance to the way the medical system ought to be used.
I'm sympathetic to your feelings about responsibility, jorgelito, but I think that in practical terms you have to realize that we're already treating those people when they show up in the ED with conditions that are vastly more serious and costly than they would have been had the person addressed them at the proper time. Not having universal care doesn't get you out of paying for overnight detox for drug addicts, shot gang members, heart attacks in McDonald's addicts, etc.