In the new Obama reality, we may be headed towards a world where veryone gets mediocre baseline care and only the well-do-to get expensive treatments like defibrillators, renal hemo-dialysis, organ transplants, etc. Other countries, notably in Western Europe and Canada, have all tried the universl healthcare model and end up with the same choices - give everyone something, but nothing great, and have the rich able to get what they want (e.g., by going to the US or paying out of pocket at home), or offering everything but with [long] waitlists. Last time I checked, they had some pretty smart people over there and never came up with anything better. I'm not sure what the current administration thinks they can do different: perhaps they don't, and are just deciding which model they want to try to get the American people to swallow.
Clearly, good screening tests will be needed in either model in order to at least use those resources that will be spent as efficiently as possible. Right now we are sued to screening tests to decide who gets expensive treatments, but we'll have to get used to then being used to decide who gets expensive diagnostic tests, too (e.g., MRIs). Once again, doctors will get squeezed in the middle - damned if you order the test, damned if you don't and a diagnosis is missed. Of course, the malpractice lawyers will be there to "help ensure that justice is served" in their own special way.
In the new Obama reality, we may be headed towards a world where veryone gets mediocre baseline care and only the well-do-to get expensive treatments like defibrillators, renal hemo-dialysis, organ transplants, etc. Other countries, notably in Western Europe and Canada, have all tried the universl healthcare model and end up with the same choices - give everyone something, but nothing great, and have the rich able to get what they want (e.g., by going to the US or paying out of pocket at home), or offering everything but with [long] waitlists. Last time I checked, they had some pretty smart people over there and never came up with anything better. I'm not sure what the current administration thinks they can do different: perhaps they don't, and are just deciding which model they want to try to get the American people to swallow.
Clearly, good screening tests will be needed in either model in order to at least use those resources that will be spent as efficiently as possible. Right now we are sued to screening tests to decide who gets expensive treatments, but we'll have to get used to then being used to decide who gets expensive diagnostic tests, too (e.g., MRIs). Once again, doctors will get squeezed in the middle - damned if you order the test, damned if you don't and a diagnosis is missed. Of course, the malpractice lawyers will be there to "help ensure that justice is served" in their own special way.