So I've been thinking about Michael Moore's new movie "Sicko" about the health industry. It has gotten me thinking about the American health care system a lot, including personal and family experiences.

I don't understand how a hard-working person with health insurance can be driven into bankruptcy and lose everything they have because of copays, deductibles, and life-time coverage limits, and no one bats an eyelash.

I don't understand how someone with a job can flat out be denied health insurance because of "pre-existing medical conditions."

I don't understand how an insurance agency can have so much influence over a doctor's medical care and diagnostic decisions.

I don't understand how a college kid, who recently graduated and dropped off his parent's insurance, and doesn't yet have his first job, can be left to die from cancer because he doesn't have insurance and can't afford the nearly half million dollars in medical bills for treatment.

It's just so insane. How do we fix it? I'm not sure.

In another thread socialized medicine was discussed. If the insurance agencies were dissolved and a state run organization was created in its place, this might have the effect of creating an entity that is not driven entirely by profits, which is a good thing. On the other hand, although this system may work in other countries our government's bureaucrats seem to be totally incompetent on multiple levels, so giving them control of our health seems less than desirable.

One thought I've had though is that perhaps HMOs/insurance agencies/etc. should be reformed into non-profit or not-for-profit corporate entities, where profits are reinvested into the well-being of their customers. These entities would have strict licensing and regulatory requirements imposed by the government.

I'm just wondering if anyone has any other ideas? Or if you'd like to share medical horror stories, that would be interesting to hear too.

Over the last 9 years I've had quite a bit of experience with the medical system and Medicare. I found in general that things worked pretty well. In fact I expected much worse and was surprised by how well it did work. I do have a few things that I can share.

One thing is that there is often more help available than first appears but it takes some real effort to find it and secure it. It is not for the timid. One has to be an advocate for one's patient.

I had amazingly good experiences with hospital social workers and in one particular case a social worker for the adult protective services. I think these folks are an overlooked and under appreciated resource.

For diseases like Alzheimer's there really should be some kind of longer-term care system similar to hospice. Otherwise the system is all about cure and there are some things that have none.

There should be some changes made to several systems for the benefit of caregivers, especially those who are 24/7. In particular changes should be made in social security benefits and some kind of health insurance provision for caregivers and definitely some better programs to address caregiver health.

There really is a strange discontinuity between the provider of care and the client when it comes to cost. And it is terribly complicated. There is almost no way to assess the value received from a consumer standpoint and then to take any reasonable action or use the information in future circumstances.

Probably other stuff. It's been so long now that I've become accustomed but when I first began I recall it was a rather frightening adventure.

Medicine is a business. That's all it really is. There is and should be no right to receive whatever cutting edge medical treatment is available. It's just not a socially workable scenario.

We have insurance for those who can afford it. Others? They can die. Everyone has to die eventually. The college student right out of school with no coverage qualifies for several private plans which would cover a scenario like that. Also, if he's unemployed, he might qualify for some sort of public assistance.

Setting up a system where everyone gets the same treatment is not only going to be unreasonably expensive (and the expense will be borne by the most productive in society), it'll also be physically unworkable.

The reason health care is expensive is a function of the free market economy. There is a scarcity in the facilities/people who can treat certain conditions. That scarcity means the price goes up... that means that people who are willing to part with more assets are the first to get treated.

Don't like it? I guess you could always move to Cuba.

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Wow. Midtowner and I are on exactly the same page!

Obviously this not a popular stance, but when you consider how the medical advances the human race has already made has impacted the population growth of the world overall... well, checks and balances are still needed.

And nature provides those, by and large...

Okay, so the medicine and medical care aspects are a business. Let's agree on that. Why does the insurance aspect of all of this have to be a business, or at least a for-profit business?

Let's assume that the college kid could have gotten Cobra coverage but he didn't... because he's a young kid and doesn't know anything about health care coverage. So basically he's screwed. That seems entirely immoral to me. And what about people who have insurance but they pass their lifetime coverage limit and the insurance company stops paying? This is happening more and more often today as health care becomes vastly more expensive. Should they simply expend all of their savings and then 'just die' when they have nothing left to spend? The free market does not control everything in our society, not should it. The police don't ignore murderers when the victims families don't have enough to pay for a police investigation, and the fire department doesn't ignore your burning home when you don't have enough money to cut them a check for their time and trouble.

You know, the US is now the only industrialized nation in the world that doesn't have universal health care. I'd say that someone out there has found a way to make this work. I don't agree that the system would be unworkable... not any more so than the labyrinth of policy and procedure which currently shrouds the insurance claims world. I do agree that the system would probably be more expensive, not as far as the end user goes but from the standpoint of everyone's tax rates increasing. I'm not sure how much this would be though and here's why... right now different people are charged different rates for their drugs and medical care depending on their group's coverage, which is usually determined by the size of the group/company you work for and the level of benefits they are willing to provide. Earlier this year we saw that Wal-Mart was able to effectively lower its drug prices by creating a massive group theoretically consisting of its customers. If you eliminate all of that and create a single group made up of all 300 million Americans, you can eliminate all of that. It would be interesting to see some studies that try to determine how much of an offset could be created. Also, the nation's Medicare and Medicaid systems could be reformed at the same time. Today there is a ton of fraud in the system, and a lot of artificial pricing. Perhaps that could be eliminated too.

Keep in mind what I am advocating here has to do with the HMOs/insurance agencies, not the drug companies, medical companies, hospitals, or any other medical provider.

You know, I get so tired of this statement. You know what, I actually care about my country and I will not move, I will stay here and try to change things because America deserves better than the BS it receives from its small-minded politicians. If you care so little about your fellow Americans that you would allow them to die and think nothing of it, perhaps you are the one who should leave the country. Sometimes being a moral person doesn't mean just caring about the unborn -- those of us who are living deserve a little compassion too.