AP,

I think how we got here is by not having a national health care program. What I object to with Obamacare is that it forces everyone into the private health insurance system and lacks a government option. Critics said gov't. can't do anything efficiently, and that private enterprise can do it better. I tend to agree, but the way to prove that is to also include a gov't. option. If it's as bad as its critics claim it would be, no one would choose it unless they had no other option or simply declined to buy personal health insurance.

I favor having a national health care system, and I think Obamacare - as it's come to be called - was designed to fail.

Getting back to the specific question as it was asked to Ron Paul, the correct answer is to provide emergency service to the uninsured young man and then send him home to die in his coma. The reason is that the man knew what choice America made, i.e., requiring each person to purchase health insurance. The man made a conscious choice to not insure himself, essentially choosing to deny himself live-saving care should he some day need it. When that day arrived, we undermine the purpose and value of society if we avoid the uncomfortable fact that actions have consequences. While hard-hearted, society needs to act in a manner consistent with the principles it claims to have chosen (in this case buy the insurance or suffer the consequences). Of course it wouldn't have been PC popular except among the extremists for Ron Paul to answer that way. Had he done so, my respect for him would have increased significantly.

As a society we refuse to come to terms with those things we find uncomfortable. The undeniable truth is that we cannot save everyone - nobody's getting out of here alive. Further, we cannot even as a society afford to treat every citizen for every condition, yet we avoid the discomfort of addressing that. Take the 94 yr old woman for example. The hip replacement may be reasonable if she was otherwise healthy and mobile. Since she also required brain surgery, clearly she wasn't healthy, and since 94 is a pretty ripe old age, the benevolent death panel (the insurance companies in many cases) should have denied both treatments.

I've read a couple of times that over 90% of a person's lifetime medical expenses occur in the last 6 months of life - trying to postpone the inevitable. Those kinds of medical investments should not be borne by society altho the wealthy are free to try and spend their own fortunes trying to stay alive as long as they can.

An intelligent, benevolent, and rational society would craft a health care plan and system that IDs each medical condition and corresponding treatment and then prioritize them. Then decide how much people - individually and collectively via the national plan - are willing to spend on the nation's health care system. There are approximately 545 conditions and treatments; the money goes a finite distance down the list, and that becomes the limit of public health care. If you want coverage for more conditions, you buy it via private health insurance.

How does this work? Simple things (that prevent subsequent major disease and expense) are covered, like vaccinations, pre-natal care and a host of very treatable conditions and diseases that are likely to return the patient to a productive and rewarding life are all included. Less common and experimental and treatments that are not expected to result in patient recovery are low on that list and not covered. With those conditions the patient gets hospice and morphine and well wishes for the after-life if they believe in one. We can't do it all, and we shouldn't pretend that we can. Instead we create derogatory remarks about death panels while avoiding the rational discussion that we already have them and avoid pointing out that if one has the personal resources they can spend all they want on insurance and treatments that more likely than not will not change the outcome.

Sg