Charlie, and "All"

A quick note of thanks to Charlie for introducing what I consider to be one of
the most interesting and lively debates we've had on the List in some time.

Thanks also to those who've shared their thoughts, opinions, and knowledge
'bout the topic under discussion.  The wonderful variety and high quality of
minds in this group never ceases to amaze me.

Excuse me... RITA WEEKS!  DAVID MORELAND, et all, WAKE UP!!! <grinning> (yawn)

Barb Mallut
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----------
From:   Parkinson's Information Exchange on behalf of Charles T. Meyer
Sent:   Monday, August 18, 1997 9:52 AM
To:     Multiple recipients of list PARKINSN
Subject:        Re: 2 questions

Hi David,=20

I hope you had a good weekend on that Island in the Java Sea. While you
were doing that I spent my weekend in Beloit Wisconsin, a small
industrial town near Rockford IL.  I guess you won the battle of the
most esoteric weekend. =20

My weekend involved taking my youngest son to begin his freshman year of
college.  Maybe you 've got a point by the way about the authoritarian
streak you accused me of.  When we were saying good-bye to him and
joking with him that he was "free at last" he replied by asking where
his 40 acres and a mule were. (That was what the emancipated slaves were
given after the Civil War!!!)  On second thought maybe my wife & I
should have gotten the mule.     =20

Abbreviating our previous interchange:
Chas > > I don't know how the system is funded in Indonesia or European
> countries but Social Security is a tax in the US not an insurance progr=
am.

Dav> If you want an idea of the way an authoritarian state can run,
study
> Indonesia. Indonesia is an example of why I am concerned for personal f=
reedom
>  without coercion from the State in whatever form  it takes.
> In Europe social security is often a percentage of income=20
 mostly. (pressure on the system) from demographics, higher unemployment
(whose fault is that - another
> argument)and higher expectations. ...  do not believe the claimant
> is asking for something for nothing).The reason I look on it as an insu=
rance is
>... one pays a sum of money which covers a whole range of situations eg
> unemployment, sickness, basic pension. An individual will take more or =
less according to what
> happens during life, which more  often or not is outside the individual=
s control. I...- I presume
> our subject did pay or has been deemed to have paid, and as such should=
 be
> entitled to the benefits. I agree with you (REALLY?? !!) there have to =
be limits,
> I am totaly against fraud, abuse of the system etc. These are theft and=
 should be
> treated as such.  Presumably, the subject of this discusion  really has=
 PD and is not
> attempting fraud.

NEW-  BUT THE PROBLEM IS SEPARATING CONSCIENCE FROM FRAUD.  IN THEORY ,=20
IF A PERSON WAS GENUINELY AGAINST THE USE OF MEDICATIONS AND COULD PROVE
THAT WAS A MORAL ANATHEMA TO HIM/HER MUCH LIKE A CONSCIENTIOUS OBJECTOR
(co) IN WARTIME I COULD SUPPORT THAT INDIVIDUAL GETTING BENEFITS.  THE
PROBLEM IS THE RISK OF ABUSE.  WHAT IS TO PREVENT SOMEONE FROM INDUCING
A MEDICAL CONDITION OR FAILING TO TREAT AN ACTUAL CONDITION FOR THE
PERIOD UP UNTIL HE GETS DISABILITY INCOME AND THEN BEGIN TAKING MEDS
AFTER THE EXAM?   I DO THINK A PROCESS SIMILAR TO FILING FOR CO COULD
COVER THOSE FEW PEOPLE WHO WOULD REJECT MEDICAL TREATMENT ON GROUNDS OF
CONSCIENCE

Chas ...The system will go broke in the early 21st century.  We don't
have the luxury of a generous
> > definition of eligibility.
>=20
Dave-  >Funding is a real issue. I feel the problem is mixed up with
peoples
> misunderstanding of insurance (and social security). ... Insurance runs=
 on an actuarial
> concept ie there are a random number of people who will claim and a num=
ber who will
> not. The concept> will not work if there is no random group.=20
>  With insurance, the luckiest person is the one who never claims.
> Politicians have  cut back and cut back on taxes because people feel go=
od about it on
> the day - they  never think of tomorrow. This and choices of where taxe=
s go is the
> real problem. People are not prepared to accept the real cost, they exp=
ect something
> for nothing. If you start bringing selection into health insurance, soc=
ial
> security where does it end, genetic testing etc?

NEW-  THAT IS ONE REASON WHY I HAVE SO MUCH TROUBLE WITH THE INSURANCE
INDUSTRY.  tHEY WANT SOMETHING FOR NOTHING TOO.  IF THEY CAN DEVELOP A
METHOD OF PREDICTING WHO WILL GET SICK OR DIE THEY COULD WIND UP
COLLECTING A GREAT DEAL AND PAYING OUT NEXT TO NOTHING.  THAT LEAVES THE
REST OF THE POPULATION EITHER RECEIVING CHARITY  OR RECEIVING PUBLIC
AID.  SOCIAL SECURITY IS FOR EVERYONE.  BTW I DON'T THINK IT IS THE
GOVERNMENT'S FAULT THAT THE DEMOGRAPHICS HAVE CHANGED AND THEY HAVE
LITTLE CONTROL OVER THE NUMBER OF JOBS WHICH ISN'T THE PROBLEM IN THE US
NOW ANYWAY  =20

DAV> > Why should the government support Udall (if as a non American I
> > understand it)? Why don't PWP's  pay for all the research themselves.
> > > Why do you expect consideration from others? We are not their
> responsibility.

NEW  I STILL MAINTAIN THAT THERE IS A NET BENEFIT FISCALLY AS WELL AS
MORALLY OVER THE LONG TERM.

CHAS> From solely the economic argument assuming that patients accepted
the
> > results of the research,  increased duration of productive
> employment, decreased duration in total dependent situations- e.g. nurs=
ing home
> make it a good economic investment
=20
DAV>I wonder from a  strict cost point of view if this is true. One
needs to
> balance the cost of an untreated situation with a treated scenario. How=
 much
> does it cost a company  to have a disabled person in a job. I would exp=
ect quite a
> bit in lost productivity etc. Can the company regain its loss from soci=
al
> security?

NEW>> AS I HAVE WRITTEN BEFORE I THINK THE EMPLOYER AND PARTIALLY
DISABLED EMPLOYEE NEED TO NEGOTIATE COMPENSATION AT A TIME OF DECREASING
PRODUCTIVITY DURING A PROGRESSIVE ILLNESS.  THIS COULD ALLOW FOR
EXTENDED CONTINUED WORK
>=20
Chas An insurance program must have criteria for benefits to be paid
out-
> > otherwise it should be a savings program.
>=20
Dave>>Call it a tax or what you will, the man has contributed. This is
also
> a government programme. Rules are often subject to interpretation and
> change.  The government serves the people, not the other way. Governmen=
 thas a
> moral responsibility to include the whole spectrum of needs and that me=
ans
> everyone> (do you not treat sexually transmitted diseases, AIDS for ins=
tance -
> they are  self inflicted? - no the lobby is too powerful and there are =
drug
> companies out there waiting to make a killing on an AIDS cure) Criteria=
 are often
> changed, but normally for political motives.

NEW>> WE BOTH SUPPORT CRITERIA AT THIS POINT.  THERE IS A DIFFERENCE
BETWEEN CONTRACTING AN ILLNESS IN THE PROCESS OF LIVING AND PURPOSELY
GOING OUT TO GET SICK.  OTHERWISE IF YOU GET A TROPICAL DISEASE IT IS
SOMETHING THAT YOU COULD HAVE AVOIDED BY NOT  GOING TO INDONESIA.=20
HOWEVER IF YOU DELIBERATELY WENT INTO A MALARIA INFESTED SWAMP WITH THE
INTENTION OF CATCHING MALARIA AND GETTING BENEFITS AND THEN REFUSED
TREATMENT THEN I WOULD NOT SUPPORT YOUR CLAIM FOR DISABILITY.=20

>=20
> So, back to the point. Making certain basic assumptions: the guy is sic=
k with PD
> =B7 he made contributions to the social security fund he did not contri=
ve to have PD to obtain the benefit
> =B7 he should therefore expect some support If you do not accept this t=
hen maybe the next step of the social
> security officer will be "you must have a pallidotomy" or "you must hav=
e a frontal
> lobotomy, you'll feel a lot better and society won't have to pay so muc=
h for your
> upkeep". It's the  thin edge of the  wedge, it's only a matter  of degr=
ee.

I AGREE AND HAVE POSED THAT QUESTION IN AN EARLIER PART OF THIS THREAD
IN MY EXAMPLES. wHERE DOE ONE DRAW THE LINE? IF A PERSON HAS A SEVERE
FRACTURED LEG AND REFUSES TREATMENT FOR IT AND IT LEADS TO DISABILITY
SHOULD HE GET BENEFITS?
>=20
> My God that's enough. Anyone who gets to this point deserves a merit
> award.

NEW: I THINK WE ARE BEATING THIS POOR DEAD HORSE INTO THE GROUND.  I
DON'T THINK WE NEEDED YOUR ASBESTOS SUITS BUT KEEP THEM HANDY.  WHILE I
DON'T THINK WE WERE SO FAR APART ON THE ISSUE I THINK WE BOTH ENJOY A
GOOD INTELLECTUAL BATTLE ONCE IN A WHILE AND I SUSPECT WE WILL GET INTO
IT AGAIN.

GOOD SHOW

Charlie=20
>=20
> Regards
>=20
> David

--=20

CHARLES T. MEYER, M.D.
Middleton, WI
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