Sure, there are waiting lists in other countries with a national health care system for things like kidney transplants, just as there are here. If that's the sort of thing you're talking about, then sure it happens, because patients like me are much more medically fragile and we are apt to die sooner. The life expectancy of a dialysis patient in the U.S. is five years from the day she starts dialysis. I'm on the transplant list, and my expected wait time on the list is at least six years. I intend to live at least that long. But I can tell you from communications I have with other kidney patients in other countries, that if you have an urgent or emergent health care issue arise under a system of national health care, it is treated immediately and the patient is not at potential risk of losing his life's savings and his home because of it, unlike here.

If you're talking about other issues that are non-urgent, sure, there might be some lag time, just like there is here for most people trying to get a doctor's appointment or an expensive test. But nobody, or almost nobody, dies simply because they have to wait for a knee replacement or the like. They may die for other reasons while waiting for a knee replacement, but that's not what kills them.

Do the rights of the zygote, which is not yet a living human being, supersede the rights of the woman, who IS a living human being, in whose body the zygote is developing? That's really what it comes down to for me, and why I am pro-choice.

Would you want the law to state that your body must play host to another organism for a period of time, no matter what the species, and no matter that it may put you in a potentially medically dangerous situation?

Would you expect that individuals would choose insurance coverage regardless of what the premiums, co-pays, co-insurance, and other out-of-pocket expenses were? Would you put a cap of any kind on insurance company premiums or out-of-pocket maximums? Would you mandate that insurers accept anyone who applies and can pay, or would you allow cherry picking?

One of the biggest costs is the health care needed by chronically ill patients. This does not fall into any of your categories above, and I'm curious as to how you would address it, particularly as to the needs of (a) transplant patients and (b) other patients who will die without ongoing intensive (but not in-hospital) medical care. And what would the price limit be on your proposed "add-on insurance", or would there be one?

You write: "No one should be penalized for having had an illness which was outside of their control."

I agree. I would amend that to "no one should be penalized for having or having had an illness." Period. Leave out the part about "outside of their control".

Whether or not common wisdom says that an illness is someone's "fault" or not, the illness now exists or existed in the past, and the person who is or was ill should not be penalized for it. And common wisdom is not necessarily correct.

Common wisdom says that the reason my kidneys failed is out of control diabetes, and that since it's type 2 diabetes, it's "my fault" that I have it. I did all the right things when I was diagnosed with pre-diabetes back around 1989-1990. I was following my doctor's instructions to the letter, but I got diabetes anyway. I went to an endocrinologist when I was diagnosed with diabetes. I was directed to go to a diabetes education class. They told us we needed to eat a diet with a controlled amount of carbohydrates, but that we should still be following the FDA food pyramid and getting 6-11 servings a day of carbohydrates from grains and an additional 2 servings or so per day of carbohydrates from fruit and some more carbohydrates in the form of dairy products (milk sugar is still a carbohydrate) every day. I tried and tried to lose weight but I couldn't do it on that diet, and I didn't know what was wrong; I was following instructions to the letter again and my doctor and nurse practitioner assumed that I was cheating all the time. Not so. I managed to get my diabetes under control with medication pretty fast and have stayed under control with medication. It's not that my diabetes was not under control - it was and is. So tell me - common wisdom aside - whether my diabetes was "my fault" or whether it happened because I was given the wrong instructions, which were the medical standard of the day?

I managed to finally lose weight by following a low-carb (almost a no-carb) diet. For me, that works. If I eat any grain foods, I can watch my blood sugars go up; even something as simple as a piece of low-sugar 100% whole wheat bread will do it. (I know what is in the bread because I make it from scratch.) A piece of fresh fruit is OK but fruit juice is not. I know what triggers a rise in blood glucose and I stay away from those things for the most part, or compensate for them with extra medication if I have something (a serving of brown rice, for instance). I have successfully avoided going on insulin for 13 years this way and am still on medication.

Common wisdom also says that losing weight and achieving a normal weight will cure type 2 diabetes. In some people, that may be true, but it is certainly not true for all, and I wish the medical establishment and its adjuncts would quit pushing that meme.

In fact, my kidneys probably failed due to a combination of factors, including high blood pressure (for which I take medication, but in the last year of kidney disease, not even a combination of 6 different medications could control it), massive kidney stones that I never pass which scar up the inside of my kidneys, and recurrent kidney infections for no known reason.

The kidney stones are a factor that I blame, and I blame the doctor who wouldn't do anything about them back in 1985 for a lot of my loss of kidney function. They were found then and she told me that since they were too large to pass, she wouldn't recommend that anything be done about them. Lithotrypsy was a new thing back then and they could have been broken up and removed by that method, but she wouldn't refer me to that procedure so I couldn't get it. In the Kaiser system, if your doctor wouldn't approve a procedure, that was pretty much the end of that. In 2000 I had them removed and found out that they had scarred my kidneys so badly that I had lost most of the function in one kidney, with a little over 20% remaining.

For 7 years the other one compensated and took over all function, and then it quit, too, and now I'm on dialysis and my insurance is paying nearly $300 every single day for it. Dialysis is expensive, even though I've chosen the cheapest method there is.

Disease should be "no fault"; it is no respecter of lifestyle. A person can do everything right and still get type 2 diabetes (I've met people like that). There should be no fault or blame assigned to the contraction of a disease, nor should fault be assumed in assigning health care benefits and costs.

One of the biggest issues facing chronically ill patients is lifetime maximum caps on insurance policies. These set a dollar amount on a person's lifespan; once you have used up that amount, you will not be insured by that company. If this is the only insurance offered by your employer or your spouse's employer, you're just out of luck (and out of life soon after, most likely). My spouse's employer has chosen a policy with a lifetime maximum cap of $2 million. This may seem like quite a lot, but when you figure in the cost of dialysis ($297 per day, every single day) and a kidney transplant, including testing and donor expenses, it's not much and can be used up quickly. We have figured out that with no hospital stays, no surgery, and no transplant, I'll still use it up in under ten years.

As a dialysis patient, I am eligible for Medicare although I am only 48. I signed up for it the first day that I could. But Medicare is not perfect; traditional Medicare requires that the patient pay 20% of many charges, which can quickly bankrupt a family, "socialized medicine" or no. Many Medicare subscribers elect to get a "Medigap" plan to cover the things that Medicare does not. I would do so as well if I could. However, Medigap plans are not legally obligated to sell coverage to someone under 65 who has Medicare only because of kidney failure. In this state, at least, the fact that they're not obligated to do so means that they refuse to do so.

The other alternative once the lifetime maximum cap is reached is the state high-risk pool. I evaluated the plans available and chose the best of them for me. Given everything, it would cost upwards of $29,000 per year, not including full payment on prescription drugs, to insure me on that plan, and it too has a lifetime maximum cap of $2 million. That's ten more years or so if everything goes swimmingly and if I turn down the opportunity to get my life back by getting a transplant, much less if I get one.

Then there are the anti-rejection medications that the transplant recipient must take for the rest of his life to have a chance of keeping the organ. Without insurance of some kind, the recipient is unlikely to be able to afford them on his own, since they cost upwards of $20,000 per year. There are the clinic visits; every day at first, then most of the days of the week, then a couple of days a week, and tapering off until it's just once a month. The clinic will charge for every visit. Medicare pays for most of the transplant drugs if you have a Part D plan, if I'm not mistaken; however, once the kidney has been in place and working for three years, Medicare considers the patient cured, and the patient is no longer eligible for Medicare. If he happens to lose his job (which is not too uncommon in this economy), he loses his insurance unless he can afford the huge COBRA payment every month, and thus loses his transplant. He winds up right back on dialysis, and then - THEN - he gets Medicare again!

What is a transplant recipient to do if he has used up the lifetime maximum cap on his insurance by being on dialysis and getting the transplant? He probably won't be able to afford the anti-rejection drugs on his own if he earns an average wage, certainly not if he earns a low wage.

I submit that lifetime maximum caps are cruel and inhumane. They place a price on a person's head, and when that amount is reached, the insurance company treats the person as if he is no longer of any value to society. It doesn't matter whether the patient is 5, 25, or 55; the message it sends is "you're too expensive to let live".