This Article, though not specifically about socialized healthcare addresses some of my concerns with socialized and overly liberal healthcare systems.

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Minnesota state government will no longer pay for low-income patients' sex changes. In related news, until now Minnesota's government paid for patients' sex changes

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State stops paying for Viagra, sex changes
Maura Lerner, Star Tribune
September 1, 2005 NO

The state of Minnesota is quietly getting out of the business of paying for three controversial treatments that affect the sex lives or sex organs of low-income patients.

Starting today, the state will no longer cover routine circumcisions, unless "required by religious practice," under its insurance plans for 670,000 low-income Minnesotans, according to the Department of Human Services.

It's also dropping coverage of Viagra and other impotence drugs.

And last month, it completely stopped paying for sex-change operations.

Each of the three changes in coverage may face legal problems.

The Legislature voted to end the payments with little fanfare during the special session in July. Supporters say they were "no brainers" at a time when legislators desperately needed to cut costs without doing serious harm to the programs: MinnesotaCare, Medical Assistance and General Assistance Medical Care.

Even state officials admit that the new rules may be challenged by civil liberties groups and activists, and in one case would require a federal agency to reverse its policy.

But at least one Stillwater woman hopes the changes will spur a sea change in Minnesota, to help turn the tide against what she considers an unnecessary and barbaric procedure.

Ending circumcisions

In recent years, about 10,000 baby boys have been circumcised each year at state expense, at an average cost of $54, according to the Human Services Department. That's 10,000 too many to Cindy Tregilgas, a Stillwater financial manager and mother of two sons. For several years, as a volunteer for NoCirc, the National Organization of Circumcision Information Resource Centers, she had lobbied the Legislature to stop circumcision. This year, her testimony helped change the policy, making Minnesota the 16th state to do so.

At a House hearing in March, she said: "I have come here today not to ask for money, but instead to show you where money can be saved." She argued that taxpayer dollars were wasted on a "cosmetic procedure." While she opposes circumcision on moral grounds, she said, the money argument was especially persuasive. "Frankly if it's ten dollars to spend on something that's totally unnecessary and can cause harm vs. spending on necessary medical services for low-income people, it's a no-brainer," she said.

The bill's sponsor, Rep. Jim Abeler, R-Anoka, a chiropractor and father of six boys, agreed. "There's no medical indication, [and] we're looking for ways to save some money," he said. However, he added two exemptions, to allow payment if it's medically necessary or part of someone's "religious practice."

Circumcision is practiced by Jews and Muslims, but he said neither group asked for the exemption. "I thought it seemed reasonable," he said.

Assistant Human Services Commissioner Brian Osberg, who oversees the state health plans, acknowledged that the religious exemption might pose problems. "We have not determined exactly how we're going to process that exception," he said.

Its legality was questioned by Charles Samuelson, executive director of the American Civil Liberties Union of Minnesota, who wondered how the state could base payments on a patient's religion. "It just doesn't make sense," he said. "My guess is that if it was challenged, they would be hard pressed to keep that exception."

Abeler, the sponsor, said he included it as a show of respect to other religions, and doesn't believe it affects many people. "So if it's an issue, there wouldn't be a big fight," he said.

In any case, Tregilgas hopes this is just the beginning. Now, most private insurers cover routine circumcision in Minnesota. In other states, she said, private insurers have followed the government's lead. "I think it will take some time. But I do think that over time, [fewer] insurance companies are going to cover it."

No more Viagra

About 2,000 men got impotence drugs last year courtesy of the state's Medicaid program, at a cost of roughly $7 a pill (up to six a month), state officials say.

It seemed like a natural place to save money, said Suzy Geroux, administrator for the House Health Policy and Finance committee. For the past seven years, Minnesota has covered impotence drugs under pressure from the federal government. In 1998, the Clinton administration issued a directive warning that states could lose federal funds if the drugs weren't covered under Medicaid.

With the change in political winds, state officials say this is the time to challenge that policy. "It's really an interpretation of the law," Osberg said. Although the ban kicks in today, the state hasn't obtained federal permission to implement the change. Officials say they plan to submit that request later this month.

Closing a 'loophole'

Minnesota has tried to end Medicaid payments for sex-change operations for 10 years. But activists have challenged the restrictions in court. As a result, two to three people a year have had their sex-change operations paid for by state programs, at a total cost of about $15,000 in state funds, officials say. The new law, which took effect Aug. 1, "completely closes the loophole," Geroux said.

State lawyers say they expect court challenges to continue. Phil Duran, a lawyer for OutFront Minnesota, an advocacy group, says he's appealing the department's denials to five patients awaiting sex-change surgery. "It's certainly our position that this is not about saving money," he said. "This is about imposing a [penalty] on politically unpopular people."

Can you elaborate on that some?

I am from Minnesota, a student, and at the moment without health insurance. Unless I have been sleeping the past couple years or something, medicine in Minnesota is not socialized...

I am aware of Minnesota Care, but from what I understand, this is income based. That is, people do pay money each month as they would for insurance, but this is simply based on income so that low income people can have low cost health care. So, someone like me who doesn't make a lot of money, would still pay about $50 a month for health care or more depending on the ability to pay. (I actually applied a few years ago for it, but instead was able to get insurance through my college.) Me, being a socialist, wouldn't consider this program to be socialized medicine. Socialized medicine, at least to me, is generally something which is free to all individuals, but socially supported by taxes, government expenditures, income caps, etc.

As for how Minnesota care is used, I am not opposed to it being used for sex changes, impotence, or circumcision.

I don't consider sex changes to be a cosmetic or frivolous use of health care, since, being trangendered can be a very painful, depressing, experience.

I am sure that few of you would like it very much if you were kidnapped in the middle of the night, experimented on, then forced to live the rest of your life as the opposite sex, knowing full well that you are a man in a woman's body or a woman in a man's body. That is sort of what it is like to be transgendered. You feel out of place in your body. That it is something forced upon you. A body can be prison with a life sentense.

I think that these people do have a right to change their body, since to them, this is a right to be a happier and more complete human being.

But as a whole, I think humans have a right to health care, irrespective of how much money they have. We are all equally human and capable of experiencing suffering, disease, and death, so I don't believe that health care should be only available to the few of us that are better off.

Right on H!

A guy doesn't just wake up one day and think "hmm, I don't really like my penis... I think I'm going to go to the doctor and get it removed." It's a very BIG decision. And, unfortunately, money is a huge factor in said big decision. Yeah this should be paid for by the state. We have this technology, let's use it for good rather than profit.

And no Minnesota care is not 'socialized'. I'm from Minnesota as well, and as a matter of fact, I'm applying for Minnesota care for my father because he's poor and has a mountain of hospital bills. If it weren't for such programs like Minnesota care, he would be out on his own, with a rotting leg, and a seizure disorder. But you're right, he should be subjected to the whims of our private for profit health care system, where he would have had to pay in excess of a hundred thousand dollars in hospital bills (I'm in control of his finances, and I'm not exaggerating) out of his own pocket. And speaking of which, my mother and father recently divorced. My father was entitled to a settlement in this case, and because you have to be poor to be on Minnesota care, it's up in the air about whether or not he's going to be able to keep the money for the settlement, that he was going to spend on a new house.

That is not socialized medicine.

That is the biggest crock of bullshit I have ever heard. Whereas I agree with the fact that people have the right to modify their body in any way they choose, I don't think it should be covered by ANY form of health coverage, let the derranged fuck pay for it's own sex change, don't burden me with it. You have the right to the PURSUIT of happiness, not hapiness itself. Hapiness is a privilege, and quite frankly I don't give two shits if anyone is happy.

I'm not saying the government should mandate cable television, I'm talking about the government giving an option for someone who feels trapped in their own bodies. Being transgendered is a very real, very serious thing. And don't worry, for every tax dollar spent on someone's sex change operation, a thousand are being spent on killing Iraqi children.

I am motivated by a concern for human life and human suffering, which is why I think people do have a right to health care. I would gladly have less so that someone could have more. Maybe there is something wrong with me, but you know, the idea of sick poor people who can't afford treatment, or elderly people who can't afford meds, makes me a little sad.

I guess I have to work on becoming a callous asshole, tips would be appreciated.

Never the less, there are some market oriented reasons for providing health care for poor people. For instance, I think it gets to be a problem if your workers are sick all of the time. It is hard for a worker to meet their productive potential they are diseased. And dead people can't work at all....

I don't think tax money should be spent on either.

I absolutely agree that the government should help provide some benefits for poor children, and some poor adults in certain cirumstances and for certain needs. But I think less taxes and more money in peoples pockets would work better.

And how do you know that the market will put more money in the hands of the majority of people if government expenditures, taxes, and government regulation is scaled back? (these are things that I assume you would support, so correct me if I am wrong)

Laissez faire capitalism, in my opinion, tends to create more poverty. For example, if we look at IMF policies of privatization, fiscal austerity, and liberalization in such countries as Russia, Argentina, Venezuela, among others, we see that the laissez faire policies created increased poverty, economic distress, and in the cases of Argentina and Venezuela, social unrest. These policies did not put more money into the hands of poor people, but instead, concentrated wealth in the hands of a few.

Maybe you can explain your idea of how the market could work to benefit the majority of people, when it seems to me it hasn't and can't.