Today's Debate: Who says no?

Who gets an implant and who doesn't? More important, who decides?

Eli Manning and his shoulderToday's news brings one of those happy hockey stick graphs, this time from the folks who do shoulder implants.

Millenium Research Group estimates the market for shoulder implants will double over the next five years, from $260 million to over $540 million.

One reason is the rise of the so-called "reverse implant," in which the ball of the socket is on the chest side of the shoulder, rather than the arm end, as God made it.

Another reason is osteoarthritis, which is a disease of aging. Which we're all doing, like it or not.

A shoulder implant can let an aging patient live fairly pain-free for years, which is good. But it's also expensive. And unless we're talking about Eli Manning or Tom Brady it's not a life-or-death deal. (Neither currently needs a shoulder implant. They just hurt there.)

So, who gets an implant and who doesn't? More important, who decides? Right now the decision is based on wealth -- if you're rich you're treated like Tom Brady, if not you're Joey Harrington. (Sorry, couldn't help myself.)

Actually you're just like hundreds of retired NFL stars now begging Congress for adequate health coverage, only without the press clippings with which to gain sympathy, or the big money modern game from which to elicit funding.

Note, please, that if we're going to tackle health care reform in a meaningful way, and take these decisions out of the hands of insurers, they still have to go somewhere. So, where?

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