What should decide what medical procedures Medicare covers?

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Let's be consistent, here.

Not being American, its probably not my place to vote but in my opinion the poll asks the wrong question.

America, like every other civilised developed country needs a National Health Service. End of story.

I cringed when I selected votes of the politicians, because our current politicians stink.

What was so bad about the other two options that forced you to select the middle one?

If it were up to the medical community everything under the sun would be covered only because it would mean more money for them. That's like giving a mouse the key to the cheese.

The general populace does not have the level of information and analytical ability to fully understand the ramifications, especially economic. And, the medical community would simply want everything covered, including breast augmentation and cosmetic dentistry. Maybe, even tattoos.

As I understand, the medical community wants community-accepted procedures to treat diagnosed illnesses covered; I have not heard of any major medical organization wanting simple cosmesis covered.

Now breast augmentation is covered for women who have had mastectomy due to breast cancer, that has been accepted. On some insurance plans, breast augmentation may also be covered to treat gender dysphoria/gender identity disorder, decided on a case-by-case basis.

As for cosmetic dentistry, beyond braces to correct the alignment of your teeth (which has to do a lot more with function than with cosmesis) and other orthodontic procedures, I have not heard of any major medical or dental organization call for cosmetic dentistry to be covered under dental plans.

I trust the medical community to determine medical necessity, particular treatments for particular diagnoses. I don't think that everything under the sun would be covered, because the medical community is a scientific community and has its own internal policing: Peer-reviewed articles and clinical experience would need to demonstrate the effectiveness of a treatment for a particular disorder before they would call for coverage.

Politicians would be beholden to the will of the populace; less popular, though still effective, treatments to be covered, such as sex reassignment therapy for gender dysphoria/gender identity disorder would not be covered, and those with conditions for which the only effective treatments are unpopular would have to suffer from the lack of care, possibly putting greater burden on the health system than if they could receive those effective treatments as their conditions worsen. That is unethical.

I do not want the ignorant controlling the decision-making, either directly or by putting pressure on their politicians.

Maybe there should be a combination of several entities deciding together.

Not a very good list of options to choose from.
- The up and down vote of the people is determined by which news agency they get their brain washings from.
- The votes of the politicians depends on their electorate and whoever's shovelling campaign contributions at them.
- The medical community will decide based on what's best for their wallets, right and wrong be damned.

Noe of the above. Medicare should be just like any other insurance policy. Maybe the same care a veteran who has no service connected disabilities is entitled to from the VA. No cosmetic procedures.

What would you consider to be cosmetic?

What if it is medically necessary to treat an illness and simply has a cosmetic effect? Should it be banned anyway?

In general, we need to keep in mind that somebody pays for whatever is provided. While the government is currently printing money, that money is backed by loans, much from foreign governments. So, spending decisions must consider the burden on those who ultimately pay. True health issues are fairly clear. However, elective, purely cosmetic, and lifestyle matters are not so clear. Ideally, everyone would get what they want, but no matter what, when someone takes from the system, the system takes from somebody else. Braces for a kid with crooked teeth, yes, if we can. Cosmetic surgery for Paris Hilton or one of the Kardashians, no.

Cosmetic would be face lifts, microdermabrasion, Botox, chemical peels, liposuction, hair removal. lip jobs, boob jobs, butt lifts, skin tightening and whatever else causes someone to become physically attractive. Ugliness is not a medical condition unless someone has tumors growing everywhere and it's just absolutely a hellish existence. People need to stop being so darned superficial about how something looks. Your boobs sag, deal with it or come up with the money to fix it yourself.

/\ They'll say that being physically unattractive causes depression, anxiety, etc. and by not treating with cosmetic surgery it will lead to greater expenses in terms of psychiatric care. To that I'd say give them neither.

Man, people seriously need to chill out and quit obsessing on the way they look already. It's gotten ridiculous. It was easier before they came up with all this stuff! People just looked the way they looked and that was that!
If given the choice between the two, I would say treat the anxiety or depression and people learn to deal with the way they look.

^ Yeah,let's deny anorexic teenagers mental health services.Problems all in their heads,they should just get over it.Maybe force feed them like a pate duck.