Tuesday, February 7, 2012

America the Exceptional


Philosophy is among the many disciplines at which I remain hopelessly deficient, so I’m going to duck the question of whether healthcare is a right. Actually I’m only going to pretend to duck.  

You are absolutely correct (or at least I think so) to opine that the disconnect between expenditure and cost is a major cause in escalating healthcare outlays. People who don’t pay for what they get have no trouble spending someone else’s money. When I talk to patients about how much a test or treatment costs they look at me as if I have two heads.

And you are also correct that basing health care on employment, an unintended legacy of  WWII wage and price controls, is a terrible idea. And now we are in a mess. In the most optimistic projection, Medicare runs out of money in 2024, and that projection is made by cooking the books. 2016 may be the more realistic figure, which means that the next President, whoever he is, will have to deal with it.

So how would you fix this? No other industrialized nation funds healthcare the way we do. Everyone else has some sort of centralized system, be in government run (the U.K), government insured (Canada and many others), private government regulated monopoly (Switzerland) or some mix of all of the above (Germany). 300 million people. Twenty per cent of the world’s largest economy. Just get rid of the whole thing and let everybody fend for themselves! Let the miracle of the market unfold! That’s the answer?

Come live in my world, for a day. I’d like to see what you think from the front lines.


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