Thursday, September 20, 2012


How do you explain the success of Lasik and plastic surgery in lowering costs and increasing choice and availability. Neither generally covered by insurance or Medicaid/Medicare. Both fee for service. How is that not evidence of the power of choice. You are  pro-choice aren't you? 

What Will Obamacare Mean For Care at the End Of Life?


You ask.

I don't know but I am guessing not much. Ryancare (if I may coin the phrase) shifts costs to patients and hopes that such an approach will reduce those costs by introducing competition. Such a notion is a fantasy with no data to support it IMO. Obamacare seeks to reduce costs by stealthily, inexorably paying the healthcare sector less to provide the same amount of care that it does now, also a fantasy for the reasons you have so elegantly articulated throughout this blog. Neither plan will have much effect upon the broad metrics that matter, such as life expectancy and infant mortality, since those metrics depend more on the non fancy parts of healthcare than upon what goes on in an intensive care unit or neonatal unit.

Until we Americans all along the political spectrum can accept the simple proposition that what we get has to be paid for or we get less, no plan will matter.

November after the election will be interesting, albeit terrifying. If we actually get through the next budget crisis without blowing up our economy I'll be impressed. If the Israelis don't bomb the Iranian nuclear facilities and thus plunge the entire Middle East into chaos and the price of oil into the stratosphere I'll be stunned.


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