Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

How American Health Care Killed My Father
The Atlantic ^ | September 2009 | David Goldhill

Posted on 08/12/2009 10:46:26 AM PDT by Lorianne

After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. Here’s a radical solution to an agonizing problem. ___ All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create.

Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that—most important—remove consumers from our irreplaceable role as the ultimate ensurer of value.

These are the impersonal forces, I’ve come to believe, that explain why things have gone so badly wrong in health care, producing the national dilemma of runaway costs and poorly covered millions. The problems I’ve explored in the past year hardly count as breakthrough discoveries—health-care experts undoubtedly view all of them as old news. But some experts, it seems, have come to see many of these problems as inevitable in any health-care system—as conditions to be patched up, papered over, or worked around, but not problems to be solved.

(Excerpt) Read more at theatlantic.com ...


TOPICS: Business/Economy; Government; Politics/Elections
KEYWORDS: 111th; bhohealthcare; democrats; healthcare; obamacare; socializedmedicine
Navigation: use the links below to view more comments.
first 1-2021-4041-6061-77 next last
Long article, but the author makes some very salient points ... particularly that we shouldn't be 'fixing' something until we truly understand it.
1 posted on 08/12/2009 10:46:26 AM PDT by Lorianne
[ Post Reply | Private Reply | View Replies]

To: Lorianne

The current healthcare system sucks, but it is still MUCH better than Canadian/Euro style socialized medicine, which is evil.

I miss the pre-insurance days when we went to the Dr. and then paid him. Gee, what a concept.


2 posted on 08/12/2009 10:55:03 AM PDT by Retired Greyhound
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne

Obamacare will do solve the problem of infections picked up in hospitals. It will probably make them even more common.


3 posted on 08/12/2009 11:00:08 AM PDT by La Lydia
[ Post Reply | Private Reply | To 1 | View Replies]

To: Retired Greyhound
I miss the pre-insurance days when we went to the Dr. and then paid him. Gee, what a concept.

Or when he made house calls -- like ours did when I ruptured an eardrum one Sunday. He was 3 houses down the street.

4 posted on 08/12/2009 11:01:26 AM PDT by sionnsar (IranAzadi|5yst3m 0wn3d-it's N0t Y0ur5:SONY|Remember Neda Agha-Soltan|TV--it's NOT news you can trust)
[ Post Reply | Private Reply | To 2 | View Replies]

To: Lorianne

Our healthcare system does have flaws, LARGELY due to lawyers and insurance companies.

The benchmark still remains - MORE people come to AMERICA for their healthcare, than go to Canada, the UK, Cuba or anywhere else for healthcare.


5 posted on 08/12/2009 11:04:34 AM PDT by DustyMoment (FloriDUH - proud inventors of pregnant/hanging chads and judicide!!)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne
Saving what we have is idiotic. Private insurance has demonstrated over and over its not up to the job. They may win this debate again with their army of useful idiots but at some point in the future they will lose as the American people have already lost under the current system.
6 posted on 08/12/2009 11:09:20 AM PDT by montanajoe
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne

Interesting read. A democrat I could sit down with over a brewski or two and have a meaningful meeting of the minds.


7 posted on 08/12/2009 11:11:00 AM PDT by NonValueAdded (Why Does Obama Want Health Care in 4 Weeks When it Took Him 6 Months to Pick a Dog?)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne

Best damn single article on the problem I have ever read.

It hits all the salient points. I can’t believe The Atlantic printed it.


8 posted on 08/12/2009 11:11:30 AM PDT by sinanju
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne

This guy’s proposed solution is pretty close to mine. Cat insurance and MSAs. I would have different aspects around those two components - but IMO the only way to get control of the situation is to take that approach. But that cuts government AND the insurance companies out of controlling the system.


9 posted on 08/12/2009 11:13:25 AM PDT by dirtboy
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne

Health care is not a one-size fits all business. Good health care is as individual as each and every person who requires it. It is also sought for as many reasons as there are those who seek it — the advanced age person who is in the final stages of a life threatening disease (not necessarily cancer, as it metastasizes more slowly the older the victim is [I actually had a grandmother who outlived skin cancers on her body]), but there are those who seek to delay the inevitable at any cost. I, for one, do not see the good judgment in doing orthopedic surgery on those who are about to succumb to a disease with a more urgent timetable, but there are others who must accomplish something before it happens and it is, therefore, incumbent upon health care to do what it can. Those who will suffer under government-mandated procedures and insurance profitability guidelines will always be those who need it the most. The rest of us will carry on without a thought to it, paying premiums and enjoying very little benefit — UNTIL we require it ourselves. The federal government approach is destined to fail as it cannot, by its very nature, be responsive to the needs of the individual. That’s the bottom line, folks.


10 posted on 08/12/2009 11:14:04 AM PDT by Constitutions Grandchild
[ Post Reply | Private Reply | To 1 | View Replies]

To: montanajoe
Saving what we have is idiotic.

The problem is, the only thing more idiotic is turning the system over to the Dems.

11 posted on 08/12/2009 11:14:23 AM PDT by dirtboy
[ Post Reply | Private Reply | To 6 | View Replies]

To: long hard slogger; FormerACLUmember; Harrius Magnus; hocndoc; parousia; Hydroshock; skippermd; ...


Socialized Medicine aka Universal Health Care PING LIST

FReepmail me if you want to be added to or removed from this ping list.

**This is a high volume ping list! (sign of the times)**


12 posted on 08/12/2009 11:15:12 AM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne
"Like every grieving family member, I looked for someone to blame for my father’s death. But... his hospital physicians were smart, thoughtful, and hard-working.... his nurses were dedicated and compassionate. Nor from financial limitations... the issue of expense was never once raised. There were no greedy pharmaceutical companies, evil health insurers, or other popular villains in his particular tragedy.

I suspect that our collective search for villains—for someone to blame—has distracted us and our political leaders from addressing the fundamental causes of our nation’s health-care crisis."


He was doing fine until the "our collective search" and "has distracted us" parts. Clearly, the Democrats are doing all they can to rush a political overthrow of free enterprise hidden under a gauze of medical necessity.

13 posted on 08/12/2009 11:16:55 AM PDT by Albion Wilde ("A cultural problem cannot be solved with a political solution." -- Selwyn Duke)
[ Post Reply | Private Reply | To 1 | View Replies]

To: sionnsar

You want to know what killed the housecall?

1. Technology. I can’t carry more then a few drugs and basic pieces of equipment in my bag. No one would put up with that level of sophistication nowadays. The vast majority of physicians wouldn’t feel comfortable doing it.
Miss something and it’s anal rape by the lawyers.

2. Patient abuses. Robert Heinlein called it in several of his novels. Once upon a time in order to make a house call, someone had to get out of bed and go the doctors house, usually on a horse to get the doctor. They weren’t likely to do that lightly. Then the telephone was invented, and it became very easy to summon a doctor. Every kid with a fever, every tummy ache now became an emergency for a house call. That got old quick.


14 posted on 08/12/2009 11:18:09 AM PDT by Kozak (USA 7/4/1776 to 1/20/2009 Reqiescat in Pace)
[ Post Reply | Private Reply | To 4 | View Replies]

To: dirtboy
I am not optimistic that politicians of either party can fix it. But I am sure when the baby boomers start really needing the system the fix at that point is going to be far worse than anything contemplated now. Just as the American health care system doesn't believe in preventative care the American electorate seems not to believe in preventative reform to the system.
15 posted on 08/12/2009 11:20:06 AM PDT by montanajoe
[ Post Reply | Private Reply | To 11 | View Replies]

To: Lorianne

Sigh. One of the things we need to get back to is the rules that Lister came up with in the beginning of the “antiseptic era”. Hospitals that look like hospitals not hotels ( a lot of this is patient driven they don’t LIKE that “sterile” atmosphere). That means painter walls, tile floors, plastic or stainless steel surfaces, no carpeting, drapes, paintings etc. Surfaces that can be steamed or scrubbed CLEAN. Nurses and doctors wearing white uniforms, bed linen that cam be cleaned at high temperature or steamed. An obsession with cleanliness. It worked before, it can work again.


16 posted on 08/12/2009 11:22:35 AM PDT by Kozak (USA 7/4/1776 to 1/20/2009 Reqiescat in Pace)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Lorianne
"Society’s excess cost from health insurance’s administrative expense pales next to the damage caused by 'moral hazard'—the tendency we all have to change our behavior, becoming spendthrifts and otherwise taking less care with our decisions, when someone else is covering the costs. ...[H]ospitals, drug companies, health insurers, and medical-device manufacturers now spend roughly $6 billion a year on advertising. If the demand for health care is purely a response to unavoidable medical need, why do these companies do so much advertising?"
17 posted on 08/12/2009 11:24:12 AM PDT by Albion Wilde ("A cultural problem cannot be solved with a political solution." -- Selwyn Duke)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Retired Greyhound
I miss the pre-insurance days when we went to the Dr. and then paid him. Gee, what a concept.

For years, I thought that a "single-payor plan" was when the patient paid the entire bill (the single payer) and sought reimbursement from his or her insurance carrier, rather than the patient, the insurance company, and in some cases the gov'ment each paying a portion of the same bill directly to the doctor. This very simple concept would probably do more to lower the cost of health care and increase resources for the least amount of money, then any of the proposals coming from the RATS or the PUBS. People would be less likely to see their doctor for a bloody nose, hangnail, or the common cold, if they had to pay the $150 out of pocket,and then spend an hour filling out the paperowrk for reimbursement from their insurance company and/or medicaid/medicare, and even more time fighting for the payment; and the insurance companies would have to be more price competitive and consumer friendly if they are dealing with the consumer directly. Doctors could then cut costs because they would not need the added staff to deal with the insurance companies and medicaid/medicare, and would have more time to deal with real medical problems, rather than self-healing bumps and bruises.

And what about the people who don't have the funds to pay for medical services up front and wait for reimbursement? I can pretty much guarantee that economic forces will result in many doctors accepting payment by credit card, payment over time, and/or an assignment from the patient of the insurance/medicaid/medicare reimbursement.

18 posted on 08/12/2009 11:25:20 AM PDT by Labyrinthos
[ Post Reply | Private Reply | To 2 | View Replies]

To: Retired Greyhound

I dont think I agree with your assertion that “current healtcare sucks”, My daughter faced a year long life threatening situation and while there were many obstacles and many TWO way arguments she is alive and healthy, I have have no idea where she would be in another country but thank God it happened here in this shidddy ol USA.


19 posted on 08/12/2009 11:27:40 AM PDT by VaRepublican (I would propagate taglines but I don't know how.)
[ Post Reply | Private Reply | To 2 | View Replies]

To: Lorianne

To paraphrase Winston Churchill, the only thing worse would be more government involvement.


20 posted on 08/12/2009 11:27:41 AM PDT by gorilla_warrior (Metrosexual hairless RINOs for hopey-changey bipartisan-ness)
[ Post Reply | Private Reply | To 1 | View Replies]


Navigation: use the links below to view more comments.
first 1-2021-4041-6061-77 next last

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson