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 ...
"How would the health-care reform that’s now taking shape solve these core problems? The Obama administration and Congress are still working out the details, but it looks like this generation of 'comprehensive' reform will not address the underlying issues.... Instead it will put yet more patches on the walls of an edifice that is fundamentally unsound—and then build that edifice higher."
Excellent article. He made some great points, and IMHO, offers a far better solution than any I have heard before. One thing for sure — more government hands in the soup will only make things far more expensive and more people will die needlessly.
What if the federal government got out of the business of health care altogether; like if we can erase LBJ from the USA consciousness; then the poor can be cared for by the states and county hospitals, and church clinics. That all worked very well.
From the article:
Anyone with whom I discuss this approach has the same question: How am I supposed to be able to afford health care in this system? Well, what if I gave you $1.77 million? Recall, that’s how much an insured 22-year-old at my company could expect to pay—and to have paid on his and his family’s behalf—over his lifetime, assuming health-care costs are tamed. Sure, most of that money doesn’t pass through your hands now. It’s hidden in company payments for premiums, or in Medicare taxes and premiums. But think about it: If you had access to those funds over your lifetime, wouldn’t you be able to afford your own care? And wouldn’t you consume health care differently if you and your family didn’t have to spend that money only on care?
Where's your proposal? Or do you think that shouting "No!" every fifteen years is going to keep working?
P.S. His beef about his father's death centered on the 100,000 hospital patients who die each year due to sub-standard hospital hygiene. So how would you know which hospital is the right one to enroll in, huh?
Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention.
Health care (the healing arts) is and has always been about treating problems. Health and well-being (so-called preventative care) is usually called a "physical fitness" program. The practice of medicine has deteriorated significantly precisely because the government has interfered and pressured the medical field to shift focus from treatment to prevention.
That is like telling auto mechanics that teaching customers basic maintenance is more important than doing the repairs. A good mechanic will mention maintenance without being told to (just as a good doctor will suggest preventive measures) but the main job of mechanics and doctors has been and should be repairs/treatment.
0bozo and all these lefty power grabbers are clueless morons when it comes to medicine. But health care isn't their real agenda is it?
I guess you have no idea of what is being contemplated now; the government having access to our bank accounts; the IRS intimately involved in the process; a government data bank with ALL our medical records on file?
Why do you think people are so upset at these town halls? The government will be dictating to us every aspect of our lives.
America, as we know it, will cease to exist.
We see nothing but failure of the left’s agenda for the government intervention in every facet of our society, but yet we want to give them more control. Just look to schools, criminal justice system, railroads, and the post office to name a few. I could go on but why bother.
the protests are good and need to continue, but not necessarily as polite respectful little drones as the left want us to be. When then are against something, it is a loud foul mouth and violent. Long live the revolution.
Ping. A long, but excellent economic and social analysis of the healthcare dilemma, with proposed free-market incentives.
Free market principles are prevented by the middleman/employer.
If you had read more, or can make the time to read it later, you might learn something. It is an excellent overview of the present system and how it might be improved other than the ways currently being proposed, including your reactions.
As for having an advocate, it is absolutely not a solution to the complex issues addressed by this article; it is only a defensive tactic for those lucky enough to have one near at hand when a health crisis strikes, or drags on.
Doctors in France still make house calls.
The insurance companies, and even the lawyers, are relative bit players in the larger problem.
It's the government that is the problem, yet the government parades around in drag, pretending to be the solution.
The Atlantic must have paid him by the word.
Absolutely excellent article. Anyone who wants to understand health care in America should read the whole article. Can’t say it enough. Excellent. Thank you David Goldhill.
If you’re not going to read the article, then why should anyone read your long post?
It’s not private insurance but government interference which is the problem.
Again, I agree 100%. The left has repeatedly demonstrated in the past that "passive resistance" is an open invitation to more beatings. Loud, vocal protests are ok when it's THEIR side, but NOT from ours!! They don't like getting their own crap thrown back at them.
On a side note, there was an interesting note that popped up on Hannity yesterday. After Pelousy and Hoyer piped up calling all the anti-healthcare people "un-American" and "nazis", Pelousy did a 180 that must have given her whiplash. Suddenly, she is making statements to the contrary, now saying that the protests are "American" and the "people's right to speak out". Speculation is that zero told her to back off. I almost wrecked my car laughing when I heard the sound bite with her "new" tone about the protests. Long live the revolution. IMO, it's on, my FRiend!
Government is certainly a big part of the problem, but I blame lawyers and insurance companies more. I live in Texas and we enacted tort reform a few years back that capped how much a jury could award a victim in a malpractice suit. The result is that healthcare costs are lower here because malpractice insurance rates are lower. Another benefit we are deriving from this is that doctors are closing their offices in other parts of the country and re-locating here.
I'm not bragging about any of this, just using it to demonstrate that tort reform WORKS and it boggles the mind that it is NOT part of zero's DeathCare plan!
He had a lot to say, and I think he said it well. He gave me some food for thought.
This is not an issue that can be discussed rationally in sound bytes.
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