The country does need medical reform, but not Obungacare.
The size of obungacare indicates to me that it is about power and not about health care. Likewise Mark Steyn notes that the job of director or head of public health has become the biggest govt. job in European countries which have public health care i.e. it would be a step upwards from PM or President or King or Grand Duke or anything else to head of health care. In other words, European health care is ultimate bureaucracy. If I had the power to I would institute a sort of a basic health care reform which would be overwhelmingly simple and which would resemble the thing we're reading about in no way, shape, or manner. Key points would be:
1. Elimination of lawsuits against doctors and other medical providers. There would be a general fund to compensate victims of malpractice for actual damage and a non-inbred system for weeding out those guilty of malpractice. The non-inbred system would be a tribunal composed not just of oher doctors, but of plumbers, electricians, engineers, and everybody else as well.
2. Elimination of the artificial exclusivity of the medical system. In other words our medical schools could easily produce two or three times the number of doctors they do with no noticeable drop off in quality.
3. Elimination of the factors which drive the cost of medicines towards unaffordability. That would include both lawsuits against pharmaceutical companies and government agencies which force costs into the billions to develop any new drug. There should be no suing a pharmaceutical for any drug which has passed FDA approval and somewhere between thalidamide and what we have now, there should be a happy medium.
4. Elimination of the outmoded WW-II notion of triage in favor of a system which took some rational account of who pays for the system and who doesn't. The horror stories I keep reading about the middle-class guy with an injured child having to fill out forms for three hours while an endless procession of illegal immigrants just walks in and are seen, would end, as would any possibility of that child waiting three hours for treatment while people were being seen for heroin overdoses or other lifestyle issues.
All of those things would fall under the heading of what TR called "trust busting". There would also be some system for caring the truly indigent, but the need and cost would be far less than at present.
By far the biggest item is that first one. I don't know the exact numbers but if you add every cost involved in our present out-of-control lawyering, it has to be a major fraction if not more than half of our medical costs. The trial lawyers' guild being one of the two major pillars of financial support for the democrat party is the basic reason nobody is saying anything about that part of the problem.
Other than that, you almost have to have seen some of the problems close up to have any sort of a feel for them.
Item 2, this is what I saw in grad school some time ago, although I do not have any reason to think much has changed. In the school I attended, there appeared to be sixty or seventy first year med students walking around and all but one or two of them would have made perfectly good doctors, they were all very bright and highly motivated. The only way the school should have lost any of those kids was either they discovered they couldn't deal with the sight of blood in real life or six months later they changed their minds and went off to Hollywood to become actors or actresses; the school should never have lost more than ten percent of them. But they knew from day one that they were keeping 35% of that class.
That system says that you know several things about the guy working on your body: You know he's a survivor, and that's highly unlikely to be from being better qualified than 65% of the other students; You know he hasn't had enough sleep (he's doing his work and the work of that missing 65%); You know he's probably doing some sort of drugs to deal with the lack of sleep... One of my first steps as "health Tsar" or whatever would be to tell the medical schools that henceforth if they ever drop more than15% of an incoming class, they'll lose their accreditation.
Item 3. My father walks into a pharmacy in Switzerland with a bottle of pills he normally pays $50 for in Fla. and asks the pharmacist if he can fill it. "Why certainly sir!", fills the bottle of pills and says "That will be $3.50." Seeing that my father was standing there in a state of shock, the man says "Gee, I'm sorry, Mr. V., you see, we have socialized medicine in Switzerland and if you were a Swiss citizen and paid into the systemn, why I could sell you this bottle of pills for $1.50 but, since you're foreign and do not pay into the system I have to charge you the full price, certainly you can appreciate that."
The guy thought my father was in shock because he was charging him too MUCH... Clearly whatever needs to be done with drugs amounts to trust busting, and not extracting more money from the American people.
Item 4. A caller to the Chris Plant show (D.C./WMAL) the other morning, an ER nurse, noted that much of the costs which her hospital had to absorb, as do most hospitals, was the problem of people with no resources using the ER as their first and only point of contact to the medical profession. She said that there were gang members who were constantly coming in for repairs from bullet holes and knife damage and drug problems, that they could not legally turn any of those people away, and that there was zero possibility of ever collecting any money from any of them, and that the costs of that were gigantic.
Clearly throwing money at that problems is not going to help anything either. Again if I'm the "Medicine Tsar", those guys would be cared for, but not at the ER or at least not the part of the ER where normal people go, and they would not be first in line. Mostly they'd be dealing with medical students who needed the practice patching up knife and bullet damage.
As they found out in the randomized study in Oregon. Obamacare caused a 40% increase in ER visits.
You would be wrong in that. We have a $2.2 trillion health care industry in this country. And on an average year malpractice costs nationwide run about $7 billion, or one third of one percent. Something like half the states in the country enacted tort reform that caps malpractice awards, and there is zero evidence that it has led to lower healthcare rates in any of them.
I don't deny that we might often pay more for pharmaceutical products in the US than other countries do. There are several reasons for that, but primarily, it's the country of region that sets the price. Pharmaceutical companies are ham-strung because they would like to sell their product for a reasonable price, but have to do so with many constraints. Pharma companies are usually left with one of two options: they can sell their products at a greatly-reduced price, or they can not sell their product at all.
If we could incent other countries to spend a little more on life-saving medicines, we might not have to spend so much here.