Sunday, December 27, 2009

On healthcare

Where do I even begin with this clusterfuck? I could have written several pages every week about the different aspects of this health care bill that have ever so slowly trudged their way through the house and senate, but now that this process is hopefully nearing its close I can hardly expect to hook anyone with a track record of insightful analysis.

Nevertheless, I've been unable to keep a straight face against arguments to date that the US health care system does not need some sort of overhaul so if you think you have one I'd love to hear it. I'm sure you've all heard the arguments that we as a nation spend more money per capita on health care and have far worse health outcomes than many developed countries. One of the few reasonable justifications that I've heard for this is that American ingenuity in health care technology and pharmaceuticals benefits the entire world but comes at a heavy cost. It's an often cited sink for our exorbitant health care expenditures, but I've struggled to understand the line of reasoning that requires this entire financial burden to fall on U.S. shoulders. It's entirely possible to shift some of these development costs on to citizens of other countries but this requires a change from the current way of doing things. Any type of sea change in the field will surely require some legislative kick start to reincentivize business models.

I accept that we don't want to curtail American supremacy in medical innovation, because it benefits us as much as the rest of the world. But there are still clear problems in the U.S. with respect to costs, incentives, access to and quality of care. In short, the U.S. system is fraught with frivolous lawsuits against doctors, free riders who receive treatment but don't pay, ridiculous administrative costs, perverse financial incentives for doctors to run expensive and unnecessary tests, legions of individuals who have been priced out of the insurance system, and zero transparency for patients and doctors to see the costs associated with their care much less be able to maximize their return on a cost-benefit curve.

These are serious issues that absolutely require reform, and while I have many reservations about the current bill that is under debate, I do sadly think that it is the best that we are currently able to get (I'll spare you my vitriol for the senate until a later date). Therefore its clear inadequacies and greatly reduced scope should not get in the way of legislators passing it and trying to take a deep breath before tackling these issues again and hopefully passing the serious reform which this bill clearly is not.

As a side note, I highly recommend the collection of articles from Timothy Noah and Planet Money about health care, and urge you to start with this one if you're even the least bit sympathetic to republican cries for fiscal conservatism which I admittedly am... or was.

**posted on Fingerprints.and.Snowflakes**

1 comment:

  1. oops, I wrote a comment to this but I lost it. Basically it was about how I was pissed off at the Democrats for messing this up.