If you want to understand our health cost problems, you should read this Atlantic article by David Goldhill.
Here's the heart of his argument:
I'm a Democrat, and have long been concerned about America's lack of a health safety net. But based on my own work experience, I also believe that unless we fix the problems at the foundation of our health system—largely problems of incentives—our reforms won't do much good, and may do harm. To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government's role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy.
As I mentioned in this post, I have made similar arguments over the years, but I have never put them together in one big post.
By the way, you don't have to take just my word that this article is worth reading. On today's Gang of Four show, David Horsey recommended the article and said, though not in these words, that it had made him rethink his support for the current Democratic health insurance "reform" proposals.
Because the article is so long, and because I want you to think about it, I'm going to close the comments over the weekend. On Monday, I will either open up the post, or put up a brand new post just for comments on the article. (Later next week, I will put up a guest post by a person who favors the current Democratic proposals.)
Posted by Jim Miller at August 28, 2009 11:49 AM | Email This1. The customers (us) can drive the cost if they are responsible for paying their primary care
2. The customers would have a special post tax savings account for primary care that once it had the basic saving in it could also be used for other purposes.
3. Health insurance would be for catastrophic problems.
We would not have an unworkable 'single payer' system.
Posted by: Tim on August 31, 2009 09:00 AMI see now that health-care has not been a "free market" in the way we usually think about markets. Imagine if a grocery store negotiated different prices for bread based on customers' ability to pay (uninsured versus insured) and that they were required by law to give bread to those who couldn't afford anything, and that their biggest customer (Uncle Sam) basically dictated a low-ball price he was going to pay! Who could accurately pinpoint the "market value" of a loaf of bread under such conditions? Who could blame the grocer for overcharging other paying customers in order to stay in business?
What profit margin is reasonable for health care? And how does that compare to aerospace, software, oil, or other business sectors?
I don't know all the answers. Nor do I necessarily agree with the author on every point. But it has given me a lot to think about.
Posted by: Doug King on August 31, 2009 09:04 PMWe need ROMNEYCARE.
Cap and Trade is bad.
Uh, sorry I mean cap and trade is GOOD.
Forgive me it is so hard to keep up when as a Movement Republican my core values must change suddenly all the time without notice.
Posted by: Beth on September 1, 2009 09:11 AM