Cyphire, I’d like to be guaranteed good health care. I’d also like to be guaranteed good food, good housing, good…. In fact, much of my life is spent trying to achieve these security goals, so my comments on this are far from flippant or unsympathetic.
I think it’s interesting that one of the largest well-off nations on the planet also has an unusual arrangement for the health care of its residents. When I was growing up in a society with a lot of these guarantees, I noticed the US seemed to have more economic drive and success than we did. Could it be that the effort I now expend to achieve this economic security is shared by many others here? Could it be that it’s one of the reasons why the US does as well as it does economically (and examining the record over very long time horizons)? I don’t know, but it’s worth some fairly deep reflection as part of any debate on our future health care system.
I see horrible waste in our health care system here, but my impression is that first began to be serious in the 1960’s. When primary responsibility for almost all payments for medical goods and services are handed over to a weak 3rd party, Medicare or a private insurer, logic would say costs would start to escalate. I suspect that the cumulative health cost inflation we’ve experienced since 1960 is the biggest contributor to poor health care today.
There is more than one solution to the cost inflation. One solution is to put an all-powerful “dictator” in charge of the health care system – a European-style government health agency. They can then impose cost controls through price orders and rationing. We do it for other things, like physical security. It seems to work OK in Europe. But I wonder if it’s also possible to cure most of the unaffordability problem by removing much of the 3rd party management.
If most patients and doctors had to come to an agreement on prices and services without a 3rd party, I suspect prevailing prices would be dramatically lower. If I only had to pay $25 for a doctor’s visit, then even when I’m pretty poor I’m likely to go when I really need it. And most communities would have doctors who would occasionally forgive the bills for their poorest and most deserving patients.
I agree we have the worst of both worlds now. But I just think that there may be more than one solution to this.
