Health-care crisis
January 31, 2006
Today may be a rare teaching moment about the health-care crisis, I say with my usual unwarranted optimism. The medical mess is expected to be the focus of the President’s State of the Union address tonight, and the well-written article on the subject in this week’s Economist should help us parse the President’s words of remedy, be they desperate measures or mere band-aids.
America’s health-care crisis | Desperate measures | Economist.com
America’s health system is a monster. It is by far the world’s most expensive: the United States spent $1.9 trillion on health in 2004, or 16% of GDP, almost twice as much as the OECD average (see charts 1 and 2). Health care in America is not nearly as rooted in the private sector as people assume (one way or another, more than half the bill ends up being paid by the state). But it is the only rich country where a large chunk of health care is paid for by tax-subsidised employer-based insurance.
If the President calls strongly for reform of medicare, we may be justified in finding some hope in his words. On the other hand, if he talks mainly in terms of tax twiddling, we may rest assured that he is content to pass the problem on to future administrations and future generations of taxpayers. I’m afraid that my innate optimism is not quite strong enough to create much hope for the former.
At great risk of oversimplifying, I assert that until you and I are willing to enter into, or perhaps be shoved into, drastically different relationships with our doctors and dentists and clinics and hospitals - ones characterized by improved trust and communication between patient and provider, and divested of the economic distortions and disincentives invented by belt-way do-gooders, we can confidently expect much more of the same.
I’m afraid that I have no idea how this might come about, but you already knew that, didn’t you?
Dave, whose optimism seems to be waning.
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