Tuesday, August 18, 2009

A breath of fresh air

The NRO Web Briefing recommended an article entitled “How American Health Care Killed My Father” by David Goldhill. His father died of a hospital-contracted infection which should have been easily prevented; this story has some elements in common with my aunt’s which may be part of why it resonated for me. Even leaving aside the personal element, though, this is some of the best thinking I’ve seen on health, health care, and health insurance. I’ve only read it through once and I may have some caveats once I study it more carefully but right now I’d vote for Goldhill’s plan in a heartbeat.

You simply have to read the whole thing and the concluding paragraph is dynamite but here’s the basic thrust of Goldhill’s argument:

Indeed, I suspect that our collective search for villains—for someone to blame—has distracted us and our political leaders from addressing the fundamental causes of our nation’s health-care crisis. All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that—most important—remove consumers from our irreplaceable role as the ultimate ensurer of value.

This article is like a breath of fresh air after too much time spent in the miasma of endless, pointless arguments about health care, er, insurance reform. I like Goldhill’s ideas far, far better than any other I’ve seen - including my own.


Anonymous said...

What a fine article!

"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."

-- Texan99

Elise said...

Yeah, it was the first thing I've read that makes me think the whole issue may not be totally unsolvable. Just thinking about knowing what health care would cost me and being able to make my own decisions about what to pay for and how much felt incredibly liberating.