The push for universal coverage is based on the appealing premise that everyone should have access to the best health care possible whenever they need it. That soft-hearted aspiration, however, runs into the hardheaded reality that state-of-the-art health care is increasingly expensive. At some point, someone in the system has to say there are some things we will not pay for. The big question is, who? The government? Insurance companies? Or consumers themselves? And should the answer necessarily be the same for everyone?
Inequality in economic resources is a natural but not altogether attractive feature of a free society. As health care becomes an ever larger share of the economy, we will have no choice but to struggle with the questions of how far we should allow such inequality to extend and what restrictions on our liberty we should endure in the name of fairness.
In the end of our day of philosophizing, however, we face a practical decision:
Who gets the magic pills, and who pays for them?
Sunday, September 20, 2009
Who gets the magic pills?
A good column on health care economics in the New York Times:
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4 comments:
The summary is correct, who gets the magic pills, who pays for them.
Access and cost. and those two thoughts are getting lost in the national discussion.
More physicans, nurses,by using incentive plans for medical education, would increase access without increasing cost.
Tort reform, pooling, reducing medicare fraud, NOW, would reduce cost.
It is not rocket science, but it is, not having to answer to insurance companies, lawyers, and other interest groups, with one exception.
Listen to the voters, be a one term office holder, and a statesman, or stateswoman for life.
There is a log of waste in the expense side of medical care. Big Pharma and med equip supply need more competition and less doctors investing in their companies and lopsidedly engendering their wares into the practice.
Quality care can be made available to everyone without skimping, but that shift in power is unlikely to be considered.
I think what is needed is not more competition, but rather more people paying for the medical services that they consume. How can there NOT be a tremendous amount of waste when prices for services and drugs do not factor into one’s decision to consume those services and drugs?
I would not agree to allow poor people to suffer while the moneyed spend freely on facelifts, and fat vacuums while over eating, etc. because I believe money too often comes from illicit behaviors, lying, stealing from someone else. If supply and demand ruled, we wouldn't have Enron, Madoff, Reuwer. We wouldn't have CEOs making 200000 times what the lowest paid employee makes. Taking that kind of money from your own company should be a sign that you don't deserve it, but instead we idolize the 'rich' even though the money was ill gotten and had little to do with intellect or contribution.
But I see the point that, if we don't see the sticker price, we're less likely to care. Very true. But also there is a better solution than cutting the less well off out of a long and happy life.
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