The September Atlantic has a an article by David Goldhill, How American Health Care Killed My Father. "After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. Here’s a radical solution to an agonizing problem."
It's probably the best article I've read on health care reform. He describes how the customer is really insurance companies and Medicare and not patients and how there is absolutely no price transparency in the system. He tried to find the price of an MRI and some hospitals wouldn't tell him until he actually ordered the test, let alone the prices are different for insured vs uninsured patients. And there's no good way for patients to actually measure quality of care beforehand. We're told that technology has raised the cost of medical care but technology has transformed just about every industry and usually provides greater efficiencies at lower prices, so why should health care be different?
It's a fascinating article with radical proposal. I'm not sure I like it, but I want to discuss it. Or more precisely I wish an economist I respect I would discuss it. Paul Krugman are you listening?
2 comments:
Please feel free to post interesting and excellent articles about health care that leave me boiling with rage by the time I am done reading them. Don't worry it is the good energizing rage that makes me want to see something useful done to fix or replace the system.
The points made in the article, especially lack of price transparency and the disconnection of the consumer from the market because of insurance are obvious to anyone who has ever thought about the problem, and are a big pet peeve of mine. I am not sure I agree with his radical approach to the problem, but reconnecting the consumer to the cost and removing the artificiality created by insurance companies is a step in the right direction.
I would add a caution that health care is not like other commodities since it is so bound up in our very selves. What person doesn't think no expense should be spared when they are sick or to extend their life.
Krugman has mentioned the classic economic papers that show that health care isn't like other commodities. One thing I liked about this article was the separation of catastrophic care vs regular routine care and I'm not sure if different economics should apply in those cases; seems like they could.
I was also not sure about his final point. Would the hospital when asking his grieving mother for $600K actually preferred to have had the doctor wash his hands instead? Wouldn't an insurance company that has to deal with this often (given there are a lot of deaths caused by hospital infections) be arguing louder than a single (or merely individual) widow for a systemic correction? I don't think hospitals and doctors are trying to kill patients for profit, but as other articles have pointed out, the current system rewards treatment, not health.
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