Tuesday, December 05, 2006

What? Someone is optimistic about the Future of US health care? Well, I'll be darned.

That person is Jennifer Openshaw, writing at marketwatch.com.

US health care is a mess, no one can deny this. Although the quality of care can be generous and excellent for the lucky insured, treatment is expensive for the uninsured middle class and for employers and employees, who collectively are the market participants paying the price for government health benefits for the uninsured lower income bracket and elderly.

Where every other country seems to be offering nationalized care -- France, Germany, England, Sweden, Norway, Holland, Spain, Canada, etc., i.e. most "civilized" nations -- the US seems to be dragging its heels.

And rightly so. Some of us can see that national health systems have huge bugs in them, most notably (1) a lack of open and public price negotiation (the public is not involved in the pricing procedure, but rather a limited number of payers negotiate with caregivers behind closed doors to fix and contract prices for a defined period of time), which leads to (2) the equivalent of government price controls, leading to (3) less innovation and research, coupled with (4) poor medical sector remuneration, all the above leading to (5) inferior care on an overall basis, including long waiting lists.

In their defense, I must say that people like the French are very happy with their system. Their doctors and nurses seem to be people of religious devotion to their vocation, willing to work for less pay and do it with a smile. But those contented patients and caregivers in France don't notice that more ambitious health professionals have abandoned the country for greener pastures.

Soon we will face a national debate about this issue, as Hillary, the great defender of national care, and/or her Democrat colleagues get their act together; and we Libertarians who defend the free market at every chance expect to cringe; but we may be surprised to see that even the Democrats can understand the market problem with a one-payer system, and that even they may come up with some compromise solutions that could be worth considering.

[Thanks to dread.net/~amina for the photo.]

Market participants are already finding ways to introduce competition into the US system, according to Ms. Openshaw. Aetna has initiated a program whereby they publicize hospital and medical charges so that those who pay co-payments and high deductibles can become aware of how much caregivers are invoicing *before* choosing one. Florida's government health service department is doing likewise. (Don't forget, state governments are market participants, too.)

Maybe there's hope? It's the first optimistic note I've heard on this subject in a long, long time.


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