Monday, August 06, 2007

Bad Roads and Rich Doctors

There is nothing better than a long drive to keep the reality of the country in perspective. The political debate is truly a thin veneer over the millions of people working to keep this country something special. Maybe there is a real blessing in the perpetual civil war of the two party system, where the battles are fought between individuals of no other good use for society. In the end the collective wisdom of the aggregate whole should keep us of safe from the special wisdom of the few.

I suspect that the population wants safe roads and free travel more than they want to be ordered to pay a half days wages to keep irresponsible strangers ambulatory. John Goodman updates his ideas on the push for health finance reform.

Health Reform Part III: Sound and Fury: In a previous alert, I argued there are three important questions to be asked of one and all:

1. Does the plan force anyone - any patient, any doctor, any nurse, any hospital, any insurer, any employer, any government agency, any anybody anywhere - to choose between health care and other uses of money?

2. Does the plan force any provider of care - any doctor, any nurse, any hospital, any anybody on the provider-side - to compete for patients based on price and/or quality of care?

3. Does the plan allow patients now trapped in schemes that ration care by waiting - Medicaid, S-CHIP, Medicare, emergency room free care, VA system, CHAMPUS, Indian Health Service (Indian Health? yeah, why not?) - to have the same access to doctors, hospitals, clinics, etc., that privately insured patients have?

If the answer to the first question is "no," the plan will not control costs. If the answer to the second question is "no," the plan will not improve quality. If the answer to the third question is "no," the plan will not increase access to care. If the answer to the full set is "no, no and no" (and I believe in almost all cases it is "no, no and no"), the plan is hardly worth talking about.

Health Care is not a problem in the United States. Finding enough money to pay the asking price for everything is the problem.