Monday, January 30, 2006

Fumbling the Health Care Ball

Matt Bai has an interesting piece in this week's New York Times Magazine that highlights just how bad this country's health-care crisis has become and just how bankrupt we are of leadership on the issue (or on much of anything in Washington these days). President Bush is expected to unveil an unimpressive health care initiative in tomorrow night's State of the Union, and that fact, along with any number of others in the last year, makes it clear once again just how crucial the 2004 election was.

America is at a crossroads on a long list of huge issues (among the most pressing of which is health care), and this administration simply lacks the creativity to start solving it. According to several articles, Bush's proposals will be little more than retreads of the tax-credit, private-market answers the Republicans have been putting forth on numerous domestic issues for years. But as Bai points out, this problem is much bigger than these proposals will even come close to solving.

What we need is a leader who will turn this country's health care system upside down. We need a leader who will be willing to look at a much larger government role in the sector (as an article in this week's Week in Review reports, numerous CEOs would not object -- anything to take that huge cost off their balance sheets) while inserting some consumer accountability and rationality into the system.

My first visit to a doctor in New York City nicely illustrated what is wrong with the system. Without telling me his diagnosis, my doctor wrote me a prescription for a bronchitis antibiotic (America has a big problem with over-using health care, which drives up everyone's insurance costs). It didn't seem like he put much deep thought into the remedy. When I asked for a generic alternative, he retrieved a free sample from Pfizer from his office (free samples impede what should be non-biased medical advice -- there have been a number of articles over the last few years that revealed abuse by pharmaceutical companies through the free-sample system). I filled the prescription but ended up not using it and wound up recovering in a couple days. The prescription ended up being unnecessary.

What we need is a system in which the poor can get the health care they need, even if they work at a low-paying, benefit-free job, the middle-class are forced to be critical consumers, the upper-class help pay for it all and corporations are freed from the responsibility to provide health-care benefits, allowing them to more easily compete around the world (Swedish and Dutch companies are pretty happy with the deals they have). It can't be a statist solution of the past -- something like that will prevent any sort of critical thinking from consumers or their doctors. It must be a muscular hybrid of the two (check back when I get my masters, and I may have a more specific solution for you -- the problem will likely not be solved by then).

The government will need to step into the breach, which the Bush administration will clearly be unwilling to let it do. Too bad we don't have any visionaries in the White House or on the Hill. And I have no doubt what we'll hear tomorrow night will be the same old same old from that side of the aisle.


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