How American Health Care Killed My Father
David Goldhill, The Atlantic, September 2009, page 38

This article profoundly effected my views on the health care debate. I wasn’t happy with either side of the debate, but wasn’t sure how a better plan would look. It’s an extremely complex issue. I like David’s ideas very much.

When it comes to the current debate about health care/insurance reform the Republicans on the right are disingenuous, crazy and blinded by their hatred for a black president. The proposals on the left are merely Band-Aids and do not address, nor will they fix, the causes of our medical mess.

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government · health care · politics · the atlantic

The July/August 2009 issue of Technology Review is especially good. In it there are articles on Wolfram Alpha, cap and trade, Obama’s technology stimulus, and nuclear fusion. It also contains an entire section on cloud computing and a thought-provoking essay on privacy in the age of Facebook.

A Pound of Cure (subscription required)
Andy Kessler, Technology Review, July/August 2009, pg. 75

The health-care industry’s reluctance to digitize its records is rooted in a desire to keep medicine’s lucrative business model hidden. Dangling $19 billion in front of a $2.4 trillion industry is not nearly enough to get it to reveal the financial secrets that electronic health records are likely to uncover–and upon which its huge profits depend. In those medical records lie the ugly truth about the business of medicine: sickness is profitable. The greater the number of treatments, procedures, and hospital stays, the larger the profit. There is little incentive for doctors and hospitals to identify or reduce wasteful spending in medicine.

According to a 2003 article by Dr. Steffie Woolhandler in the New England Journal of Medicine, administration accounts for 31 percent of expenses in the U.S. health-care industry, or more than $500 billion per year. (To put that in perspective, Google has spent well under 10 percent of that on all its R&D.)

I always laugh when people argue that a government health care system would be inefficient. I think they must never have visited a doctor’s office or dealt with their own health insurance company.

government · health · health care · insurance · policy · technology review · united states · usa

Why We Must Ration Health Care
Peter Singer, NY Times, July 15, 2009

I was first introduced to Peter Singer when I read his thought-provoking book, Rethinking Life and Death: The Collapse of Our Traditional Ethics.

In this New York Times Magazine essay, Singer persuasively argues that we should make health care decisions based on the economics of treatment. This should be obvious, but many feel that it is immoral to place a dollar value on human life. That absurdity is untenable.

What do you think of formulas that attempt to place a dollar value on an individual? How much are you worth?

We need a health care rationing system that is economical.

The essay should be read in its entirety. Here are a few of my favorite excerpts.

Remember the joke about the man who asks a woman if she would have sex with him for a million dollars? She reflects for a few moments and then answers that she would. “So,” he says, “would you have sex with me for $50?” Indignantly, she exclaims, “What kind of a woman do you think I am?” He replies: “We’ve already established that. Now we’re just haggling about the price.”

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death · ethics · health care · life · peter singer · policy · singer · united states · usa

The Cost Conundrum
Atul Gawande, The New Yorker, June 1, 2009

I once had a discussion with a friend who argued that the United States has the “best” health care system in the world. I nearly fell out of my seat when confronted with the absurdity. Could an intelligent person really believe such a thing? So what if we have the most highly skilled doctors and well-equipped medical facilities if those things don’t appreciably adds to our healthiness?

Medical problems contribute to more than 60% of all bankruptcies in the United States. There’s also the HUGE problem of job lock. Our health care system industry is an expensive and harmful disaster that is devastating both our health and our economy.

Atul Gawande, in this essay for The New Yorker, persuasively argues that it is not the payer who is culpable, but the system which turns physicians into market-savvy business persons. When the focus is on the money–as it is far too often–and not the patient, costs escalate and care declines.

Our country’s health care is by far the most expensive in the world. In Washington, the aim of health-care reform is not just to extend medical coverage to everybody but also to bring costs under control. Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance. It’s also devouring our government. “The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

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capitalism · free-market · health · health care · socialized medicine · united states · usa

Health system discourages innovation
Andy Sullivan, Reuters, May 28, 2009

I’ve been talking about “job lock” since long before I knew there was a term for it. It is perhaps one of the most devastating consequences of our troubled health care system industry–and one that barely receives mention. Innovation and entrepreneurship are what made this country great. Our health care system is destroying far more than our health; it’s wrecking our economy and global dominance.

Economists call this phenomenon “job lock,” and studies suggest that it keeps between 20 percent and 50 percent of workers from leaving their current jobs.

Because health insurance is tied to employment in the United States, workers who leave their jobs can see health bills skyrocket if they strike out on their own or take a position with a company that offers fewer benefits. Workers who would like to retire early stay on, unable to qualify for the government’s Medicare program until they turn 65.

As head of the National Federation of Independent Businesses, Todd Stottlemeyer frequently encountered would-be entrepreneurs who let their ideas go stale and their products languish on the workbench because they did not want to shoulder their own health care costs.

Troubling.

New Jersey saw a 14 to 20 percent rise in entrepreneurial activity due to a 1993 law making it easier for the self-employed to afford health insurance, a study by Philip DeCicca of McMaster University in Hamilton, Ontario found.

A major problem with most proposed solutions to rising health care costs and covering the uninsured is that there is little support for abandoning employer-based health insurance. The Democrats want to reduce costs and make insurance affordable for all. That’s great, but insurance companies ARE cost, and provide zero value. They make their money collecting premiums and denying care. Perhaps a public insurance option would give would-be entrepreneurs the security to leave their job and the health care benefits that went with it.

The Republicans have introduced a plan that would give each family a tax-credit to pay for insurance and remove incentives companies have had to provide health insurance to their workers. Perhaps these benefits could be converted to cash which would allow employees to shop around, thereby ending the problem of job lock.

Job lock is a real problem and should be a primary consideration in any health care discussion or proposal.

business · economy · entrepreneurship · health care · innovation · job lock · usa

The road not taken
The Economist, March 21, 2009, pg31

I recently wrote about home ownership and how the recession has the power to change America’s landscape. These changes should be encouraged and accelerated.

Recession and Geography
Brent Danley, The Rhetoric, February 22, 2009

The essay I read today in The Economist magazine only strengthened my opinions about both home ownership and health care. Both issues are devastating our economy and weakening our chances to grow and lead.

“Mobility is part of the American dream”, the author writes. And I agree. People should move to where the work is and where they will be able to find employment that will best utilize their talents and skills. Unfortunately, policies of past administrators have succeeded in promoting home ownership as the new American Dream. The consequences of this short-sighted idealism should be obvious to even the casual observer.

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america · economy · government · health care · home ownership · insurance · mobility · policy · united states · worker

We are all Keynesians now
Editorial, Boston Globe, November 25, 2008

Bush’s economic stimulus didn’t work, quite simply, because people banked the tiny checks or spent the money on foreign-produced goods. It was a political move that failed because it was bad policy. And every thinking person knew it at the time.

Obama’s stimulus promises to be far more effective. I’m glad it will be big, because it needs to be. I just hope it’s big enough.

My advice to the Obama people is to figure out how much help they think the economy needs, then add 50 percent. It’s much better, in a depressed economy, to err on the side of too much stimulus than on the side of too little.
~Paul Krugman, NY Times, November 10, 2008

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economics · health care · keynesian · obama · stimulus

Are you one of the many Americans who, with your head planted firmly in the sand, thinks the US health care system (that’s a stretch) is the best in the world?

Watch this.

In this excellent show T.R. Reid, a veteran foreign correspondent for The Washington Post, explores the universal health care systems of five wealthy nations. We could learn a lot if we simply look to other examples of what works and cherry-pick the best parts of each.

T.R. Reid is a veteran foreign correspondent for The Washington Post, a commentator for National Public Radio and the author of nine books, including three in Japanese. He is currently working on his 10th book, titled We’re Number 37!, in which he compares America’s health care system to others around the world. It is scheduled to be published by Penguin Press in early 2009.

frontline · health care · pbs · video