Wednesday, January 20, 2010

Health care magic

 While talking with George Stephanopolous on Good Morning America this morning, Republican National Committee chair Michael Steele neatly summarized the prevailing American attitude:

"Remember, 82% of the American people like their health-care plan. 
They just want us to address their costs."

Mr Steele got it in one. We want what we have. We want it to cost less. And, as other commentators this morning pointed out, we certainly don't want to raise taxes to pay for it. (Scroll down to see previous posts about magical thinking.)

But in spite of wanting to pay less for health care, an increasing number of us are strenuously opposed to any of the approaches used by other developed countries who actually do spend less per capita--generally between 40 and 60% less--and yet have health outcomes that equal or surpass our own.
  • We don't want to keep insurers' prices low by launching a competing public option, even though the Veterans Administration and Medicare are public programs with a lot of satisfied customers.
  • We don't want to require insurers to cover basic health care with not-for-profit policies, even though insurers' administrative costs have risen from less than 5% to nearly 20% since 1995.
  • We don't want to require everyone to have health-care insurance, even though only a broad pool can keep prices low for the insured.
  • We don't want to put caps on prescription drug costs or allow medications to be imported from other countries, even though U.S. drugs often cost several times more than the same drugs bought elsewhere.
  • We don't want to put caps on physicians' fees, even though our doctors--particularly the increasing percentage of specialists--are by far the best-paid physicians in the world. Nor do we want to discuss two huge expenses that all doctors face and that must be reduced if we expect them to charge reasonable fees: the high cost of a U.S. medical education and the expenses associated with the ever-lurking threat of malpractice suits.
  • And we certainly do not want any experts reviewing the literature and concluding that certain tests aren't necessary (mammograms!), or that some end-of-life care is wasteful (death panels!), or that a highly advertised designer drug is actually no more effective than a cheap generic. We want top-of-the-line medical care, as seen on TV, even when it is not medically necessary or even advisable.
The insurance, pharmaceutical, medical, and financial industries are simply delighted that a majority of Americans are now unwilling to do what it takes in order to have a fair, compassionate, and reasonably priced health-care system.

We like the health-care we currently have, even though our insurance premiums and copayments increase every year as our coverage decreases and our claims are denied. We don't want to change our system in any way. Except, of course, to make it better. And cheaper. Without actually changing anything.

We believe in magic.


rebecca mccoy dean said...

Brilliant. Thanks for writing this.
And maybe Mr. Steele is correct that 82 percent like their health care plan (82 percent seems high). I have to wonder, however, about all the people who have no health care plan because they cannot afford to purchase one. . . Well, who cares. . I guess their status isn't even deserving to be part of the national discussion anymore. Every man for himself.

Duct Tape said...

You've caught the issue better than anyone else I've read. Most Americans (at least those who do have health insurance) are rather like the man who arrived at the ER with intense chest pain - begging for a solution - "but don't do anything that might hurt!"