Your first paragraph is a great distillation of the debate, and the post keeps climbing from there. I would add that healthcare is expensive because the healthcare workforce makes up about 14% of the total US workforce and the average wages for most occupations is significantly higher than the average. But we also gain something other systems don’t have, and that is responsiveness in many parts of the system (I know - there are horror stories aplenty, but there are also scores of stories where rapid actions through the system saved lives).'We typically are not kept waiting for critical procedures like one hears about in Canada and the UK. There is no question that the system needs improvement, but that can happen only if we are willing to allow new ideas to be tried rather than stifled by massive bureaucracy in the public and private sectors.
Great piece Robert. I've always been amazed when people felt that they'd get better care in Cuba. The care here is complicated, and sometimes expensive, but remarkable.
I don't know, but I strongly suspect that general American healthcare is expensive because it subsidizes government programs. I retired and went on Medicare almost a year ago, and subsequently had some fairly major heart surgery with assorted minor complications. It is nothing short of humiliating to see how Medicare gives my providers the shaft; I assume the shortfall is made up through private insurance plans.
Great insight and argument... I have had this very thing stumbling around in the more obscure recesses of my mind for some time, but have never been able to wrestle it into the open and into a coherent line of thought. So refreshing to have someone do that for me.
People really do pursue what they want, characterized by their means, and insistence upon liberty. Tell them what to buy, with what to cook, what to drive, where to live, (etc. and et al.) and increasingly bump a stump (often many different stumps), to the every lasting exasperation and frustration of the political elites who know what is best for us. Seems simple, to me. Unlike Russia, for example, we do not have a citizenry evolved over hundreds of years of centralized cultural, political and societal command and control – a DNA of equality of poverty and coherence of repression that even today leads many in Russia to look back on the Stalin years with wistful nostalgia. Although we do have a large segment of our population who might imply otherwise. I suppose every polity must include a high ratio of sheep.
I'm late reading this post, but I can't resist making some comments. You make some good points,and perhaps our spending is not as out of control as those with an agenda would have us believe. On the other hand...
(1) Big numbers hide a lot of small sins. This argument doesn't address the very poor care and limited options for those who do not have employment-based commercial insurance or Medicare. Medicaid is crap, so between uninsured and Medicaid one would hope the nation with so much wealth could do better.
(2) Why should we be satisfied with the same crappy healthcare delivery systems as other developed nations? Why aim for European mediocrity? Why not, in traditional American fashion, make healthcare something that is simultaneously improving in quality, decreasing in cost, and increasing in availability? Why not unleash market forces on healthcare? As you correctly point out, the discussion around reform in this country concerns things that won't really move the needle. Rather than constantly chasing the unintended consequences of the last government intervention, let try the only thing that has ever created value -- a free market.
Your first paragraph is a great distillation of the debate, and the post keeps climbing from there. I would add that healthcare is expensive because the healthcare workforce makes up about 14% of the total US workforce and the average wages for most occupations is significantly higher than the average. But we also gain something other systems don’t have, and that is responsiveness in many parts of the system (I know - there are horror stories aplenty, but there are also scores of stories where rapid actions through the system saved lives).'We typically are not kept waiting for critical procedures like one hears about in Canada and the UK. There is no question that the system needs improvement, but that can happen only if we are willing to allow new ideas to be tried rather than stifled by massive bureaucracy in the public and private sectors.
Great piece Robert. I've always been amazed when people felt that they'd get better care in Cuba. The care here is complicated, and sometimes expensive, but remarkable.
I don't know, but I strongly suspect that general American healthcare is expensive because it subsidizes government programs. I retired and went on Medicare almost a year ago, and subsequently had some fairly major heart surgery with assorted minor complications. It is nothing short of humiliating to see how Medicare gives my providers the shaft; I assume the shortfall is made up through private insurance plans.
Great insight and argument... I have had this very thing stumbling around in the more obscure recesses of my mind for some time, but have never been able to wrestle it into the open and into a coherent line of thought. So refreshing to have someone do that for me.
People really do pursue what they want, characterized by their means, and insistence upon liberty. Tell them what to buy, with what to cook, what to drive, where to live, (etc. and et al.) and increasingly bump a stump (often many different stumps), to the every lasting exasperation and frustration of the political elites who know what is best for us. Seems simple, to me. Unlike Russia, for example, we do not have a citizenry evolved over hundreds of years of centralized cultural, political and societal command and control – a DNA of equality of poverty and coherence of repression that even today leads many in Russia to look back on the Stalin years with wistful nostalgia. Although we do have a large segment of our population who might imply otherwise. I suppose every polity must include a high ratio of sheep.
I'm late reading this post, but I can't resist making some comments. You make some good points,and perhaps our spending is not as out of control as those with an agenda would have us believe. On the other hand...
(1) Big numbers hide a lot of small sins. This argument doesn't address the very poor care and limited options for those who do not have employment-based commercial insurance or Medicare. Medicaid is crap, so between uninsured and Medicaid one would hope the nation with so much wealth could do better.
(2) Why should we be satisfied with the same crappy healthcare delivery systems as other developed nations? Why aim for European mediocrity? Why not, in traditional American fashion, make healthcare something that is simultaneously improving in quality, decreasing in cost, and increasing in availability? Why not unleash market forces on healthcare? As you correctly point out, the discussion around reform in this country concerns things that won't really move the needle. Rather than constantly chasing the unintended consequences of the last government intervention, let try the only thing that has ever created value -- a free market.