We want to have access to all cutting age medical therapies but are reluctant to pay for their full value. We take for granted the many choices we have in selecting physicians and hospitals, but would rather not pay for these. We want to be seen, examined, diagnosed and treated right away, and hate to wait for the delivery of our healthcare. We want cheap drugs, but fail to understand that driving prices down (by regulations) will no doubt reduce the incentive for drug companies to bring new drugs to the market. Most Americans with terminal illnesses would fight vigorously to prolong life, at a very large cost to benefit ratio.
Well, many of us have the kind of healthcare we want (to a considerable degree) but the cost is literally bankrupting many of our companies and helping derail our economy. Is there any way we can continue to have all that, as well as add tens of millions people who are currently uninsured, at a much lower cost?
This is the $64 billion question, and while people from all political persuasions have their pet answers, the simple truth is that we have to choose between cutting cost and cutting privileges. What should we do? There are logical answers, and there are emotional answers. There are harsh answers and there are compassionate answers. There are sweeping changes and there is tinkering at the edges.
In our strong capitalistic system, the need to maximize profit is ill suited to deal with healthcare challenges. Furthermore, in the healthcare system, where outcomes are probably the least predictable of all human endeavor (on an individual basis) and expectations for perfection are the highest, where an ideal customer (for insurers) is one who is doing well throughout her long life and then dies suddenly, economic models borrowed from other disciplines are untenable and new ones need to be formulated. This tension between profit seeking entities (leading to high costs of drugs, surgeries, procedures, hospital stays) and the universal need for the services (unlike for any other item or service) makes it impossible for the “market” to work effectively.
The argument for or against a single-payer system for the U.S., like the ones that most western countries have, is raging now. Before such a system could work here, a major transformation (or at least recalibration) of our hard capitalistic principles will need to take place—an unlikely event despite the popularity of the current President and his Congress. Then again, not many of us would have predicted that banks might be nationalized.
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