Economics: Reinventing Health Care

Just saw this program on KCET.

Very lively and heated discussion!

About 2/3rd into the program, moderator, law professor, Arthur Miller said the magic words: rationing.

After all the back and forth about the different systems each country uses and the scenarios of various individuals and the numerous statistics thrown around, it comes down to WHO decides WHAT should be covered?

And of course, there was many recitations of the famous triad of the health insurance problem: access, cost and quality.

Want to cut costs in health care?

"Someone" can decide that procedure X is deemed too expensive so it isn't covered.

Want to increase access?

A minimal package has to be identified and the rich taxed to help cover the poor.

Want quality?

The profit motive drives innovation but also inequity. How can we design a system that maximizes innovation but moves toward equity on some defined minimal coverage.

At the end of the show, there seemed to be some agreement that a basic insurance package should cover preventative primary care and catastrophic.

But the challenge is WHO decides what this package is? And on what basis will the decision on WHAT to cover be decided?

With a Democrat House and 60 votes in the Senate and a White House committed to health care reform, something might happen. Will it be an improvement or will it make things worse?

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