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Healthcare Reform: A Bitter Pill to Swallow

Geoffrey on October 22, 2009 at 2:28 pm

The American healthcare system, as presently configured is unsustainable and will eventually collapse.

It will collapse due to developing demographic pressures. We are well into the beginnings of that collapse. Without substantive reform, in 5-20 yrs the infrastructural problems endemic to our current healthcare system plus the demographic pressures of a large aging baby boomer generation and smaller succeeding generation(s) of young tax-paying adults will overwhelm it.

However, private health care can survive and even thrive, if the problems affecting it are addressed.

Extra-structural reforms that retain cohesiveness with the current healthcare system can yield substantive and highly positive results. Just eliminating the current third party healthcare system, common-sense tort reform and allowing the offering of health insurance across state lines would greatly improve the current system by reducing costs.

However, those improvements will not address the heart of the liberal demand; universal healthcare.

That demand is fueled by the premise that a compassionate and wealthy society cannot in good conscience allow needless suffering to go unaddressed. Certainly that is a worthy goal, the disagreement lies in how we go about the pursuit of it.

The heart of the matter is that we presently face a trade-off. We can continue to have excellent healthcare for 90% of Americans, with the remaining 10% or 35 million Americans having at most basic healthcare and many with little beyond emergency care or we can have basic healthcare for everyone, but healthcare demonstrably poorer for everyone but the economic elite.

The proof of this assertion is that participants in single payer systems such as Canada and the UK typically wait much longer to see doctors than in the US and are frequently denied treatment bureaucrats deem ‘not to be cost-effective’. This is the primary reason why every year, of the 1.6 million Canadians who receive US healthcare, more than 400,000 Canadians visit strictly to avail themselves of the US healthcare system. In the UK, there is increasing reportage of treatment being primarily determined by the age of the patient with treatment of age-related conditions being deemed not cost-effective. Britain is letting its old die, all in the name of saving money.

To the degree to which, in the name of compassion, we ‘make’ insurance ‘affordable’ through a public option, it will impose major consequences: greatly increased wait times, treatment availability determined by its ‘cost-effectiveness’ and the consequence of an increasing tax burden upon the productive; the unintended result of an increasing tax burden upon the productive is just that of “the drowning man pulling under his rescuer and both drowning.

We can throw a drowning man a ‘rope’ and pull him to safety but he has to hold on to the rope. If he, for whatever the reason, refuses to grab hold of the rope, we cannot save him.

This is the hardest reality of the healthcare reform issue.

Morgen adds: The National Health Care Journal has been hosting an online debate all year, featuring notable health policy experts. (Including Uwe Reinhardt, who I quoted in an earlier post). Earlier this week they took up the question of what defines “universal coverage”, but ended up having an interesting debate on the trade-offs inherent in spending federal money in order to achieve this. It’s worth a look as they touch on several of the points that Geoffrey makes here.

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Category: Health & Education |

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