No, I'm not being facetious. The revelation earlier today that Michael Jackson was probably killed by a propofol overdose encapsulates a core issue in the healthcare debate that has not received enough attention:
"MORE" HEALTHCARE IS NOT ALWAYS BETTER!
Now of course, many Americans subscribe to the "big is better" and "greed is good" philosophies that were espoused by Milton Friedman and enacted by Ronald Reagan. So pervasive are these ideas, that it has become almost a given that more healthcare (read: more expensive healthcare) must always be better than smart, evidence-based, cost-effective healthcare. When Pres. Obama rightly suggested that some doctors perform procedures to make money, he was roundly pilloried. The exact medical scenario may not have been accurate, but in principle he was spot on.
As an academic cardiologist, I am thankfully free of the perverse incentives that govern most fee-based private medical practices. I earn a fixed salary which is not indexed to how many procedures I perform or how many tests I order. If only that were the case across the board. Unfortunately it isn't. Ask any practicing physician whom you really know and trust and they will tell you: Doctors order unnecessary tests and perform unnecessary procedures to make money. It happens all the time. And what's more, some of these tests and treatments are dangerous.
Michael Jackson is an almost too-perfect case in point. With limitless wealth, he was able to afford what, presumably, for Republicans is the ultimate: your own private doctor who will "tailor" your treatment to your needs. And look where that got him.
Contrast this with a public option, or better still a single-payer government run healthcare system like Medicare or the NHS. It seems absurd to point out that such systems would not be able to afford a personal doctor in your home to put you under anesthesia every night, and rightly so. In general terms, as far as the human body is concerned, one size does in fact fit all. Medical tests and treatments can be studied with modern statistical models to determine, objectively, which work and which don't.
Once more for clarity: the entire premise that "more" healthcare is "better" healthcare needs to be challenged aggressively. More healthcare is sometimes better healthcare, but it's often expensive, unnecessary, and dangerous. For more check out these links:
http://www.newyorker.com/...
http://www.nytimes.com/...