To some extent, I despair of Health Care Reform ever coming to the U.S.
Nothing Obama or the democrats has ever said, has given me the slightest assurance they understand the scope of the problem or have the courage to offer solutions.
The real issue, even more than universal coverage, more than everything you have ever heard in the newspapers or on the campaign trail, is a failure of Americans to understand that heath care needs to be rationed. Currently it is rationed kinda (in a terrible way), because only the elite have insurance and get the most care.
We waste more health care dollars than anyplace on earth. For a good summary of the issue look at the new McKinsey Global Institute economists breakdown on the US health care problem.
Outpatient care accounts for 41% of total care and 67% of total "waste," and its growth is out-of-control, according to the report.
We waste so much of each dollar of course because we don't have to pay for it personally. When I visit a doctor I want the most expensive tests and technology available, regardless of whether its cost effective. That is just human nature.
Other countries ration health care. In the UK, chemotherapy is routinely denied when a government body suspects its not cost effective. Sure, that happens here too occasionally in HMOs, but can you imagine when us elitists start getting slammed with denials too?
Currently US private insurance pays almost without regard to outcome. To have universal care, we would have to change gears 100% and come to grips for the first time that health care resources must be denied to some for the good of all.
As most of you know, we spend something like 40% of our lifetime health care dollars in the last 3 months of our lives, usually just to make them more wretched.
When my father was dying we were repeatedly offered hundreds of thousands of dollars in operations and therapies that might have extended his life a few weeks at most. Does anybody really believe any politician would have the stomach to turn down such abuse? He would be hounded out of office by the right, the middle, and the left.
Sorry I just can't see it ever happening here. What will pass instead is the usual mushy half solution which gives everybody a little something and passes on the waste and bankruptcy to the next generation.
I suspect I will be opposing universal health care solutions without a string rationing component, which is to say I don't expect to see a solution in my lifetime.