- the reliance on cleaning up "waste" to fund some of the proposals. Ronald Reagan made me suspicious of that idea long ago. Certainly I could see some big gains in efficiency if the entire system were as efficient as say Kaiser, or the Cleveland Clinic. But I'm too cynical to believe "waste". It's like what's-his-face's (Stockman--remembered a minute later) magic asterisk in Reagan's first budget.
- the focus on dollars doesn't pay enough attention to the health-care supply. Even if, by some miracle, we converted tomorrow to a single-payer system which cut administrative costs from 20 percent to 5 percent, we still have a problem. We need the doctors, nurses, labs, and clinics to provide the additional health care needed by the uncovered population (or by the covered population whose illness is not covered). Granted, as Ezra says, it will take time to implement changes and the uncovered people need, on average, less health care than the currently covered, I still have my doubts. Given that part of the financing is to be cutting reimbursements to providers, that's a signal to youngsters considering health care to go somewhere else. (Perhaps, given Obama's budget, to education or environmental occupations.)
Thursday, September 03, 2009
A Health Care Concern
Ezra Klein in the chat linked to in my previous post responded to a question that's been worrying me. Generally speaking on health care I'd be for a European system. Lacking that, I'd support some of the proposals being floated, Wyden-Bennett if it were feasible. My biggest concerns are: