Health care ‘reform’ must be undertaken carefully
To the Editor:
As recent attempts to address the economic crisis evidence, there can be great political temptation (particularly, as now, where one political party controls both the legislative and executive branches) to force a “fix” on problems which may not truly be problems.
The number, often cited from the 2005 census, of 46 million uninsured, requires a close look. When distilled down to U.S. citizens who do not actually have access to health coverage, it becomes a substantially lower number, most likely closer to 10 million. But even the latter number warrants a closer close look because it includes people subject to very different circumstances that require very different, tailored solutions.
There is also the question of whether we want a “nanny” approach that would force younger adults with lower health risks and many others, who are included in the 46 million and could afford health insurance, to purchase health insurance when they have otherwise chosen to avoid the expense.
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Also, there is no mystery as to why health care costs have risen so much. Today, we have very sophisticated, specialized and technologically advanced medical procedures and treatments that, although we may now take them for granted, did not exist a few years ago. The cost of developing these medical miracles, acquiring the knowledge and skills to employ them and addressing risk allocation for these more invasive and intensive procedures and treatments in the world’s most litigious society, however, is high.
If my father, uncle and grandfather, who all died of sudden heart attacks in their mid-50s, had access to modern heart medication, diagnostic tools, and surgical and other procedures, they would likely have had been able to keep their heart disease in check and live much longer lives. I am sure that, given the choice, they gladly would have paid even today’s higher medical costs for the opportunity to know their grandchildren and great grandchildren. Any effort to change our health care system must preserve the incentives that promote medical innovation and attract the talent and investment to employ both the cost-intensive medical options that we enjoy today and those that will come in the future.
We also need to keep in mind that the government generally does a poor job when it ventures into the private sector. During the course of my career, we had the opportunity to live in a number of other countries that had nationalized health care. Going to a doctor’s office or hospital in those countries often seemed as though we were stepping back in time 20 years or more. Medical services were invariably rationed resulting in long waits, even for ailments that were life threatening or involved severe physical impairments. For elective procedures where cosmetic repair, comfort or functionality was the primary motivation, the wait was even longer, and, in some cases, the treatment was effectively unavailable.
Often advanced procedures were simply not offered in country, because the system lacked the financial incentive to develop or employ them or to attract and train the requisite medical experts. While current reform proposals now appear, fortunately, to be shying away from establishment of a national health care system, the basic principle still applies – any changes to the health care system that expand the role of government must take into account the impact and likely distortions that they will cause.
As Congress and the administration move toward the “reform” of health care in this country, they need to move cautiously and take these, and other, important factors into account. Politic opportunism aside, there is no need to rush this process at the potential of sacrificing a system that, for the most part and for the vast majority of us, does work and work amazingly well in terms of the medical advances and options that are, and will in the future, be available to us – to the envy of most other countries.
What is required is a careful, methodical, almost surgical approach that addresses only those parts of the system that really warrant attention. What needs to be avoided is a rush to apply a “meat cleaver” approach where the result may be a cure worse than the disease that it aimed to treat.
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