A Short History of Health Care - Slate (2007)

[WillyT]

A Short History of Health Care
Jonathan Cohn shows how we got here.
By Timothy Noah
Posted Tuesday, March 13, 2007, at 6:52 PM ET

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Any successful attempt to reform health care in the United States must accommodate two realities.

Reality 1: The current system is increasingly inaccessible to many poor and lower-middle-class people (about 47 million Americans lack health insurance, up from about 40 million in 2000); those lucky enough to have coverage are paying steadily more and/or receiving steadily fewer benefits; the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and resources; and the end result is that the United States pays roughly twice as much per capita for health care as Canada, France, and the United Kingdom yet experiences slightly lower life expectancy than those countries and significantly higher infant mortality. The problems inherent in the U.S. system of health care are literally killing people.

Reality 2: Open discussion of a "single-payer" system in which the government pays for and regulates health care is verboten within the political mainstream because it is presumed that Americans would never accept socialized medicine. Whatever solution arrived at by Congress and the president (in all likelihood, not this president) will have to harness market forces because, it's widely believed, markets will always outperform the dead hand of government. The lesson of "Hillarycare," a sweeping proposed health-care reform that died in Congress and may have delivered the House and Senate to the Republicans in 1994, weighs heavily on Democrats' minds (even though Hillarycare was not a socialized-medicine scheme but rather an attempt to reorder the private insurance market).

The trouble with the policy debate that's slowly beginning to emerge as the medical-industrial complex spins out of control is that it pays maximum deference to Reality 2 (political reality) and minimum deference to Reality 1 (the thing itself). This is an occupational hazard for mainstream political thinkers, who tend to define a pragmatist as someone who can find common ground between Republicans and Democrats no matter how irrelevant the compromise may be to the problem it's meant to solve. Thus in a recent column, Slate editor Jacob Weisberg noted with admiration that Sen. Ron Wyden, D.-Ore., author of an elaborate new market-based health-care reform bill, was so determined to "learn from previous Democratic mistakes" that he "read The System, David Broder and Haynes Johnson's massive tome on the failure of the Clinton health-care reform plan, no less than five times." But wouldn't it have made more sense to read The System just once or twice and then move on to a book focused not on Congress and the White House but on hospitals, insurance companies, doctors' offices, and the patients they're meant to serve?

Jonathan Cohn, a senior editor at the New Republic, has written such a book, and I would urge Sen. Wyden to read it at least three times. Cohn's book, to be published next month, is Sick: The Untold Story of America's Health Care Crisis—And the People Who Paid the Price. Each chapter of Cohn's book is devoted to one or two patient narratives that illuminate a particular dysfunction of the present medical system, and the chapters are arranged in such a way that the dysfunctions appear more or less in the order in which they first became significant national problems. The result is an 80-year chronology of repeated market failure, with each successive reform serving at best as temporary respite from the previous problem. Read it and weep. Capitalism can't deliver decent health care.

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More: http://www.slate.com/id/2161736/

:shrug:

[secondwind]

1. Thanks for posting this, WillyT!

[WillyT]

2. You Are Quite Welcome !!!

:hi: