And, we have the HHS Secretary being reported as saying this:
“There’s no question, right now, health care is being decided by insurance companies,” said Sebelius. “Part of the Affordable Care Act is to make sure that the tools are back in the hands of health care providers and patients to make their own decisions and so I think his leadership at this time is going to be critical.”Taking decisions out of the hands of insurance companies and putting those decisions in the hands of health care providers and patients sounds good to me.
However, Dr Berwick talks about not fully resourcing our health care system, so we can find where the bottlenecks are.
“You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach,” Berwick said. “You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”That doesn't sound like putting things in the hands of the physicians and patients. It sounds like putting things in the hands of the accountants. As usual, I come down on the side of those who believe the Government is not capable to setting prices efficiently for a whole economy.♠
The blog I originally went to noted that this approach of rationing to find the proper equilibrium in the medical market, provides this kind of situation:
Britain's higher cancer mortality rate results in 25,000 more cancer deaths per year compared to a similar population size in the United States. But because the U.S. population is roughly five times larger than the United Kingdom's, that would translate into 125,000 unnecessary American cancer deaths every year. This is more than all the mothers and fathers, aunts and uncles, cousins and children in Topeka, Kan. And keep in mind, these numbers are for cancer alone. America also has better survival rates for other major killers, such as heart attacks and strokes.I will agree with Dr Berwick that we need reasonably equal health care all. We have too many people who are not getting reasonable care. Part of that is due to a shortage of medical providers, something the new Health Insurance Reform is not going to fix. But, are we really saying that Senator Edward Kennedy should not have been allowed to use his wealth to get the absolute best care he could afford?
Regards — Cliff
♠ And rationing of any kind leads to a growing black market. The black market, in turn, can lead to financial and then political chaos.