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Jul 31 / Jonathan

A ‘Common Sense’ American Health Reform Plan – Economix Blog – NYTimes.com

Uwe E. Reinhardt is an economics professor at Princeton. There’s more at the link.

20narc-190.jpgA ‘Common Sense’ American Health Reform Plan

The All-American Wish List for Health Reform

1. Only patients and their own doctors should decide what clinical response is appropriate for a given medical condition, even if that response involves unproven clinical procedures or technology.

2. Neither government bureaucrats nor private insurance bureaucrats should ever refuse to pay for whatever patients and their doctors have decided to do in response to a given medical condition. An insurer’s refusal to pay for a medical procedure is tantamount to rationing health care.

3. Rationing health care is un-American.

4. Cost-effectiveness analysis should never be the basis of any coverage decision by public or private third-party payers in health care, for to do so would put a price on human life — which, in America, unlike everywhere else, is priceless.

5. Government should not require individuals to purchase health insurance. Such a mandate would violate the constitutional rights of freedom-loving Americans.

6. Americans have a moral right to life-saving and potentially highly expensive medical care, should they fall critically ill, even if they are uninsured and could not possibly pay for that care with their own financial resources. (Why else would God have created hospitals and their emergency rooms?)

7. Government should stay out of health care. Specifically, government should not control health care prices, nor should it increase its spending on health care, which is out of control.

8. Even small reductions to the future growth of Medicare spending — called “cuts” in Washington parlance — unfairly burden the elderly, along with the doctors and hospitals that serve them and the manufacturers of health products, lest the pace of technical innovation be impaired.

One Comment

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  1. Loren / Aug 1 2009

    Cynically makes an excellent point, or as a M.D. friend say, “Americans can’t say no.” Nonetheless, this disregards very real flaws with our current system that are behind many of these silly demands.
    1. Very reasonable coverage is unfairly denied in many cases.
    2. The rationale behind refusals to pay is often opaque, arbitrary, and inconsistently applied.
    3. This seems just silly, and irrelevant in that private insurance clearly restricts coverage so is a form of rationing. No unrationed system is on the table or has ever existed here. Yet there are Americans so blind as to say such a thing, I would agree.
    4. False choice: there is no cost-effectiveness based proposal in site or in practice.
    5. (a) The argument against requiring health insurance comes out of a desire for everyone to have affordable coverage if they need it (which insurance companies say isn’t possible without the requirement by law). I don’t think there’s an argument against allowing people to completely opt out if they don’t seek health care later. (b) There is no serious contention of a constitutional claim.
    6. I think there is a serious moral question of caring for all, but the silly parenthetical religious line is just a dig not worth a response.
    7. The role of gov’t is a serious issue but again there is no option in sight where gov’t completely drops all its health care involvement.
    8. This is politics as usual, but I don’t think there is a serious claim behind this supposed position.

    So while I agree with the overall point of conflicting and often unreasonable positions, these facetious supposed set of requirements don’t seem to advance the debate. I’ve heard the writer interviewed and found him insightful so I imagine this comes from deep frustration (understandable) observing the politics of the debate.

    I wish I knew something positive to offer here, but Washington’s handling of the need for health care reform seems to be irrevocably set far afield from anything like a sensible policy. Representative democracy does not at all seem to be functioning with perhaps the best publicly supported option (single payer) firmly set off the table.

    Excellent graphic of the American (human?) psyche.

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