I’ll just put up a few items which speak for themselves which won’t stop me from a few comments. Paul B Ginsburg has an article in tomorrow’s NEJM – Getting to the Real issues in Health Care Reform. He describes the bills emerging from the House and Senate which would “reform” the country’s healthcare “system”. His tone is dispassionate and analytical. It’s like a matter of fact description of someone walking down the middle of an interstate highway at a peak traffic hour naked save for a canvas sack over his head. Ginsburg’s concluding paragraph is a gem of nonchalant inadvertence:
If combined House-Senate reform legislation makes it to the President’s desk for signature, enactment would be only a start to the reform process. regulations will need to be written, organizations (such as exchanges) will need to be built, and midcourse corrections will need to be legislated to deal with the unforeseen consequences. And since only tentative steps will have been taken to reform care delivery, policymakers will inevitably have to return to battle on that front.
Doubtless Ginsburg is right. If you are not horrified by the above you don’t understand where we’re headed. Dr Ginsburg (he’s a PhD) works for the center for Studying Health System Change in Washington, DC. The legislation about to emerge from congress is his retirement plan, his children’s education, the educations of his grandchildren and that of his descendants down to the end of recorded time.
MSNBC, which is more left than Warren Spahn, quotes a piece from the NY Times about the ever increasing incidence of medical bankruptcy. If you actually read the article you’ll find this in the 11th paragraph: How many personal bankruptcies might be avoided is unpredictable, as it is not clear how often medical debt plays a back-breaking role. There were 1.1 million personal bankruptcy filings in 2008. In essence the argument is made that we should reform healthcare because it will relive bankruptcy due to overwhelming medical bills though we don’t know whether or not this is a common event.
MSNBC also reports that one in four American mortgage holders are under water – ie, they owe more than their homes are worth. This would seem to be at least as big a problem as medical bankruptcy, probably worse. Why not have mortgage reform which would have the government compete with banks in offering low cost mortgages which would never be allowed to sink beneath the surface of our turbulent economic sea? Come to think of it we already did. Do you remember how that worked out?
Once you realize how much fun it is to reform things there’s no reason to stop spreading the enjoyment to every state, county, precinct, ward, and boulevard of our benighted and largely unreformed land, especially when it really doesn’t cost anything as the Chinese seem willing to pay for it all.