Friday, August 14, 2009

Uwe Reinhardt, a Princeton economics professor and health care expert, writes about Americans' general inconsistencies when it comes to health care reform. Here's his list of things that Americans want from their health care system:

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.

As I've said before, there are two different issues before us when it comes to health care reform. The first is universal coverage. The second is how to reduce the costs of the entire system. Universal coverage comes down to the fundamental issue of whether we should provide basic health care to those who can't afford it. It is not an issue of cost, although it needs to be taken into account when dealing with the cost issue.

Reinhardt's column focuses primarily on the need to reduce costs, and the inability of Americans to understand that we simply cannot have all the health care we want, all of the time. A moment's thought would reveal this to be true; there is a limited supply, and an unlimited demand. But until we come to grips with this reality, we will continue down the road to ruin.

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