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At the Village Square, we started out knowing not-so-very-much about healthcare. Then, through the wonder of the internet and a little old-fashioned elbow grease, we became students of the health care debate. We've spent time with experts, read policy-wonk-ish studies until our eyeballs bled (requiring us to need – uh – health care) and even invited 200 people to dinner to talk about it all (Take 2 Aspirin, Fix Health Care & Call Me in the Morning.)
Until such time as we show up at your door with scalpels, here - with affection - is our non-surgical gift to you:
Doing nothing really isn't an option.The rising costs are unsustainable; they bankrupt individuals, handicap small businesses and even hurt larger businesses competing in global markets.
Free market forces simply aren't working in health care.The pro forma partisan argument between offering a market solution and a governmental one misses the salient point: The incentives that drive down cost & increase quality in a market economy are inverted in health care. The current system encourages more treatment over better care; we need to flip it. Fixing convoluted incentives is a complex task that requires grown-ups to come to the table, not the five-year-olds who seem to usually show up.
The advertising of pharmaceuticals probably ought to stop.Heavily advertised allergy, hair loss and erectile dysfunction medications create a huge health care bill for things we often don't really need. It builds a consumer-driven demand effectively, yet consumers don't directly pay for what they're demanding. It's like if the mall management started paying for your teenage daughter's shopping, a situation that doesn't tend to produce rational decision-making and restraint. This doesn't mean some of us don't need these medications, but our doctor will guide us to them when we do. Winning with the endless-erectile-rama isn't just Big Pharma, it's also the networks selling them ads. Losing is – uh – taxpayers (and good golly gosh our kiddos who have to listen to 15,000 Cialis ads an afternoon).
Common sense lawsuit reform needs to stop being a political football and start happening.There are measured voices on the left (among them Governor Howard Dean and President Obama) who admit that excessive malpractice awards can't help but weight the practice of medicine towards overutilization of testing. Democrats have to just wake up and smell this coffee. And Republicans need to stop pretending that the health reform sun rises and falls with tort reform. It doesn't.
Cost-control is the big gorilla in the room.No real advice here, because this gives me a headache.
Rome wasn't built in a day.Whatever reforms we try will be imperfect and will need to be incrementally improved. That's as it always has been. Good results can start with imperfect beginnings.
Grow up and lose the breathless good and evil story lines.At some point the body politic needs to stop searching for a villain. Every interest in the health care fight has skeletons in their closet and owns a part of what has to change. We'd like to see them stop throwing stones from their glass houses and – in the words of President Obama – "grab a mop." There are even skeletons in the closet of the vaunted American citizen. Which leads me to a last bonus health insurance insight...
We are overweight.70% of health care costs are lifestyle dependent. We want to eat, drink and be merry then we want someone to give us a pill to fix it when our chickens come home to roost. And if somebody expects us to pay for the pills ourselves, we're going to vote them the heck out of Dodge.
If you read only two articles on health care reform, here are The Village Square picks (both long, both well worth it):
How American Health Care Killed My Father by David Goldhill in The Atlantic
The Cost Conundrum, by Atul Gawande in The New Yorker