Good links on the topic of health care are coming fast and furious this week.
New Yorker writer Atul Gawande has written another piece on health care to follow up on his widely read article on disparities in health care expenditures and the reasons for them. In his new article, he lays out his prescription for health care policy.
The article is really a pep talk on the necessity of health care reform. As he points out, there are many health care systems around the world, and all of them are products of the time and circumstances within which they were instituted. Gawande recommends a mandate for universal coverage as they have in Massachusetts combined with greater measures to control costs, which brings me to my next reading recommendation.
Abraham Verghese writes in the Wall Street Journal about high health care costs, and making the argument that doctors being paid on a per-treatment basis is the fundamental problem with the system. Doctors make more when they order more procedures, and they don’t get paid at all for practices that would save money and increase patient health. Have you ever waited two hours to talk to a doctor for a minute or two about something that could have been handled over the phone? It’s because they can bill the insurance company for the office visit but not the phone call. This is how nationalized systems and single-payer systems save money: doctors are paid a salary and the economic incentives for doctors are completely different. This is, I think, the toughest problem we’re going to have to overcome, because with multiple insurers and doctors in private practice, there’s no easy way to change the incentives built into the system.
Nate Silver explains why the government should theoretically be able to provide health insurance in a more economically efficient way than private insurers. Robert Reich explains why the arguments against a public option are wrong.
I don’t have an ideological dog in the fight over health insurance, but what I do know is that the arc of my adult life would have been different if any American could go out and buy health insurance from a company or the government without regard to previous employment or preexisting conditions. I’ve taken jobs in the past for the sole reason that they offered health insurance. I’d ask everyone to think about how different their life would be if they didn’t have to worry about health insurance.