Monday, April 28, 2008

The New American Solution

Here is another quote from the Feb 7 2008 NEJM article of Robert Kuttner, a journalist and member of a political advocacy group, with the misleading name "Market based failure, a second opinion on US health care costs"

"Defenders of commercialized health care contend that economic incentives work. And indeed they do — but often in perverse ways. The privately regulated medical market is signaling pressured physicians to behave more like entrepreneurs, inspiring some to defect to "boutique medicine," in which well-to-do patients pay a premium, physicians maintain good incomes, and both get leisurely consultation time. It's a convenient solution, but only for the very affluent and their doctors, and it increases overall medical outlays."

And indeed economical incentives work. Who would have thought so? Money is the most direct connection to everybody's mind and heart. The author recognizing the effectiveness, but immediatley moves away to the supposed drawbacks ..."it works in perverse ways". It mihgt be counterproductive intially, when people do not go to doctors to save money, but sooner or later they will recognize that it is better to have a mammogram, rather than having to treat breast cancer at some point in time. Poeple have to learn that prevention is good, we cannot force them. We cannot regulate, administrate intelligence and cost efficient behaviour. It is simply impossible. People will have to learn.
We do not force everybody to start saving at age 15, and invest the interest back into the savings account. Right? Even though regular saving or investing with adding back the interest is one of the most powerful instruments to accumulate wealth, we do not force everybody to do it.
Why is health care so different? Why do we have to try to administrate our way to perfection in health care? Why do we not trust anybody with their own decisions?
We are on our own when we buy cars and take care of our cars. If we neglect them, they will rust, they will fall apart earlier and we will have to replace them earlier. People know this and take care of their cars. Why is health care different?

Apparently personal responsibility is undesired in health care, too many of us want to "have it all covered" and pay a high price for it, a price that, as it turns out, gets higher and higher every year.
The only solution to cost control in health care is to have consumers pay directly, cash. Only then will physicians be asked "Doctor, what is the most cost effective way to deal with this problem?"
Until we decide to go this route, health care costs will continue to climb and climb and climb, seemingly "unstoppable".
Well, not unstoppable at all. Health care costs are going up in exactly the same way in ALL countries in Europe and most countires around the world, yes exactly the same way as here in the US....
and why? Because the all use the "third party payer" system, that isolates the consumer from any kind of knowledge and responsibility of health care cost.
It is not the weird "market" here in the US, that is not even a real market, that dribves cost up, because cost goes up in single payer systems such as Canada and in three tier systems such as Germany. These systems are not the solution. They all struggle with cost increases. Why look to Europe when they have the same percentage of cost increases and the same range of dissatisfaction with their health care systems.
Are we not the greatest nation? Why would we look to the other ones for examples? Should we not lead instead of following?
We should lead by being the first country to institute cash care! Direct medicine. Responsibility and Affordability.
Capitalism is not the cause of the problems that plague our health care system, it is the CURE
More to follow

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