Healthcare Reform

There are a lot of people talking about healthcare reform. New York Times columnists, Nobel Prize winning economists, Nobel economists arguing with conservatives... I'm a fan of the speech former Oregon governor John Kitzhaber gives about healthcare, comparing it to public education and the trade-offs we face in that domain.

I find these discussions interesting. All the people I listen to make sense. And yet the politicians seem to ignore all these sensible ideas. I think it's clear that the insurance industry would rather not die, and is spending a lot of money lobbying congress to make sure it can continue leeching off us.

The insane out there will argue that free markets lead to efficiency. But the function of supply and demand doesn't work in health care. There's infinite demand. I want to be healthy, and I'll spend lots of money on it rather than be sick or die.
The incentives in the system now are for profit, not health. They need to be changed so that long-term prevention is rewarded more than expensive surgeries.

And the system isn't fair. Some people get better benefits than others from their jobs. And insurance companies can kick people out of plans for getting sick. That's evil.
The only way it's going to work is if we all pool our resources to take care of everybody. That means young healthy people paying into a system they don't use. And that does mean not paying for expensive things that don't improve health much.

The schools metaphor makes a lot of sense to me. Like the schools, we have public funding for a certain baseline education. Everyone pays for it, whether they have kids or not. (Everyone was entitled to an education when they were young, too.) Some luxuries aren't part of the system. If you're rich, you can go to a thriving private marketplace and get those extras.

Healthcare should be the same way. Because then we could give people pills and plans instead of expensive emergency room visits and hospital stays. Because we spend twice as much as other countries and we're less healthy.

I'm hopeful that Congress will make a change. And that it will make it better. I doubt it will be the best it could be, but hopefully we'll take some steps in a forward direction.