I generally don't wade into the health care debate too much, as it is a field much better covered by others. But with the death of Goldwater's Ghost's blog (and his presence here as a fact checker/contributor) I feel like I can step out a bit today.
The Washington Post has a common sense editorial up this morning in which it describes universal care as a laudable, yet unaffordable goal. I agree with this assessment, but more to the point, with the Post's two suggestions on where to proceed in cutting costs/making quality care more affordable. Here's the key graph:
"Two cost-saving measures hold the most promise. First, what's known as comparative effectiveness research, which tracks what works and what doesn't, would also require outside boards directing doctors and hospitals about what procedures they could and couldn't use. Policymakers have tended to dance around the second part of the equation. Second, eliminating the tax break for employer-provided health care could generate a good deal of savings and help bring down health-care inflation. But, again, there's a political challenge; President Obama would have to admit that Sen. John McCain, his GOP opponent in the presidential campaign, was right on this idea."
Tucked into this little paragraph are two political landmines, one for each party--which ultimately creates the opportunity for reasonable compromise. "Comparative effectiveness research" is a term that makes many Conservatives queasy, as it conjures up images of bureaucrats "rationing" health care. What some call "rationing" I call "rational", and that is, the creation of protocols based on science and analysis that specify which procedures and treatments are most effective (and yes, cost effective). Other options should still be open to patients, but at their own expense. As for eliminating the tax break for employee sponsored care (something the President viciously demagogued during the campaign) anything that breaks the connection between employment and insurance is a good thing as far as I'm concerned (whoops, that is except the single payer government option). But elimination of the tax break MUST be a part of a broader, more comprehensive reform, including an income tax credit to individuals AND market reforms that empower individuals in the choices they have in receiving health care (such as small business pooling and the ability to purchase out of state policies).
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If I may wade into the deep end for a moment. Quite a few businesses operate with "best practices" and/or using "best of breed" software, tools, etc. I see "Comparative effectiveness research" as a possible tool in which hospital leadership/boards can operate utilizing "best practices". Operating under this scenario of course means new methods, procedures and drugs must still be invented, developed and tested. They just can't be put into widespead use until there is agreement on their effectiveness. Who are the people who will rule upon the effectiveness? Hopefully not a bureaucrat! It'll have to be a partnership of healthcare professionals, hospital administrators, the insurance and pharma industries. I'm undecided as to whether patient advocates and government functionaries need to be on this board.
Doc - You beat me to the point that drew me here as well. Where will the innovative techniques that are the hallmark of the best health care in the world come from if we first have to wait on government bureaucrats who will first charge a tax to even review the proposal, then take their usual job-securing two to three years to assess it? No thank you. If the US Transportation Department had existed with the same protocols when Orville and Wilbur proposed their new transportation mode, we would still be riding trains across the country and cruise liners to other continents. The dems keep telling us to keep the government out of their wombs...well keep them out of my emergency room. The last thing I want is a bureaucrat overseeing my medical care. I am not one of those who thinks the US medical system is broken. And I still say that if you want to make it more affordable, start some serious prison terms for those caught abusing the medicare/medicaid benefits. They can get all the free health care, room and board in prison. Problem solved.
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