"There is always a philosophy for lack of courage."—Albert Camus

Wednesday, November 28, 2007

This Is Entertainment

The New York Times, aka the Journal of Record, published an editorial on Sunday entitled "The High Cost of Health Care," eliciting from readers a stream of letters to the editor published today.

One Reno DiScala makes the crucial point that health care reform faces "true complexities," and will never be achieved until "there is fundamental compromise," which faces obstacles from those "guided only by their political ambitions." Thank you, Reno!

Mr. Peter Hanauer weighs in with a plea for "Medicare for all," justified by the fictoid that "the administrative costs of Medicare are approximately 20 percent of [those] of private insurance," an utter non sequitur, and utterly incorrect anyway, as demonstrated in recent Manhattan Institute research located here. Please forgive me, Peter.

Melvin H Kirschner, M.D. finds single-payer government-run health care to be a panacea. No, I am not kidding: Dr. Kirschner likes "one form to file, one payer, one set of rules... and the assurance that everyone has health care coverage..." Why, then, are so many doctors fleeing Medicare and Medicaid? Alas, Dr. Kirschner is unavailable to comment further.

Professor Jan Warren-Findlow believes that the U.S. should "allocate our economic, medical, and research resources to provide good health to every American; then we can figure out how to do it cost-effectively." All right, then!

Mr. Allan Ostergren believes that we should raise taxes, and then allow patients to choose between a Canadian-style system and private insurance operating under a guaranteed-issue, community-rating system. He seems not to realize that only the sick would buy private coverage, and the government would get all the healthy people. A bonanza for the Beltway!

The ineffable Marcia Angell, M.D.---not economics Ph.D---opines that "some sort of single-payer system will be necessary to control costs, even if not sufficient," an observation utterly clueless about the difference between reported and hidden costs. That's our Marcia!

Joshua U. Klein, M.D., reminds us that "there's no such thing as a free lunch." Truer words were never spoken.

Mr. John A Rowland supports federalism: "The federal government should not develop a one-size-fits-all national program." (Applause track here.) Uh, will the states pay for this themselves? Or will they demand Uncle Sam's dollars? The question answers itself, but seems not to have occurred to Mr. Rowland. But he gets a B+ for class participation.

Mr. William L. Burge points out that "health care costs cannot be contained without addressing the legal issues," to wit, the tort system. Mr. Burge goes to the head of the class with Dr. Klein.

And finally, Kenneth A. Fisher, M.D. complains that too many die in costly intensive-care facilities. True enough; that is one outcome when patients spend other people's money.

And so remember: All this wisdom was published on one day in the NYT! Proving, of course, that it all was fit to print.

[cross-posted from www.medicalprogresstoday.com/blog/]

2 comments:

James F. Elliott said...

Snark is not rebuttal. Please play again.

Tom Van Dyke said...

one form to file, one payer, one set of rules... and the assurance that everyone has health care coverage..." Why, then, are so many doctors fleeing Medicare and Medicaid?

They're the last of a breed, Ben. I worked as a headhunter for doctors briefly, and only the old rank-and-file see their profession and vocation with any degree of liberty and excellence, and even they know they sold out as a group long ago.

All the young ones coming in know it's more like being a civil servant. Put in the hours, fill in the forms. Do the best you can out of personal pride if you have any.

In the just-passed days, any individual with intelligence or moxie used to deliberate between law or med school. No more.

Did I ever mention I'm now a headhunter for lawyers?