I appreciate your thoughtful comment. My blueprint for healthcare reform is not meant to be practical. It is meant as a starting place. Browning said, "A man's reach should exceed his grasp, or what's a heaven for?" Without a vision of where we want to go, we can never get there. The essay was meant to imagine a good health care system. It may or may not be the best possible. Assuming it is a vision that more than a few can agree on, a way can always be found to make the dream a reality. Obviously, this will take a long long time.
You put forth plenty of good things that "should" happen, that we "need", that we "must" do. Trouble is, there is no mechanism that will cause these things to happen. In fact, most have the deck stacked against them, and they pretty much cannot happen. When I was a young teen in the 60's, I was leaving the clinic with my Mom and when we walked past the cashiers and never stopped, I asked why we weren't stopping to pay. She said, "Nobody pays for medical care, everyone has insurance to pay for it". I was horrified, instantly, because it couldn't have been clearer this was a system destined to be taken over by the very worst money-grubbing scum in society. Nobody cares what it costs, no incentive to limit demand, the providers will want more, more, more, and those paying benefit from higher prices and more demand, as it's obviously more lucrative to sell insurance for luxury yachts than john boats. Hmm, how's this gonna play out? The amazing thing was it didn't fall apart even faster, it was a few decades before it started getting totally out of hand. But, beyond that, even with market discipline intact, health care is a different animal for many obvious reasons. Unless it's government-funded, it will only work in a decent, moral society, where price-gouging is hated, not revered, and where the less fortunate are everybody's problem. So where are we? Lost. It can't be fixed. Even going to single-payer won't work, the countries where it functions reasonably well instituted single-payer before their medical establishment gobbled up 18% of GDP and climbing, with the power that goes along. I'm 72, and have finally had to admit the truth to myself - we're toast. The breakneck speed of the disintegration we have now is worse than I expected, but it was inevitable. Many have observed it's just the nature of men and societies - I've written too many words already, suffice to say there are many inexorable forces that cause a society to decay and finally collapse.
I appreciate your thoughtful comment. My blueprint for healthcare reform is not meant to be practical. It is meant as a starting place. Browning said, "A man's reach should exceed his grasp, or what's a heaven for?" Without a vision of where we want to go, we can never get there. The essay was meant to imagine a good health care system. It may or may not be the best possible. Assuming it is a vision that more than a few can agree on, a way can always be found to make the dream a reality. Obviously, this will take a long long time.
You put forth plenty of good things that "should" happen, that we "need", that we "must" do. Trouble is, there is no mechanism that will cause these things to happen. In fact, most have the deck stacked against them, and they pretty much cannot happen. When I was a young teen in the 60's, I was leaving the clinic with my Mom and when we walked past the cashiers and never stopped, I asked why we weren't stopping to pay. She said, "Nobody pays for medical care, everyone has insurance to pay for it". I was horrified, instantly, because it couldn't have been clearer this was a system destined to be taken over by the very worst money-grubbing scum in society. Nobody cares what it costs, no incentive to limit demand, the providers will want more, more, more, and those paying benefit from higher prices and more demand, as it's obviously more lucrative to sell insurance for luxury yachts than john boats. Hmm, how's this gonna play out? The amazing thing was it didn't fall apart even faster, it was a few decades before it started getting totally out of hand. But, beyond that, even with market discipline intact, health care is a different animal for many obvious reasons. Unless it's government-funded, it will only work in a decent, moral society, where price-gouging is hated, not revered, and where the less fortunate are everybody's problem. So where are we? Lost. It can't be fixed. Even going to single-payer won't work, the countries where it functions reasonably well instituted single-payer before their medical establishment gobbled up 18% of GDP and climbing, with the power that goes along. I'm 72, and have finally had to admit the truth to myself - we're toast. The breakneck speed of the disintegration we have now is worse than I expected, but it was inevitable. Many have observed it's just the nature of men and societies - I've written too many words already, suffice to say there are many inexorable forces that cause a society to decay and finally collapse.