Posted by
Crispian on Friday, September 04, 2009 6:29:03 AM
In an article in the Atlantic,
How American Health Care Killed My Father, David Goldhill observes something so simple and obvious that it has been largely ignored: "Health Insurance Isn't Health Care."
"How often have you heard a politician say that millions of Americans
“have no health care,” when he or she meant they have no health insurance? How has a method of financing health care become synonymous with care itself?
. . .
We’ve become so used to health insurance that we
don’t realize how absurd that is. We can’t imagine paying for gas with
our auto-insurance policy, or for our electric bills with our
homeowners insurance, but we all assume that our regular checkups and
dental cleanings will be covered at least partially by insurance. Most
pregnancies are planned, and deliveries are predictable many months in
advance, yet they’re financed the same way we finance fixing a car
after a wreck—through an insurance claim.
Goldhill speaks of the perverse incentives for higher costs under our insurance-centric model and offers smart alternatives. Obama has been held up as intellectually agile, measured, and thoughtful. This health care debacle has revealed a very different Obama: one who is heavy-handed, rigid, and partisan.
In my view, fiddling with health insurance is a zero-sum game - one can only spread the care thinner with fewer options and less availability (if one doesn't wish to spend more money). Those on the left are satisfied with this result, saying it is for the 'greater good.' But if we can address the root causes of high costs and weaken (rather than strenghten!) insurance's hold on our care, the cost and availability of insurance can be more easily addressed. Goldhill's article offers more insights than I can adequately address in a blog of reasonable length and is well worth reading.