Researching health care
December 30, 2009
The health care reform bills produced by both the U.S. House and Senate entrench the status quo. In this letter, I will refer readers from both left and right to some very enlightening commentary on the issue. You can get to the resumes of the authors and the text of the works from several directions, from the magazine websites, Wikipedia or Google. Enter the ff. search strings into Google.
Most recent: Google (Atul Gawande + Testing, Testing) This essay was published in The New Yorker on Dec. 14. Dr. Gawande sees the “pilot programs” buried in the current bills as the beginning of the process of true reform. He cites a pilot program begun in 1903 that led to the creation of the U.S. Department of Agriculture Cooperative Extension Service in 1914. In 1900, the average family spent 40 percent of its income on food; by 1930, that had been reduced to 4 percent. Thousands of voluntary decisions by hundreds of thousands of participants, growers, distributors and inspectors led to this. Dr. Gawande’s new book (Atul Gawande + The Checklist Manifesto) is an expansion of his earlier essay of Dec. 10, 2007, (Atul Gawande + New Yorker + 12/10/07) that showed how simple common-sense checklists significantly reduced medical errors.
Google (How American Health Care Killed My Father + David Goldhill) and you’ll get his Atlantic essay of September 2009 plus infinitude of favorable commentary from both left and right. This essay concentrates of the economic incentives to misdirect expenditures away from patients to almost everything else. David Henderson’s review in the Library of Economics and Liberty quotes Goldhill’s statement: “For fun, let’s imagine confiscating all the profits of all the famously greedy health-insurance companies. That would pay for four days of health care for all Americans. Let’s add in the profits of the 10 biggest rapacious U.S. drug companies. Another 7 days.”
Only a week after Dr. Gawande’s article above appeared in The New Yorker in 2007, Goldhill’s father had died from a hospital-acquired infection five weeks after walking in under his own power. His caregivers hadn’t washed their hands, and the janitors came by only once a day. His widow received a bill for $636,687, of which Medicare paid all but $992.
Google (The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care). This is a 277-page book by T. R. Reid. Again, read favorable reviews from both left and right, medical professionals of all stripes, and from many countries. The Aspen library just got this book.
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These writers set out the magnitude of the problem. Goldhill states that it will take a generation to straighten all this out. Gawande takes the long view as well. Reading these writers will temper the disappointment and rage over what is going through the national legislature now.