Sense and Nonsense on Health Care

President Obama is right, when he says in his op-ed piece in today's NYT that the current debate we're engaged in on health care is a good thing. Everytime I read a new piece that presents a fresh angle on the problem, I learn something new. Hopefully, through the back and forth of discussion at many levels, whatever comes out of it will be a better solution than would otherwise be the case.

I also think the President is right in saying that reform would (and should) bring better protection for the average citizen than is now available. Many millions of people are falling through the cracks of our insurance and heath care systems, and that is not really acceptable.

Where I find the President less convincing is the assertion that reform will bring costs under control. I'm still dubious about that, and that is certainly the toughest nut to crack in this whole thing. There is absolutely no way we, either individually or as a society, will be able to afford all the health care that we might want and even need. Choices are going to have to be made, and in a variety of different ways. That is the big challenge facing us.

President Obama writes: "I don’t believe anyone should be in charge of your health care decisions but you and your doctor — not government bureaucrats, not insurance companies." That sounds really nice, but what if I can't pay for the premiums--or copays--for whatever it is that we and our doctors all decide we want and need? What if Medicare goes broke because we're not careful about the care we have from age 65 until we die?

I think there is going to need to be a new ethos in this country that says, I'm not going to always demand the latest prescription drug no matter what it costs. Perhaps a somewhat older generic drug will do. Perhaps I'm going to make sure that I don't have or demand every last test or scan that can be given, if my doctor is 95% sure without them. Perhaps I'm going to do a better job of eating better, exercising, watching my weight.

Other countries with planned health care systems keep their total costs at about 10% of GNP or lower. That is sensible. We're at 17% now and rising. If we think that we can have a prosperous society while spending 25-30-or-35% of our GNP on health care, we're out of our freakin' minds. It ain't gonna' happen.