Monday, November 1, 2010

On Health Care and Technology

This Chart brings home that state of American Health Care together real well. How many times in the health debate did you hear predictions of rationing and death panels? Wingers stoking those fears hit upon the fact that the USA has kick ass technology when it comes to health care delivery. The winger will point to statistics showing the good ol' USA kicks the hell out of all the other countries when it comes to the number latest and greatest life saving gadgets on the market.

Do you really want to have a healthcare system like Sweden, the Nutter may say,
"They have 10 times fewer super cool life saving gadgets than we do per capita? That kind of sounds like a death panel to me, Moonbeam. Do you really want that?"
Well, on the surface this is a valid point. However there is more to Health Care than gadgets per capita.

With the exception of available technology, we do not rate well against comparable countries. And that’s the take home message. We can argue about which metric is best to describe the quality of a health care system, but it almost doesn’t matter what you pick. Don’t like population statistics? Fine. Choose another. But unless you think the only important thing is how many MRI machines are available, we’re still going to look bad. Not only does the system not perform up to snuff, but pretty much every stakeholder I discussed agreed that it’s not good.

But even if you still want to quibble, you have to remember that we have a hugely expensive system. Moreover, lots of people may have trouble accessing it.

That is correct.

The Health Care Delivery system is largely profit based and competitive. Businesses compete with each other for customers (patients). Technology is an easy was to differentiate your product from the competition. The competition opens an advanced heart center - you do the same, but yours is a little bigger and better.

The other day there was an ad on the radio for a local hospital pitching its capabilities in some area or some cool gadget they had that another hospital may not have. When you're sick come to us was the ad's basic message. After the ad, my daughter said "dad that commercial is stupid. When you need to go to a hospital, you just go to the closest one." From the mouth's of babes.

On the surface this is correct. Why not go to the closest place for care and usually the closest hospital is just fine for ordinary care. However for non-routine care requiring super duper high tech gadgets, this may not be the case. And that’s what this chart shows.

Your town may have several hospitals, but how many Life Bird Copters are actually needed to service the area? The answer is probably one with a two or three pilots on stand by. So why pay for 3 or 4 Birds to over supply the market when those costs are just passed on in the form of higher premiums? But this seems to be how things work with technology and competition and we wind up with awesome technology (that you probably will never need if you have insurance, or couldn't afford if you don’t have insurance), but the other problems of quality and the like remain.

The other day I was reading a manifesto written by a wingnut welfare outfit called The Heartland Institute, which the kind folks there had published for the unwashed Teabagging Masses coming to Congress. Since Teabaggers are basically just Republicans who are pissed off about having lost the Presidential election, they don’t have any guiding ideology other than anger. Well the kind folks at Heartland thought they’d help these Baggers out by publishing talking points on variety of subjects including health care. This way the baggers could provide an answer (other than NO) to questions about their preferred alternative to the health insurance reform passed by congress. What followed in the manifesto was a variety of libertarian talking points starting off with the pronouncement that Health Care is no different than any other service governed by the law of supply and demand. Free Market Baby!

But you see that this is not true. For a market based Health Care system to even exist, the safety net programs of Medicare, Medicaid and SCHIP would have to be relegated to the ash bin of history. And who wants to do that, other than Paul Ryan and the most ideological of unholy Teabaggers?

The free market alone, may be good to ensure that every town has 3 or 4 more emergency helicopters than it needs, but fails to price its product where the uninsured can pay costs of treatment when they do receive treatment.

Anyway this is a good chart.

[h/t Drum]

No comments:

Post a Comment

Stay the Course

Stay the Course
He's Probably got the hang of it by now. So give'em another chance. And with the Supreme Court and the good Lord on his side, why not give it a try. Write in Bush.