8Going to the doctor


We have never been supporters of an all-inclusive law governing the healthcare industry.

 

It is, after all, huge — the economic system that provides goods and services to treat patients with curative, preventive,

rehabilitative, and palliative care. Total health care spending in the U.S. was 18% of GDP in 2011, the highest in the world at $2.3 trillion. The very size of the whole enterprise – from individual medicine practiced by doctors to hospitalization and public health programs – perhaps a sixth of the American economy — suggests how difficult it is to get a perspective on its problems much less possible solutions.

 

That’s why we saw Obamacare as not only not a solution to the problem, but because it attempted to solve all the medical health problems in one piece of legislation, a menace and not just a legislative mistake. All that was compounded by the secrecy, the speed, and the one-party authorship – there was not a single Republican vote for the legislation – doomed it.

 

As Obamacare continues to implode under its own deficiencies, the search for a soluition to the America’s health problems continues. But, again, one would be more sanguine were that a search for solutions to individual problems than one overall panacea which is now the case.

 

The search, of course, is for a system that delivers more access to its potential clients at lower prices.

 

It is with this point of view that we approach the current debate over health care legislation now in the excruciatingly complex process of legislative production, with a House of Representatives version now in the hands of the more arcane rules of the U.S. Senate. That would, in a first stage, presumably, present a different version which would have to be compromised between the two pieces of proposed legislation for final legislation t be voted into law by both houses..

 

It is tragic, we believe, that because of the generation of Obamacare, it is now considered a given that it must be replaced by an equally all-reaching one piece of law. For some of the same reasons as with Obamacare, we fear that it will inevitably produce some of the same results.

 

Given what are generally regarded as better solutions in some other countries’ developed economies achieving more economic returns from the vast expenditures on healthcare in the U.S., introducing cost-saving and more access measures does not seem to be an unobtainable goal.

 

Also in much of the discussion it ignores the growing role of technology which while supplying new and often unanticipated solutions to individual health concerns, often incurs new costs in equipment and its application, only a small part of which we suspect is reducing existing costs. The ordinary individual with the ordinary afflictions has little difficulty in seeing this kind of solution all around him as the progress in medical practice improves extremely rapidly.

 

As we write, the Senate is in the process of originating its own particular approach to the healthcare industry. As we have noted, unfortunately, it is already assumed that the Senate’s product will be a substitute for the proposed legislation already enacted in the House but, indeed, both a replacement of Obamacare. It may have been critical that the question of linking the withdrawal of Obamacare and presenting “a replacement” have been linked for many legislators. Unfortunately, it also guarantees that some of the problems of Obamacare will inevitably reassert themselves in any new legislation.

 

It is early, of course, to take a pessimistic view of this whole complicated process. We can only hope that as it progresses, both the Senators and the Representatives will not have their hands tied to what has gone before.

 

Sws-07-13-17.

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