Welcome back to our final part of this week’s inaugural feature Three-and-a-half questions.
Today’s guest is esteemed UMBC Professor of Political Science Roy Meyers. Dr Meyers ia an expert on government budgets and budget politics. We were in the middle of asking him about the current debate on health care policy… (USDemocrazy insights in green.)
3. What’s your suggested “healthcare fix?” Is there a fix?
The word “fix” has different meanings.
To the addict, a fix is an essential but very short-term act that has bad consequences over the long-run. I’ve long thought that the typical ideological debate about health reform has compared two fixes of this type: “single-payer” vs. “choice.” Neither approach is ever likely to develop the consensus support necessary for adoption.
Nor is single-payer or choice likely to solve the problems of adverse selection, moral hazard, and information asymmetry that are inherent to the health system.
If you are unfamiliar with these terms, a fantastic resource for learning about the complexities of the health system and many alternatives for reform are two reports released by the Congressional Budget Office:
Key Issues in Analyzing Major Health Insurance Proposals http://www.cbo.gov/doc.cfm?index=9924
Budget Options, Volume 1: Health Care
http://www.cbo.gov/doc.cfm?index=9925
See also: http://www.kaisernetwork.org/
So the solutions are complicated. One thing we do know, though, is that it is imperative to “bend the cost curve,” which means: slow the rate of growth of health care spending.
A start on doing this was made in the recent government stimulus bill, which generously funded investments in health information technology and research of the comparative effectiveness of different medical practices.
It will take time to earn returns on these investments.
If it is determined we need to pay some health care providers less as well as not pay for certain procedures and products, trouble could be brewing. Both are tremendously difficult to achieve in political terms. The same forces that scuttled Clinton’s health care reform in 1992 could reawaken to haunt President Obama ( remember the Harry and Louise television commercials?) Oh yeah…
Two final points about the complicated fix:
a. “Prevention” (ie. staying healthy) can make a very large contribution to the solution over the long-run. This will require Americans to exercise more, eat less and more carefully, reduce consumption of tobacco, alcohol, and dangerous drugs, and make other lifestyle changes. Wow…that asking a lot
- A more radical approach that deserves a close look over the long-run has been proposed by Len Burman, one of the nation’s leading policy analysts: http://www.taxpolicycenter.org/publications/url.cfm?ID=901252
Your extra bonus question:
What new websites were you happy to discovered recently?
1. ProPublica, http://www.propublica.org/, is doing the kind of investigative journalism that is vanishing from mainstream newpapers these days. Their non-profit model may be one of the sustainable models for journalism in the internet age–though I wonder how well it will work in small markets.
2. Map My Ride, http://www.mapmyride.com/, a really nice tool for planning or acquiring maps and cue sheets for road cycling.
3. Watoto Wa Baraka, http://www.watotowabaraka.org/, is an orphanage in Kenya where my son Keith will be volunteering this fall.
