Friday, May 15, 2009
Peter Orszag, Obama's Director of OMB, has the whole healthcare crisis figured out. In today's WSJ, he lays out his plan.
1) Ah yes computers. It's actually brilliant. They'll solve the healthcare problem just like putting them in classrooms fixed our public schools.
2) First of all, HMOs tried to do this and got pilloried by politicians. Also, doctors don't recommend things that don't improve health because they don't know any better, they do so because if they don't run every test and perform every procedure the trial lawyers that fund the Dem party will sue them.
3) The US Government has a pretty dismal record getting involved with prevention. The blew the single most important contributor to good health -- diet. By spending 20 years recommending people avoid fat at all costs and eat like 57 servings of grains, they f'ing caused the obesity epidemic they are now whining about. I shudder to think how they'll screw it up next.
4) The free market would accomplish this goal very easily. Incentives to deliver high quality at low prices are exactly what happens when you have to convince people to trade their money for your particular service over someone else's. But I doubt this is what Orszag has in mind. I'm sure it's some kind of monstrous technocratic jumble of taxes and subsidies that will only cause more distortions.
How can we move toward a high-quality, lower-cost system? There are four key steps:If this is the plan, we are all fucked. If you think about these points for 5 seconds, you realize:
1) health information technology, because we can't improve what we don't measure;
2) more research into what works and what doesn't, so doctors don't recommend treatments that don't improve health;
3) prevention and wellness, so that people do the things that keep them healthy and avoid costs associated with health risks such as smoking and obesity; and
4) changes in financial incentives for providers so that they are incentivized rather than penalized for delivering high-quality care.
1) Ah yes computers. It's actually brilliant. They'll solve the healthcare problem just like putting them in classrooms fixed our public schools.
2) First of all, HMOs tried to do this and got pilloried by politicians. Also, doctors don't recommend things that don't improve health because they don't know any better, they do so because if they don't run every test and perform every procedure the trial lawyers that fund the Dem party will sue them.
3) The US Government has a pretty dismal record getting involved with prevention. The blew the single most important contributor to good health -- diet. By spending 20 years recommending people avoid fat at all costs and eat like 57 servings of grains, they f'ing caused the obesity epidemic they are now whining about. I shudder to think how they'll screw it up next.
4) The free market would accomplish this goal very easily. Incentives to deliver high quality at low prices are exactly what happens when you have to convince people to trade their money for your particular service over someone else's. But I doubt this is what Orszag has in mind. I'm sure it's some kind of monstrous technocratic jumble of taxes and subsidies that will only cause more distortions.
