The Volokh Conspiracy - Fixing Health Care:

Truth be told, I have not been following the great Health Care debate very closely, and I do not pretend to any expertise whatsoever in the subject matter of reforming the US healthcare industry. But David Goldhill's recent article in the Atlantic ("How American Health Care Killed My Father") strikes me as an enormously sensible and straightforward approach to the issue (one reason - that, and its simplicity - that it will probably get little or no traction at all in the discussion).

"All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that—most important—remove consumers from our irreplaceable role as the ultimate ensurer of value."

His focus in on consumer incentives -- because only a decentralized information-processing system (like a viable market) can possibly control and rationalize the billions upon billions of decisions that need to be made at all levels in order for health care to work.

"To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government's role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy."

I won't do Mr. Goldhill the injustice of trying to inadequately summarize his proposals - but it's the first thing I've read (and again - I don't claim to have read all that much) about this issue that makes a damned bit of sense to me.

	[David Post, August 30, 2009 at 11:01am] Trackbacks Fixing Health Care: Truth be told, I have not been following the great Health Care debate very closely, and I do not pretend to any expertise whatsoever in the subject matter of reforming the US healthcare industry. But David Goldhill's recent article in the Atlantic ("How American Health Care Killed My Father") strikes me as an enormously sensible and straightforward approach to the issue (one reason - that, and its simplicity - that it will probably get little or no traction at all in the discussion). "All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that—most important—remove consumers from our irreplaceable role as the ultimate ensurer of value." His focus in on consumer incentives -- because only a decentralized information-processing system (like a viable market) can possibly control and rationalize the billions upon billions of decisions that need to be made at all levels in order for health care to work. "To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government's role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy." I won't do Mr. Goldhill the injustice of trying to inadequately summarize his proposals - but it's the first thing I've read (and again - I don't claim to have read all that much) about this issue that makes a damned bit of sense to me.