That is the title of this paper, in which I trace the history, politics, and economics of our health care system The bottom line:
The health care reforms that were debated in 2009 and 2010 did not address the fundamental choices that America must eventually face. As heated as the debate became, the proposed changes were only superficial. Down the road, the choices will be more difficult. At some point, we either have to impose stronger rationing of care by the government or we have to force individuals to confront more of the cost of their own care, perhaps using a voucher system to fund health spending.
READER COMMENTS
Thucydides
Aug 24 2010 at 10:33am
Excellent post!
Health care will be rationed – the question is whether to have it done by politics or by the market. People find having bureaucrats make such a decision intolerable. It is as Hayek pointed out, more bearable that the market do it. That way, it seems more like luck-of-the-draw (who is lucky enough to have the means to pay) than some collective decision as to who should get treatment and who should not.
jorod
Aug 24 2010 at 12:06pm
Rahm Emanuel proposed health care vouchers in 2004. See Chicago Tribune January 20, 2004.
Tracy W
Aug 24 2010 at 4:58pm
A very interesting article, although as a non-American, I wondered how much of the values thing was actually all that specific to the USA. One difference I see between American and NZ or UK healthcare is that there are a lot more procedures in the USA, eg no one has ever thought that I, young and healthy, should be getting annual checkups. But on the other hand, the desire for all sorts of procedures, the difficulty in controlling costs, strikes me as familiar.
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