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Posted by on Apr 20, 2009 in Health | 50 comments

Naive Questions About Healthcare Reform

My knowledge of our healthcare system is basically limited to my own experience as a patient. The actual health care has been quite good. But my experience with health insurance has been pretty awful, mostly because I’ve spent time at three universities and two different jobs over the past several years.

Right now, I have insurance through COBRA, which means I still have insurance through my previous employer, but have to cover my employer’s share of the cost. Basically, I’m now paying three times as much for the same insurance. With premiums as high as they are now, that really hurts.

Not surprisingly, I tend to believe that our healthcare system needs a major overhaul to make it more affordable. What kind of overhaul? I dunno. I know what I want — portable and affordable insurance that covers the same high quality services I get now. I just have no idea how to get from here to there. As such, my ears perked up yesterday when Larry Summers, the economics point man at the White House, said this on Meet the Press:

By doing the right kind of cost-effectiveness, by making the right kinds of investments and protection, some experts that we–estimate that we could take as much as $700 billion a year out of our health care system. Now, we wouldn’t have to do anything like that, we wouldn’t have to do a third of that in order to pay for a very aggressive program of increased coverage.

That seems like a silver bullet. Is it really possible that we could save that much just by being more efficient without consuming less healthcare? I sure hope so. But if healthcare is a business, why haven’t insurance firms noticed these mountains of inefficiency and improved their own profit margins by squeezing them out of the system?

But say for a minute that these inefficiencies really are there and ripe for elimination. Summers’ estimate suggest that if we get rid of inefficiency, we could either finance a government-supported program to provide healthcare to the uninsured, or we could build a much leaner private insurance system that makes coverage affordable for the currently unininsured.

My sense is that the Obama administration is learning toward the former option, but we may not know the details for a while. Personally, I don’t like the idea of the government taking charge of such a massive program if there is a way for the private sector to do it equally well. If inefficiency is killing the system now, I’m not inclined to believe that more government is the answer. But who is out there, leading the charge, explaining how to save the healthcare system in a way that encourages competition and entrepreneurship, rather than central direction?

I’m all ears

Cross-posted at Conventional Folly