Click here for an excellent analysis of the structural problems and perverse incentives that contribute to the problems in our health care system today. Offers some interesting solutions, too.
Unfortunately, what he's proposing is rather out-of-the-box. If enacted, it wouldn't clearly be a Win for Obama, or a Defeat for Obama. Therefore, I doubt anyone in the political system will be much interested in these ideas.
One of the article's most powerful passages is a comparison between the relatively free market conditions around LASIK surgery (which is generally paid for out of pocket, and therefore is subject to all kinds of consumer-driven pressures) and MRI's (which generally are paid for by Medicare, Medicaid, or insurance, and therefore are almost completely insulated from consumer-driven pressures). No coincidence that LASIK is getting downright cheap these days, while MRI's are as expensive as ever.
What the author says about the backwardness of the health care system is spot-on. The outfit I rent movies from has infinitely better information management systems than the hospital where I work.
I've been moving fairly close to the article's proposals. The system I've been pondering has two major components: 1) a very basic single payor plan to replace Medicare and Medicaid, that offers minimalistic, bare-bones, strictly cost-controlled coverage, and 2) a free market for anything above and beyond that. The free market would include various plans by insurors, as well as simple fee-for-service. Some combination system like this could offer some of the security people want against extremely expensive catastrophic health problems, while also restoring consumers' power to make choices and make the system responsive to their needs.
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