New Book Questions The Need For National Health Care

See Single Payer, Many Faults: Market competition in health care? Imagine that. From the WSJ, 3-12-10, p. A17. This article is actually a book review by JOSEPH RAGO, a senior editorial page writer at the Journal. The book he reviewed is called Health Care Turning Point, By Roger M. Battistella. Exerpts:

""...most consumers of health care are largely insulated from directly paying for the services they use, health care is generally perceived as an unlimited free good. . . . Wants and needs become insatiable when care is believed to be free.""

"... the original sin of modern American health care: the government's World War II-era decision that gave businesses tax incentives to sponsor insurance for their workers but that did not extend the same dispensation to individuals."

"... no one had any reason to be assiduous about controlling the cost of care."

"Health care, he writes, is one of the "most backward sectors of the economy." It ignores "managerial and corporate practices for attaining productivity and quality improvements.""

"Since no one is scrutinizing the relation between costs and marginal benefits, for instance, medical science has become ever more specialized and technologically intensive—leading to unnecessary and overly costly procedures..."

"Medical business models haven't capitalized on economies of scale either: Almost half of U.S. hospitals have fewer than 100 beds, while one-fourth of doctors practice solo. Nor have providers reorganized to manage chronic conditions, such as diabetes, which are better handled by integrated teams than today's fragmented and uncoordinated system. And because the income of doctors and the revenue of hospitals are rarely connected to the quality of the care they provide, preventable errors—like infections acquired in hospitals—may be the third leading cause of death in the U.S."

"The solution, Mr. Battistella argues, is the "hidden pragmatism of market competition." In a competitive environment..."

"This year, government health spending, mostly through Medicare and Medicaid, surpassed private health spending for the first time—even without ObamaCare, which may well bring the public share to 70% or more."

"Mr. Battistella confesses that he finds it "hard to carry on a conversation with true believers," because their idea about health care is "too deeply rooted in ideology." They simply don't want to think about practical solutions, where markets do their best work. There's no convincing some people—especially the supposed pragmatists now pushing for de facto single payer in Washington."