Who knows how to fix the U.S. healthcare system? She should, according to the family of Massachusetts Institute of Technology economist Amy Finkelstein. After her two decades of studying U.S. health policy with her longtime collaborator Liran Einav, an economist at Stanford University, Finkelstein’s father-in-law said, “Why don’t we know what to do? ?” puzzled her. he asked. we Got You Cover (Portfolio, July), co-authored with Einav, is Finkelstein’s response.
How did the US healthcare system collapse?
Over the past 70 years, our health policy has emerged haphazardly, as a variety of issues have been in the public eye and public policy responses to them. These reactions were well-intentioned, but not enough. In the late 1960s, despite the development of dialysis machines, many people were dying of end-stage renal disease. life When I wrote an article, a politician brought an end-stage kidney disease patient into the halls of Congress, and suddenly Medicare coverage was extended to all end-stage patients, regardless of age. is that none of the is sufficient.patchwork
approach. Never stepped back to see the whole thing.
What have we learned from Covid-19?
Nothing demonstrates the inadequacy of the public health system more than a public health emergency. The big problem is that about half of Americans get insurance through their employer or a family member’s employer. If you lose your job and insurance, you will have to pay everything out of the money you lost. $140 billion is currently held by medical debt collection agencies. This is the same as collection agency all other consumer debt combined.
Why is the United States so far behind in adequate health care?
Historically, we have the same goals as other countries, and the same long-standing tradition of helping people facing dire medical problems. mosquito? It was not the fate of other countries to have universal coverage, nor was it our fate to not. In Canada, doctors went on strike when universal health care was introduced. rice field. Simply put, you were unlucky, but you can recover.
Now let’s move on to the trillion dollar question. How can the US healthcare system be improved?
No further reforms, even well-meaning ones, will work. Rather than a hodgepodge fix, a basic universal autocompensation should be designed up front, with the option to buy more on a well-functioning private market. Also, basic means basic. You can’t see your favorite doctor whenever you want, not in a private hospital room. Much of what we’ve been talking about sounds like “liberal” proposals, but our arguments have been made by conservatives. This is not a Democrat or Republican proposition, it just makes sense. Our intention is to honor the social contract. To keep people from dying on the streets.
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A version of this article was published in the May 8, 2023 issue. publisher weekly Under the headline: When health care reform is not enough
