Posted: Wednesday, November 26, 2008 12:00 am
The health care reforms recommended by an Oregon task force Tuesday are on the conventional side: High-sounding goals and more state insurance on the one hand, and more taxes on health care providers on the other. Not exactly original.
There is only one big problem with medicine, and all others stem from it: It has become so expensive that fewer and fewer employers can afford to insure against it, and individuals can afford it even less.
If you have reasonable insurance, there is no problem with medical care at all. So at the very least, the public discussion should cease dwelling on "health care reform" and, instead, talk about what we are really concerned about: What to do about the price.
Normally, if you want to reduce the cost of something, you increase its supply or reduce the demand. That works with a lot of things, gasoline being the most recent example, but it doesn't seem to work with medicine.
If you go in with heartburn, the cost of your visit may skyrocket because they insist on giving you an EKG. You can tell the doc that that's not what you came in for and you are sure it is a pointless expense. But the clinic probably figures that even though the chance is small, if they miss a heart attack and you die, your relatives are going to collect millions in liability insurance.
So one way to reduce the cost is not to go in for treatment in the first place, a choice not many people are willing to make, especially if it hurts.
One avenue might be legislation to take away the need for defensive medicine. A change in liability law might remove the incentive for duplicate or unnecessary tests and procedures.
But the price is still the main issue. Spreading the cost by making insurance mandatory and universal - and forcibly separating it from employment by making it taxable to the recipient, for example - would be one answer. But even that won't suffice until ways are found to bring down the price. (hh)