Here is the single most important article on health care costs I have stumbled across recently. Everyone should read it. It is written by Atul Gawande and appears in the New Yorker and its about why health care costs are so high in McAllen, Texas and in so many other places.
It's a fascinating piece about the culture of doctors using medicine to enrich themselves. This is predatory medicine, giving the patients what the doctors need: more money.
Paradoxically, places like the Mayo Clinics deliver relatively low cost health care, despite being graded by the experts as some of the best medical care in the nation.
Gawande's article helps explain why a public insurance program is needed and what this plan will have to do if we get it, and it won't be pretty.
Atul Gawande is a surgeon and was an early adviser to Bill Clinton back in the day when I was in New York and Governor Cuomo had turned his back on a presidential race. Gawande's article is long and complicated, as I have said, but in the end it is extremely rewarding to read, not the least because he is a wonderful writer.
My only criticism is that his thesis---that spiraling health care costs are due to too many doctors using their profession to make themselves rich---would save perhaps one third of the spending on Medicare, a huge deal. But in general, we spend far too much on medicine generally in the U.S. and this will mean that all of medicine will have to be put on a diet and given incentives to practice the best medicine and to forgo procedures that are wasteful, but bring in cash for the doctors.
Health care reform long ago stopped being a moral issue: today reform is urgent, mandatory and necessary. If we let this opportunity slip through our fingers we are letting our futures slip through our fingers. Health care costs will destroy American public spending far more than war, or bail-outs for banks, or Social Security or budget deficits to climb out of recessions. It threatens whole industries and our global competitiveness.
I don't recall ever seeing a single television news hour or pundit giving a lengthy, detailed and informative explanation of why reform is no longer an option, and why Democratic Senators like Ben Nelson (Dem., NB) are throwing away the opportunity to save us, all because he wants to "defend" the private insurance companies.
As for the Republicans, who expects them to understand how the modern world works anyway since they seem to base their worldview on fundamentalism, either market fundamentalism or biblical fundamentalism?
It's up to the Democrats and the ball is in their court and they only need 50 votes. If they fail, then we fail.
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